Thalassemia Major is common in India. Every year, about 10000 new patients are diagnosed in India. Treatment requires lifelong monthly transfusions, iron chelation therapy, and other care. A large number of children die before 20 years of age, even before 10 years of age in many rural areas. Average cost of care is Rs. 15,00,000 (fifteen lac) by age 15. Cost goes up with increasing age of child...

Chelation therapy, spending several decades in obscurity, has emerged as a potential intervention to benefit patients with prior myocardial infarctions, and especially in those with diabetes. While many questions remain unanswered, the TACT1 trial presents strong evidence in support of the benefits of IV EDTA and OMVM on reducing total mortality and recurrent cardiac events, with the most drama...

Transfusional iron overload is a major target in the care of patients with transfusion-dependent thalassemia (TDT) and other refractory anemias. Iron accumulates in the liver, heart, and endocrine organs leading to a wide array of complications. In this review, we summarize the characteristics of the approved iron chelators, deferoxamine, deferiprone, and deferasirox, and the evidence behind th...

This article outlines evidence that advanced glycation end product (AGE) inhibitors and breakers act primarily as chelators, inhibiting metal-catalyzed oxidation reactions that catalyze AGE formation. We then present evidence that chelation is the most likely mechanism by which ACE inhibitors, angiotensin receptor blockers, and aldose reductase inhibitors inhibit AGE formation in diabetes. Fina...

IN THIS ISSUE OF JAMA, LAMAS AND COLLEAGUES 1 report the results of the Trial to Assess Chelation Therapy (TACT). In this multicenter clinical trial, 1708 patients with previous myocardial infarction (MI) were randomized to receive 40 infusions of chelation solution vs placebo. After a median follow-up of 55 months, the primary end point (a composite of total mortality, recurrent MI, stroke, co...

A 10-year-old Malay girl with underlying HbE/beta-thalassemia, on regular blood transfusion and deferoxamine iron chelation therapy, presented two-month history of bilateral blurring vision. On examination, her vision was 6/36 both eyes. Other optic nerve functions were normal. Anterior segment examination eyes unremarkable. Fundus revealed dull foveal reflex. Optical coherence tomography macul...

Cadmium (Cd) and lead (Pb) are toxic heavy metals that cause adverse health effects in humans and animals. Chelation therapy, the conventional treatment for heavy metal toxicity, is reported to have a number of safety and efficacy issues. Recent studies have shown that dietary supplements play important roles in protecting against Cd and Pb toxicity. This paper reviews the evidence for protecti...

The present research aimed to characterize the potential efficiency of deferasirox in removing thallium after its administration for 30 days following two dose levels of 20 and 160 μm of thallium (III) chloride to male Wistar rats every day. After thallium administration some abnormal clinical signs such as red staining around the eyes, greenish mottling on the liver, weakness, loss of hair and...

Clinical chelation therapy of mercury poisoning generally uses one or both of two drugs--meso-dimercaptosuccinic acid (DMSA) and dimercaptopropanesulfonic acid (DMPS), commercially sold as Chemet and Dimaval, respectively. We have used a combination of mercury L(III)-edge X-ray absorption spectroscopy and density functional theory calculations to investigate the chemistry of interaction of merc...

BACKGROUND Juvenile hemochromatosis is the most severe form of iron overloading phenotype. Although rare, it should be suspected in patients who present with hypogonadotropic hypogonadism, diabetes mellitus, or cardiomyopathy without a clear cause. CASE PRESENTATION A young Serbian male presenting with end-stage heart failure was referred for extracorporeal membrane oxygenation. An endomyocar...