Effect of Chelation Therapy on Leadinduced Hepatotoxicity: A Case Series

Background: Opium use is one of the common causes of lead toxicity. Lead poisoning can lead to hepatic, hematologic, musculoskeletal, neurological, and cardiovascular damages. In this study, we investigated the reversibility of leadinduced liver damage following chelation therapy.Methods: We reviewed the medical records of patients with opiuminduced lead poisoning regarding elevation in hepatobiliary enzymes level including Alanine Transaminase (ALT), Aspartate Transaminase (AST), and Alkaline Phosphatase (ALP) to normal level and recorded patients’ age, treatment regimen, liver enzymes level before and after treatment; we also investigated other laboratory findings to rule out other causes of liver enzymes increase.Results: We evaluated 10 male patients with the mean age of 48.3±7.42 years. All patients were referred with the chief complain of abdominal cramps (100%). The mean lead level in patients was 84.48±9.95 µg/dL. The mean serum levels of ALT, AST, and ALP significantly decreased after the treatment with chelating agents ([ALT=117.8±60.22µg/dL76.9±40.73µg/dL, P=0.022], [AST=100.9±63.96µg/dL69.9±37.41µg/dL, P=0.028], [ALP=449.8±234.81 µg/dL338.3±131.22µg/dL, P=0.037]). There was no significant correlation between patients’ lead level and liver enzymes level before and after the treatment.Conclusion: The results of this study showed that the treatment with chelating agents reverses the liver injury following the lead intoxication.