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Hemosiderosis in a patient on regular hemodialysis: treatment by desferrioxamine
Abstract:
Hemosiderosis following regular administration of parenteral iron was observed in a patient receiving maintenance hemodialysis. Infusions of desferrioxamine in doses of 2,3 and 4 g each resulted in the removal of approximately 45 mg of iron during dialysis. Desferrioxamine 2 g was infused thrice weekly during dialysis for twelve months. Body iron stores, as judged by liver iron and serum ferritin concentrations, fell by about half. This agrees well with the result calculated from the amount of iron administered and the amount removed during dialysis.
Insights
Parenteral iron can cause hemosiderosis in hemodialysis patients. Desferrioxamine chelation therapy effectively reduced iron overload over twelve months.
Area of Science:
- Nephrology
- Hematology
- Pharmacology
Background:
- Maintenance hemodialysis patients often receive parenteral iron therapy to manage anemia.
- Chronic iron administration can lead to iron overload and hemosiderosis, a condition characterized by excess iron storage.
Observation:
- A patient undergoing maintenance hemodialysis developed hemosiderosis after regular parenteral iron administration.
- Initial desferrioxamine infusions (2g, 3g, 4g) removed approximately 45 mg of iron during dialysis sessions.
Findings:
- A sustained treatment regimen of desferrioxamine (2g, thrice weekly during dialysis for 12 months) was implemented.
- This treatment resulted in a reduction of body iron stores by approximately 50%, as indicated by decreased liver iron and serum ferritin levels.
- The observed reduction in iron stores correlated well with calculated iron administration and removal amounts.
Implications:
- Desferrioxamine is an effective chelating agent for treating parenteral iron-induced hemosiderosis in hemodialysis patients.
- Monitoring iron levels and considering chelation therapy may be crucial for patients receiving long-term parenteral iron.
- This case highlights the importance of managing iron balance in hemodialysis patients to prevent complications like hemosiderosis.