Need for the lead mobilization test in children with lead poisoning

Morri E. Markowitz, John F. Rosen

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

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 μg/dl and an erythrocyte protoporphyrin level >35 μg/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<25 μg/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 ≥40 μg/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 μg/dl. Children with bPb between 40 and 55 μg/dl may receive chelation therapy without having an LMT, if the performance of the LMT is not practical. Patients with levels <25 μg/dl should be followed clinically and removed from further Pb exposure.

Original languageEnglish (US)
Pages (from-to)305-310
Number of pages6
JournalThe Journal of Pediatrics
Volume119
Issue number2
DOIs
StatePublished - 1991

Fingerprint

Lead Poisoning
ethylenediamine
Chelation Therapy
Diuresis
Centers for Disease Control and Prevention (U.S.)
Lead
Poisoning
Patient Selection
Erythrocytes
Calcium

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Need for the lead mobilization test in children with lead poisoning. / Markowitz, Morri E.; Rosen, John F.

In: The Journal of Pediatrics, Vol. 119, No. 2, 1991, p. 305-310.

Research output: Contribution to journalArticle

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