성인 연 중독 환자에서 DMSA을 이용한 착화치료 효과에 관한 증례

Abstract

Objectives We wanted to investigate the efficacy of dimercaptosuccinic acid (DMSA) for the treatment of lead poisoning in an adult.

Methods The chelation therapy was applied using oral DMSA after measuring the blood lead and performing, renal function tests, liver tests and a physical examination. This therapy with oral DMSA 30 mg/kg/day was administered three times a day for 5 days to an adult patient with a pre-chelation blood lead concentration of 75 µg/dL. Testing was performed by assessing the daily blood lead level, the blood ZPP, the urine ALA, the symptoms and side effects were assessed by conducting a physical examination.

Results DMSA therapy given for the duration of 5 days reduced the blood lead concentration from 75 µg/dL to 21.8 µg/dL. The blood ZPP concentration fell from 366 µg/dL to 300 µg/dL. The urine ALA concentration fell from 9.71 mg/L to 0.38 mg/L. In addition, the symptoms of headache, dizziness and abdominal pain that were induced by lead were improved after 2 days of chelation therapy. The vomiting did not improve after 5 days of chelation therapy, but this resolved 14 days following cessation of therapy. No adverse effects of DMSA therapy were seen.

Conclusions Oral chelation therapy with DMSA 30 mg/kg/day is possible without being admitted to a hospital and it is generally effective, safe, and relatively inexpensive. DMSA provides a positive effect on adult patients who have lead poisoning.