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April 1965

Treatment of Lead Encephalopathy: The Combined Use of Edetate and Hemodialysis

Author Affiliations

From the Department of Pediatrics and the Metabolism Laboratory of the Department of Medicine of the University of Cincinnati College of Medicine, the Children's Hospital Research Foundation, and the Cincinnati General Hospital.

Am J Dis Child. 1965;109(4):322-324. doi:10.1001/archpedi.1965.02090020324011

LEAD encephalopathy continues to have a case fatality rate of approximately 25% and to cause damage to the central nervous system in over one half of the survivors.1 The mechanisms by which lead is toxic to the body and causes encephalopathy are not fully understood. In the average case of pediatric lead poisoning, the total amount of lead stored in the body is in the range of 250 to 1,200 mg.2 Of this amount, 20 to 100 mg are extraskeletal, located in the blood and soft tissues.3 Furthermore, in untreated patients dying with lead encephalopathy, the concentration of lead in the brain is no less than 0.2 mg of lead per 100 gm of brain tissue.4 These facts suggest that the manifestations of lead encephalopathy are a direct result of the presence of lead in the brain tissues.

Currently, the chelating agent calcium disodium edetate (calcium

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