Oral penicillamine therapy for chronic lead poisoning in children

Abstract

Eight asymptomatic children with blood lead values from 66 to 75 μg per cent were treated with penicillamine for a period of two months. Each of them had had two courses of chelation therapy for lead poisoning, and none had a history of recent ingestion of lead. Urinary excretion of lead increased to 449 mg. per liter within one week after treatment was begun. Urinary ALA values dropped to 9±2.1 mg. per liter within one week and to 5.4±1.8 mg. per liter after two months. There was no significant increase after one week in the blood activity of ALA-D, but nearly normal values (112±9.0 units) were reached at the end of two months of therapy. Blood lead concentrations decreased to 39±6.4 μg per cent after two months of therapy. Inasmuch as urinary excretion of lead remained elevated in all patients during therapy, we believe penicillamine depletes lead storage sites (bones) in the body. It may be the therapy of choice for chronically lead-poisoned children whose blood values of lead are abnormally high (but below 80 μg per cent) and who are asymptomatic. Otherwise it may be useful for prolonged and supplementary therapy following effective chelation therapy. Eight asymptomatic children with blood lead values from 66 to 75 μg per cent were treated with penicillamine for a period of two months. Each of them had had two courses of chelation therapy for lead poisoning, and none had a history of recent ingestion of lead. Urinary excretion of lead increased to 449 mg. per liter within one week after treatment was begun. Urinary ALA values dropped to 9±2.1 mg. per liter within one week and to 5.4±1.8 mg. per liter after two months. There was no significant increase after one week in the blood activity of ALA-D, but nearly normal values (112±9.0 units) were reached at the end of two months of therapy. Blood lead concentrations decreased to 39±6.4 μg per cent after two months of therapy. Inasmuch as urinary excretion of lead remained elevated in all patients during therapy, we believe penicillamine depletes lead storage sites (bones) in the body. It may be the therapy of choice for chronically lead-poisoned children whose blood values of lead are abnormally high (but below 80 μg per cent) and who are asymptomatic. Otherwise it may be useful for prolonged and supplementary therapy following effective chelation therapy.