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Comparative Tests for Diagnosis of Lead Poisoning

Jean M. Morgan, MD; Helen B. Burch, MS
Arch Intern Med. 1972;130(3):335-340. doi:10.1001/archinte.1972.03650030019005.
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The level of erythrocyte enzyme delta-aminolevulinic acid dehydratase (ALA-D) has been determined in conjunction with other standard tests for lead poisoning. The mean for 53 healthy persons was previously shown to be 175 ±38 units. Lead excretion rates above 1.0 mg/24 hr in response to 1 gm of edetate disodium calcium (Calcium Disodium Versenate) given intravenously were associated with depression of the enzyme activity to 60 units or less. Enzyme activity was maximally depressed when lead excretion exceeded 2 mg/24 hr. Activity of ALA-D was more sensitive and accurate in the diagnosis of lead poisoning than urinary ALA or coproporphyrin excretion and as good as blood or urine lead determinations. Activity of ALA-D is rapidly restored toward normal by treatment with edetate disodium calcium.


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