The Role of Chelation in the Treatment of Other Metal Poisonings

Smith, Silas W.

doi:10.1007/s13181-013-0343-6

Cited by 66 publications

(40 citation statements)

References 124 publications

(158 reference statements)

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“…Treatment with chelating agents has been attempted but has not been rigorously tested [18]. Addition of amino acids has also been tried in order to increase cellular transport of the chelators [18].…”

Section: Discussionmentioning

confidence: 99%

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Cobalt Cardiomyopathy Secondary to Hip Arthroplasty: An Increasingly Prevalent Problem

Tilney

Burg

Sammut

2017

Case Reports in Cardiology

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A forty-year-old man experienced worsening heart failure four years following bilateral complicated total hip replacement. His condition was extensively worked up but no underlying pathology was immediately evident. Given the cobalt-chromium alloy component present in the hip arthroplasties, the raised cobalt blood levels, and a fitting clinical picture coupled with radiological findings, the patient underwent right hip revision. Evidence of biotribocorrosion was present on direct visualisation intraoperatively. The patient subsequently experienced symptomatic improvement (NYHA class III to class I) and echocardiography showed recovery of ejection fraction. Cobalt exists as a bivalent and trivalent molecule in circulation and produces a cytotoxicity profile similar to nanoparticles, causing neurological, thyroid, and cardiological pathology. Blood levels are not entirely useful as there is no identifiable conversion factor for levels in whole blood, serum, and erythrocytes which seem to act independently of each other. Interestingly cobalt cardiomyopathy is frequently compounded by other possible causes of cardiomyopathy such as alcohol and a link has been postulated. Definitive treatment is revision of the arthroplasty as other treatments are unproven.

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Section: Discussionmentioning

confidence: 99%

“…Addition of amino acids has also been tried in order to increase cellular transport of the chelators [18]. Haemodialysis is suspected to not have a profound effect on cobalt levels because it is primarily protein bound [19].…”

Section: Discussionmentioning

confidence: 99%

Cobalt Cardiomyopathy Secondary to Hip Arthroplasty: An Increasingly Prevalent Problem

Tilney

Burg

Sammut

2017

Case Reports in Cardiology

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“…Ethylenediaminetetraacetic acid (EDTA), the most commonly used chelator for cobalt, eliminates the metal toxin by renal excretion . However, EDTA's nonselective nature also binds other essential elements causing nutrient deficiencies.…”

Section: Discussionmentioning

confidence: 99%

Does therapeutic plasma exchange have a role in the treatment of prosthetic hip–associated cobalt toxicity? A case report and literature review

et al. 2016

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“…The use of post-provocation testing yields uninterpretable results. In addition, as discussed elsewhere in this issue [23], chelation increases delivery of uranium to the kidney, which is the target organ of concern for uranium toxicity. & The role for chelation therapy:…”

Section: Case 4: Response To Broad-spectrum Element Testingmentioning

confidence: 94%

Medical Toxicology Case Presentations: to Chelate or Not to Chelate, Is that the Question?

McKay

2013

J. Med. Toxicol.

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Four case studies described in this article were presented to a panel of physicians participating in the ACMT "Use and Misuse of Metal Chelation Therapy" Symposium in February 2012. The individuals who participated in the panel are listed in the appendix. These cases highlight some of the practical questions facing medical providers when issues of metal toxicity and its treatment arise. Medical toxicologists are valuable resources for information, public debate, consultation, and treatment of patients with concerns about heavy metal exposure.

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The Role of Chelation in the Treatment of Other Metal Poisonings

Abstract: These proceedings will review the role of chelation in five metals-aluminum, cadmium, chromium, cobalt, and uranium-in order to illustrate various chelation concepts.

Cited by 66 publications

References 124 publications

Cobalt Cardiomyopathy Secondary to Hip Arthroplasty: An Increasingly Prevalent Problem

Cobalt Cardiomyopathy Secondary to Hip Arthroplasty: An Increasingly Prevalent Problem

Does therapeutic plasma exchange have a role in the treatment of prosthetic hip–associated cobalt toxicity? A case report and literature review

Medical Toxicology Case Presentations: to Chelate or Not to Chelate, Is that the Question?

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