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Chelation therapy to treat lead toxicity in children.

The most recent Centers for Disease Control guidelines recommend routine screening of children for lead exposure. The CDC recommends close lead-level monitoring of children with lead levels greater than 10 micrograms/dL. The indications for chelation therapy have not changed. Identification and removal of sources of lead exposure are equally as important as chelation therapy. Experimental data have raised concerns about potential central nervous system effects of the most widely used chelating agent, edetate calcium disodium. A newly licensed chelating agent, succimer, appears to have fewer side effects, appears to be more effective, and has the advantage of oral administration. Indications for its use are somewhat limited but may be expanded as experience with its use increases.