Sensorimotor neurotoxicity associated with high-dose deferoxamine treatment

We report a reversible sensorimotor neurotixicity that developed in two beta-thalassemic patients treated with high-dose deferoxamine (DFO) for iron overload.

Two patients were treated with high-dose (120 mg/kg/day) intravenous DFO for iron overload.

Sensorimotor toxicity developed after 5 and 6 months of treatment, respectively. The development of the neurotoxicity did not correlate with the serum ferritin or the ratio of DFO dose to serum ferritin. Symptoms resolved in both patients with discontinuation of DFO treatment. In 1 patient, symptoms recurred with resumption of DFO treatment.

These cases demonstrate that a reversible sensorimotor neurotoxicity, a previously unreported toxicity, may complicate DFO therapy, this complements the previously reported auditory and visual neurotoxicity associated with DFO therapy. Discontinuation of therapy at the time of onset of neurotoxicity is recommended, with possible resumption at lower doses.