PMID- 1907320
OWN - NLM
STAT- MEDLINE
DCOM- 19910904
LR  - 20190630
IS  - 0022-3476 (Print)
IS  - 0022-3476 (Linking)
VI  - 119
IP  - 2
DP  - 1991 Aug
TI  - Need for the lead mobilization test in children with lead poisoning.
PG  - 305-10
AB  - We evaluated the recommendation of the Centers for Disease Control, that children 
      with moderate lead poisoning undergo the lead mobilization test (LMT) to 
      determine the need for a full course of chelation treatment. Current criteria for 
      selection for this test include a blood Pb concentration (bPb) between 25 and 55 
      micrograms/dl and an erythrocyte protoporphyrin level greater than 35 
      micrograms/dl. To determine whether the eligibility criteria could be refined to 
      a smaller group of patients, we compared bPb determinations obtained on the day 
      of the LMT in 198 children with moderate Pb poisoning to the results of the LMT. 
      We found that children with bPb less than 25 micrograms/dl were unlikely to 
      respond to the test dose of calcium disodium ethylenediamine tetraacetate with a 
      Pb diuresis (24/25 patients had low urinary Pb excretion on the LMT). In 
      contrast, 88% of children with bPb greater than or equal to 40 micrograms/dl were 
      likely to excrete sufficient Pb to indicate the need for a full course of 
      chelation. We conclude that the LMT is indicated for children with bPbs between 
      25 and 40 micrograms/dl. Children with bPb between 40 and 55 micrograms/dl may 
      receive chelation therapy without having an LMT, if the performance of the LMT is 
      not practical. Patients with levels less than 25 micrograms/dl should be followed 
      clinically and removed from further Pb exposure.
FAU - Markowitz, M E
AU  - Markowitz ME
AD  - Department of Pediatrics, Montefiore Medical Center, Albert Einstein College of 
      Medicine, Bronx, New York 10467.
FAU - Rosen, J F
AU  - Rosen JF
LA  - eng
GR  - ES04039/ES/NIEHS NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, U.S. Gov't, P.H.S.
PL  - United States
TA  - J Pediatr
JT  - The Journal of pediatrics
JID - 0375410
RN  - 0 (Chelating Agents)
RN  - 0 (Protoporphyrins)
RN  - 2P299V784P (Lead)
RN  - 9G34HU7RV0 (Edetic Acid)
SB  - IM
MH  - Chelating Agents/therapeutic use
MH  - Child
MH  - Child, Preschool
MH  - Edetic Acid
MH  - Erythrocytes/chemistry
MH  - Evaluation Studies as Topic
MH  - Humans
MH  - Infant
MH  - Lead/blood/*urine
MH  - Lead Poisoning/*diagnosis/drug therapy/metabolism
MH  - Protoporphyrins/blood
EDAT- 1991/08/01 00:00
MHDA- 1991/08/01 00:01
CRDT- 1991/08/01 00:00
PHST- 1991/08/01 00:00 [pubmed]
PHST- 1991/08/01 00:01 [medline]
PHST- 1991/08/01 00:00 [entrez]
AID - S0022-3476(05)80750-4 [pii]
AID - 10.1016/s0022-3476(05)80750-4 [doi]
PST - ppublish
SO  - J Pediatr. 1991 Aug;119(2):305-10. doi: 10.1016/s0022-3476(05)80750-4.