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Acute Liver Failure During Deferasirox Chelation: A Toxicity Worth Considering
Nathan Menaker1, Katharine Halligan, Natasha Shur
1Divisions of *Pediatric Hematology/Oncology †Genetics, Albany Medical Center ‡Department of Emergency Medicine, St Peter's Hospital, Albany, NY.
Journal of Pediatric Hematology/Oncology
|February 22, 2017
Summary
This case report describes acute liver failure in a young male with sickle cell anemia treated with deferasirox. Close monitoring of liver function is crucial for patients on this iron chelation therapy.
Area of Science:
- Hematology
- Hepatology
- Pharmacology
Background:
- Sickle cell anemia requires chronic transfusions and iron chelation therapy.
- Deferasirox is a common iron chelator, with known renal side effects.
- Hepatic toxicity from deferasirox is less documented than renal injury.
Observation:
- A 12-year-old male with sickle cell anemia developed acute liver failure.
- The patient was undergoing chronic transfusion therapy and receiving deferasirox.
- Liver function tests showed significant abnormalities.
Findings:
- The liver failure was acute and reversible upon cessation of deferasirox.
- This case adds to the limited literature on deferasirox-induced hepatic toxicity.
- Ferritin, bilirubin, and transaminase levels are key indicators.
Implications:
- Highlights the potential for deferasirox to cause severe liver injury.
- Emphasizes the need for vigilant monitoring of liver function in patients on deferasirox.
- Informs clinical practice regarding the safe management of iron overload in sickle cell disease.
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