Abstract
In 700 subjects, simultaneous measurements of FEP, ALAD and blood lead were performed. In 92 subjects, EDTA chelation tests were carried out in an attempt to assess the sensitivity of the two screening procedures and to determine how they reflected the chelatable body lead burden. Both the FEP and ALAD were abnormal in all subjects with lead values above 50 μgm%. The FEP was abnormal in 86.4% of subjects with lead values between 41-50 μgm%; the ALAD in 81.3%. Of the subjects surveyed, 9.3% had abnormal ALAD while 32.4% had abnormal FEP, reflecting the fact that FEP is also elevated in iron deficiency. The mean urinary lead excretion with FEP values of less than 100 was 0.25 μgm/mg EDTA administered and rose progressively with increasing FEP; subjects with FEP values above 300 excreted 0.83 μgm/mg EDTA. The ALAD also reflected the body lead burden. With ALAD values above 25 units, lead excretion averaged 0.16 ugm/mg EDTA while with ALAD values of less than 15 units the urinary excretion was 0.65 μgm/mg EDTA. Both the FEP and ALAD are sensitive tests of the body lead burden and correlate with the EDTA mobilization test. The simplicity of the FEP makes it more useful despite its positivity with iron deficiency.
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Oski, F., Weltzman, M., Oski, B. et al. A COMPARISON OF THE MEASUREMENT OF FREE ERYTHROCYTE PORPHYRIN (FEP) AND RED CELL AMINOLEVULINIC ACID DEHYDRASE ACTIVITY (ALAD) AS MEANS OF DETERMINING EXCESSIVE LEAD ABSORPTION. Pediatr Res 8, 407 (1974). https://doi.org/10.1203/00006450-197404000-00400
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DOI: https://doi.org/10.1203/00006450-197404000-00400