Cases chelation therapy

Treatment of acute arsenic poisoning includes removal from the exposure source, supportive measures for loss of fluids, and chelation therapy (Ibrahim et al., 2006). Chelators that can be used include dimercaprol or 2,3-dimercaptosuccinic acid. In cases of renal failure, hemodialysis should be considered. 

Arsenic Toxicosis. Urine arsenic is the best indicator of current or recent exposure. Atomic absorption spectrophotometry is preferred as the detection method. Hair or fingernail sampling may also be helpful. Use of blood is useful if analyzed soon after exposure or in cases of continuous chronic exposure. After acute exposure, chelation therapy is instituted utilizing either (1) Dimercaprol BAL (British Anti-Lewisite) and analogues ... 

Chronic Exposure (Arsenic). Primarily symptomatic treatment is chosen. Chelation therapy is practiced, but its usefulness in cases of chronic exposure is still questionable. 

Tsironi M, Deffereos S, Andriopoulos B et al. Reversal of heart failure in thalassemia major by combined chelation therapy a case report. Eur J Haematol 2005 74(l) 84-85. 

Excess transition metals can be removed by chelation therapy using chelating agents such as deferoxamine, EDTA or D-penicillamine, and supplements can be used in cases of deficiency (e.g. iron(II) suphate or zinc(II) sulfate). 

Mariam, R., Aroslo, C., Pelucchi, S., Grisoli, M., Riga, A., Tromblnl, R, Plperno, A. Iron chelation therapy in aceruloplasminemia study of a patient with a novel missense mutation (case report). Gut 2004 53 756-758... 

In summary, chelation therapy is justified in cases of symptomatic lead poisoning or when the blood lead exceeds about 80 pg/dL. When no symptom end-point... 

Chelating agents for mercury, such as cysteine and penicillamine, have been used as intervention measures to reduce the concentration of inorganic mercury. However, chelation therapy has yielded variable success in cases of alkyl mercury poisoning. Studies of MMM suggest that chelators may reduce brain and blood mercury levels if started within a few days after exposure. Surgical gallbladder drains and oral administration of a nonabsorbable thiol resin have been applied in order to interrupt biliary excretion and reabsorption of mercury by the intestine. 

In the case of leaded gasoline ingestion, chelation therapy may be used to lower the inorganic lead produced in the body. There is no antidote for triethyl lead intoxication (Garrettson 1990). 

There is a data need to develop better chelation therapies, better ways to prevent absorption of mercury into the body of children, and better ways to interfere with the mechanism of action, especially for damage to the nervous system. The current literature continues to grow with case histories of poisonings where supportive therapy and passive observation of a progressively deteriorating health status are the best that can be done. 

The specific treatment of WD is aimed at removing excessive body copper by chelation with D-penicillamine. Chelation therapy will reverse most of the clinical disturbances in the symptomatic WD patient, and will maintain nonsymptomatic WD patients in that state for their life-span (Marsden 1984, Mowet 1984). Patients who develop intolerance to D-penicillamine may be treated with equal success with Tri-entine (triethylene tetramine dihydrochloride) (Scheinberg 1991). Continuous oral zinc acetate therapy may also reduce the amount of excessive copper in the bloodstream (Brewer et al. 1983, Cossack 1987), but conclusive clinical tests on such a therapy have yet to be performed. Tetrathiomo-lybdate was successfully used to remove excessive copper in copper-poisoned sheep (Wing and Mehra 1990), and some clinical trials are currently in progress to ascertain the value of molybdenum in human WD therapy. It is pertinent to note here that in a case report on high molybdenum intake from a dietary supplement, an acute psychotic clinical picture was observed (Momci-lovic 1999). 

Chelation Children are particularly susceptible to lead poisoning, due to their smaller body sizes and rapid rates of development. In serious cases, a process called chelation therapy might be the only way to save the child s life. Chelation therapy reverses one important effect of lead poisioning, replacing toxic lead with beneficial calcium in the body. 

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