RESUMEN
Eighty-six children (mean age, 34 months) were studied to determine whether elevated blood lead levels in children are associated with lower erythropoietin concentrations. The median erythropoietin concentration was 5.9 mIU/mL (range, 2.3 to 11.5 mIU/mL), and the median blood lead level was 0.87 micromol/L (18 microg/dL; range, 2 to 84 microg/dL). Blood lead concentration was inversely and independently related to erythropoietin concentration.
Asunto(s)
Eritropoyetina/sangre , Plomo/sangre , Análisis de Varianza , Niño , Preescolar , Inhibidores Enzimáticos/sangre , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Lactante , Masculino , Proyectos Piloto , Protoporfirinas/sangreRESUMEN
OBJECTIVE: To compare the response to oral meso-2,3-dimercaptosuccinic acid (DMSA) treatment in children with an initial blood lead (BPb) concentration less than versus more than 2.17 mumol/L (45 micrograms/dl). DESIGN: Retrospective cohort study. SETTING: Regional referral lead treatment program in an urban children's hospital. PATIENTS: Thirty consecutive children, median age 34 months (range, 5 to 161 months), with an initial BPb concentration 0.97 to 2.90 mumol/L (20 to 60 micrograms/dl) selected for DMSA use. Reasons for DMSA use included BPb concentration > 2.17 mumol/L (11 children), complications with penicillamine therapy (11), chronic renal failure (1), and compassionate use (7). All patients received required environmental hazard reductions before drug administration. RESULTS: Group 1 (n = 23) had a mean BPb concentration of 1.50 mumol/L (31 micrograms/dl), and group 2 (n = 7) had a mean BPb concentration of 2.41 (51 micrograms/dl). Sixteen patients (70%) in group 1 and five patients (71%) in group 2 had had previous chelation therapy (p value not significant). No significant difference was found in the mean percentage of the reduction of BPb concentration during treatment of group 1 (60%) versus group 2 (58%). The mean BPb concentration in group 1 rebounded to 70% of pretreatment values by mean day 41; the BPb concentration in group 2 rebounded to 69% by day 37 (p value not significant). Prior chelation therapy did not result in a significant difference in either the percentage reduction of BPb concentration or the percentage of rebound BPb. CONCLUSION: DMSA is equally effective in acutely lowering BPb concentration in children with BPb concentrations less than and greater than 2.17 mumol/L.