succimer and Substance-Related-Disorders

An infant, born at 35 weeks' gestation to a woman who sniffed petrol, had a cord blood lead level eight times the accepted limit. Treatment with oral dimercaptosuccinic acid promptly reduced his blood lead levels. To our knowledge, this is the first reported case of congenital lead poisoning secondary to maternal petrol sniffing. We suggest that at-risk pregnancies should be identified, cord blood lead levels tested, and chelation therapy and developmental follow-up offered to affected infants.

Topics: Adult; Chelating Agents; Female; Humans; Infant, Newborn; Lead Poisoning, Nervous System, Childhood; Male; Petroleum; Pregnancy; Pregnancy Complications; Substance-Related Disorders; Succimer

Alkane arsenate herbicides are available commercially, and their acute toxicity has been well documented in previous studies. Animal studies have indicated that dimercaptosuccinic acid (DMSA) can be used as an oral chelating agent. A 20-y-old white male cocaine addict attempted suicide by drinking approximately 500 ml of a 16% monosodium methanearsenate solution. He vomited 10 or more times and was admitted to the intensive care unit with impending shock and early liver and renal involvement. Four 5-day courses of 30 mg DMSA/kg/24 h were given. This brought the serum arsenic level from 2,871 micrograms/L to 6 micrograms/L, and his urine arsenic level from 78,920 micrograms/L to 21 micrograms/L in 30 d. Renal function tests returned to normal, with normal renal creatinine clearance, normal blood urea nitrogen and serum creatinine. However liver functions were abnormal, with elevation of serum transaminases, which later proved secondary to chronic hepatitis. No side effects of DMSA was encountered during the therapy. DMSA was successfully used to detoxify acute organoarsenate poisoning in a clinical setting, supporting experimental reports in the literature.

Topics: Administration, Oral; Adult; Arsenic; Arsenic Poisoning; Arsenicals; Blood Cell Count; Blood Chemical Analysis; Blood Gas Analysis; Chelating Agents; Cocaine; Drug Overdose; Herbicides; Humans; Kidney; Liver; Liver Function Tests; Male; Substance-Related Disorders; Succimer; Suicide, Attempted; Urine

Mercury is an extremely toxic heavy metal that can devastate the central nervous system. The neuropsychological consequences of mercury vapor intoxication have been studied primarily in adults. We present two adolescent half-siblings, ages 13 and 15, who were unintentionally exposed to concentrated mercury vapor for 3 months. Both children participated in neuropsychological evaluations shortly after being diagnosed with mercury toxicity, and again 1 year later. Results from the initial assessments documented functional deficits consistent with diffuse encephalopathy. Upon follow-up, neuropsychological functioning had improved, but deficits remained in visuoperceptual and constructional skills, nonverbal memory, and conceptual abstraction. The deficits persisted despite removal from exposure, return of urinary and blood mercury to acceptable levels, and resolution of neuropsychiatric symptoms. The deficits were similar to, but more severe than, those found in adults suffering from mercury vapor intoxication. The results suggest that the developing brain may be especially vulnerable to mercury vapor toxicity.

Topics: Adolescent; Air Pollution, Indoor; Attention; Brain Damage, Chronic; Female; Follow-Up Studies; Humans; Male; Mercury; Mercury Poisoning; Neuropsychological Tests; Pattern Recognition, Visual; Psychomotor Performance; Substance-Related Disorders; Succimer; Volatilization