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. 2010 Mar 31;6(1):74–75. doi: 10.1007/s13181-010-0039-0

American College of Medical Toxicology Position Statement on Post-Chelator Challenge Urinary Metal Testing

American College of Medical Toxicology1
PMCID: PMC3550446  PMID: 20354920

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Disclosure

This statement has been developed by members of the ACMT with principal contribution in writing by Nathan Charlton, M.D. and Kevin L. Wallace, M.D., F.A.C.M.T., reviewed and approved by the ACMT Practice Committee and Board of Directors, and opened to comment by all members of the College. Disclosure statements for participating members of the ACMT Practice Committee and ACMT Board of Directors are available.

June 2009

References

  • 1.Anonymous (2007) Toxicological profile for lead. US Department of Health and Human Services—Agency for Toxic Substances and Disease Registry, Atlanta [PubMed]
  • 2.Anonymous (1999) Toxicological profile for mercury. US Department of Health and Human Services—Agency for Toxic Substances and Disease Registry, Atlanta
  • 3.Brodkin E, Copes R, Mattman A, Kennedy J, Kling R, Yassi A. Lead and mercury exposures: interpretation and action. CMAJ. 2007;176(1):59–63. doi: 10.1503/cmaj.060790. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Kales SN, Goldman RH. Mercury exposure: current concepts, controversies, and a clinic’s experience. J Occup Environ Med. 2002;44(2):143–154. doi: 10.1097/00043764-200202000-00009. [DOI] [PubMed] [Google Scholar]
  • 5.Risher JF, Amler SN. Mercury exposure: evaluation and intervention. The inappropriate use of chelating agents in the diagnosis and treatment of putative mercury poisoning. NeuroToxicology. 2005;26(4):691–699. doi: 10.1016/j.neuro.2005.05.004. [DOI] [PubMed] [Google Scholar]
  • 6.Vamnes JS, Eide R, Isrenn R, Hol PJ, Gjerdet NR. Diagnostic value of a chelating agent in patients with symptoms allegedly caused by amalgam fillings. J Dent Res. 2000;79(3):868–874. doi: 10.1177/00220345000790031401. [DOI] [PubMed] [Google Scholar]
  • 7.McKay C, Holland M, Nelson L. A call to arms for medical toxicologists: the dose, not the detection, makes the poison. Internet J Med Toxicol. 2003;6(1):1. [Google Scholar]
  • 8.Kalia K, Flora SJS. Strategies for safe and effective therapeutic measures for chronic arsenic and lead poisoning. J Occup Health. 2005;47(1):1–21. doi: 10.1539/joh.47.1. [DOI] [PubMed] [Google Scholar]
  • 9.Bell RF, Gilliland JC, Boland JR, Sullivan BR. Effect of oral edathamil calcium-disodium on urinary and fecal lead excretion; comparative excretory studies with intravenous therapy. AMA Arch Ind Health. 1956;13(4):366–371. [PubMed] [Google Scholar]
  • 10.Frumkin H, Manning CC, Williams PL, Sanders A, Taylor BB, Pierce M, Elon L, Hertzberg VS. Diagnostic chelation challenge with DMSA: a biomarker of long-term mercury exposure? Environ Health Perspect. 2001;109(2):167–171. doi: 10.2307/3434771. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11.Fayez I, Paiva M, Thompson M, Verjee Z, Koren G. Toxicokinetics of mercury elimination by succimer in twin toddlers. Pediatric Drugs. 2005;7(6):397–400. doi: 10.2165/00148581-200507060-00008. [DOI] [PubMed] [Google Scholar]
  • 12.Dietrich KN, Ware JH, Salganik M, Radcliffe J, Rogan WJ, Rhoads GG, Fay ME, Davoli CT, Denckla MB, Bornschein RL, Schwarz D, Dockery DW, Adubato S, Jones RL, for the Treatment of Lead-Exposed Children Clinical Trial Group Effect of chelation therapy on the neuropsychological and behavioral development of lead-exposed children after school entry. Pediatrics. 2004;114(1):19–26. doi: 10.1542/peds.114.1.19. [DOI] [PubMed] [Google Scholar]
  • 13.Brown MJ, Willis T, Omalu B, Leiker R. Deaths resulting from hypocalcemia after administration of edetate disodium: 2003-2005. Pediatrics. 2006;118(2):e534–e536. doi: 10.1542/peds.2006-0858. [DOI] [PubMed] [Google Scholar]
  • 14.Powell JJ, Burden TJ, Greenfield SM, Taylor PD, Thompson RPH. Urinary excretion of essential metals following intravenous calcium disodium edetate: an estimate of free zinc and zinc status in man. J Inorganic Biochem. 1999;75(3):159–165. doi: 10.1016/S0162-0134(99)00054-9. [DOI] [PubMed] [Google Scholar]
  • 15.Stangle DE, Smith DR, Beaudin SA, Stawderman MS, Levitsky DA, Strupp BJ. Succimer chelation improves learning, attention, and arousal regulation in lead-exposed rats but produces lasting cognitive impairment in the absence o f lead exposure. Environ Health Persp. 2007;115(2):201–209. doi: 10.1289/ehp.9263. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 16.Chisolm JJ, Thomas DJ. Use of 2, 3-dimercaptopropane-1-sulfonate in treatment of lead poisoning in children. J Pharmacol Exp Ther. 1985;235(3):665–669. [PubMed] [Google Scholar]
  • 17.Smith DR, Calacsan C, Woolard D, Luck M, Cremin J, Laughlin NK. Succimer and the urinary excretion of essential elements in a primate model of childhood lead exposure. Toxicol Sci. 2000;54(2):473–480. doi: 10.1093/toxsci/54.2.473. [DOI] [PubMed] [Google Scholar]
  • 18.Rooney JPK. The role of thiols, dithiols, nutritional factors and interacting ligands in the toxicology of mercury. Toxicology. 2007;234(3):145–156. doi: 10.1016/j.tox.2007.02.016. [DOI] [PubMed] [Google Scholar]

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