Deaths Resulting From Hypocalcemia After Administration of Edetate Disodium: 2003-2005

Author:

Brown Mary Jean1,Willis Teresa2,Omalu Bennet3,Leiker Richard4

Affiliation:

1. Lead Poisoning Prevention Branch, Division of Emergency and Environmental Health Services, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia

2. Blood Lead Surveillance Group, Texas Department of State Health Services, Austin, Texas

3. Allegheny County Medical Examiner's Office, Pittsburgh, Pennsylvania

4. Lead Poisoning Prevention Program, Oregon State Public Health, Portland, Oregon

Abstract

From 2003 to 2005, deaths of 3 individuals as a result of cardiac arrest caused by hypocalcemia during chelation therapy were reported to the Centers for Disease Control and Prevention. Two were children, both of whom were treated with edetate disodium. At the time of this writing, the adult case was still under investigation. No previous cases of death resulting from hypocalcemia during chelation have been reported. From our experience and review of the literature, we suggest that health care providers who are unfamiliar with chelation consult an expert before undertaking treatment and that hospital formularies evaluate whether stocking edetate disodium is necessary, given the risk for hypocalcemia and the availability of less toxic alternatives.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology, and Child Health

Reference16 articles.

1. Chisholm JJ Jr, Harrison HE. The treatment of acute lead encephalopathy in children. Pediatrics. 1957;19:2–20

2. Centers for Disease Control and Prevention. Blood lead levels: United States, 1999–2002. MMWR Morb Mortal Wkly Rep. 2005;54:513–516

3. Chisolm JJ Jr. The use of chelating agents in the treatment of acute and chronic lead intoxication in childhood. J Pediatr. 1968;73:1–38

4. Wedeen RP, Batuman V, Landy E. The safety of the EDTA lead-mobilization test. Environ Res. 1983;30:58–62

5. Centers for Disease Control and Prevention. Fatal pediatric lead poisoning: New Hampshire, 2000. MMWR Morb Mortal Wkly Rep. 2001;50:457–459

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