282
Views
0
CrossRef citations to date
0
Altmetric
Clinical Research

Failure of chelator-provoked urine testing results to predict heavy metal toxicity in a prospective cohort of patients referred for medical toxicology evaluation

ORCID Icon, , , ORCID Icon, ORCID Icon &
Pages 191-196 | Received 29 Mar 2021, Accepted 27 May 2021, Published online: 29 Jun 2021

References

  • Ruha A-M. Recommendations for provoked challenge urine testing. J Med Toxicol. 2013;9(4):318–325.
  • Sällsten G, Barregård L, Schütz A. Clearance half life of mercury in urine after the cessation of long term occupational exposure: influence of a chelating agent (DMPS) on excretion of mercury in urine. Occup Environ Med. 1994;51(5):337–342.
  • Roels H, Boeckx M, Ceulemans E, et al. Urinary excretion of mercury after occupational exposure to mercury vapour and influence of the chelating agent meso-2,3-dimercaptosuccinic acid (DMSA). Br J Ind Med. 1991;48(4):247–253.
  • Molin M, Schütz A, Skerfving S, et al. Mobilized mercury in subjects with varying exposure to elemental mercury vapour. Int Arch Occup Environ Health. 1991;63(3):187–192.
  • Felton DJ, Kales SN, Goldman RH. An update and review of unconventional metals testing and treatment. Toxics. 2014;2(3):403–416.
  • Frumkin H, Manning CC, Williams PL, et al. Diagnostic chelation challenge with DMSA: a biomarker of long-term mercury exposure? Environ Health Perspect. 2001;109(2):167–171.
  • Archbold G, McGuckin RM, Campbell N. Dimercaptosuccinic acid loading test for assessing mercury burden in healthy individuals. Ann Clin Biochem. 2004;41(3):233–236.
  • Hibberd Rmhah A. Mercury from dental amalgam fillings: studies on oral chelating agents for assessing and reducing mercury burdens in humans. J Nutr Environ Med. 1998;8(3):219–231.
  • Hoet P, Haufroid V, Lison D. Heavy metal chelation tests: the misleading and hazardous promise. Arch Toxicol. 2020;94(8):2893–2896.
  • McKay CA. Jr. Medical toxicology case presentations: to chelate or not to chelate, is that the question? J Med Toxicol. 2013;9(4):373–379.
  • Toxicology ACoM. ACMT recommends against use of post-chelator challenge urinary metal testing. J Med Toxicol. 2017;13:352–354.
  • Brent J. Commentary on the abuse of metal chelation therapy in patients with autism spectrum disorders. J Med Toxicol. 2013;9(4):370–372.
  • Kales SN, Goldman RH. Mercury exposure: current concepts, controversies, and a clinic’s experience. J Occup Env Med. 2002;44(2):143–154.
  • Zajac L, Johnson SA, Hauptman M. Doc, can you test me for “toxic metals”? Challenges of testing for toxicants in patients with environmental concerns. Curr Probl Pediatr Adolesc Health Care. 2020;50(2):100762.
  • Greiner A, Drexler H. Unnecessary investigations in environmental medicine: a retrospective cohort study. Dtsch Arztebl Int. 2016;113(46):773–780.
  • Jamoulle M. Quaternary prevention, an answer of family doctors to overmedicalization. Int J Health Policy Manag. 2015;4(2):61–64.
  • Risher JF, Amler SN. Mercury exposure: evaluation and intervention the inappropriate use of chelating agents in the diagnosis and treatment of putative mercury poisoning. Neurotoxicology. 2005;26(4):691–699.
  • AACT Aa [Internet]. Don’t administer a chelating agent prior to testing urine for metals, a practice referred to as “provoked” urine testing. Philadelphia (PA): Choosing Wisely; 2013 [2020 March 21]. Available from: https://www.choosingwisely.org/clinician-lists/american-college-academy-medical-toxicology-chelating-agents-prior-to-urine-test/
  • Wax PM, Kleinschmidt KC, Brent J. The toxicology investigators consortium (ToxIC) registry. J Med Toxicol. 2011;7(4):259–265.
  • Spyres MB, Farrugia LA, Kang AM, et al. The Toxicology Investigators Consortium Case Registry-the 2019 annual report. J Med Toxicol. 2020;16(4):361–387.
  • Spyres MB, Farrugia LA, Kang AM, et al. The Toxicology Investigators Consortium Case Registry-the 2018 annual report. J Med Toxicol. 2019;15(4):228–254.
  • (ATSDR) AfTSaDR. Toxicological profile for Mercury. Atlanta (GA): U.S. Department of Health and Human Services PHS; 1999.
  • Bush RK, Portnoy JM, Saxon A, et al. The medical effects of mold exposure. J Allergy Clin Immunol. 2006;117(2):326–333.
  • Hardin BD, Kelman BJ, Saxon A. Adverse human health effects associated with molds in the indoor environment. J Occup Environ Med. 2003;45(5):470–478.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.