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Sobrecarga de hierro iatrogénica por tratamiento con isomaltósido de hierro: un reporte de caso
Yao Hu1, Min Sun1, Lihui Zhong2
1Department of Nephrology, Affiliated Hospital & Clinical Medical College of Chengdu University, Chengdu, Sichuan Province, China.
Medicine
|January 10, 2026
Resumen
El exceso de isomaltósido de hierro intravenoso puede causar sobrecarga de hierro, una condición confirmada por altos niveles de ferritina y depósito en órganos. La terapia de quelación de hierro temprana con deferasirox redujo eficazmente los niveles de hierro y mejoró los síntomas del paciente.
Área de la Ciencia:
- Nefrología; Hematología; Farmacología
Sus antecedentes:
- La suplementación intravenosa (IV) de hierro es estándar para la anemia por deficiencia de hierro.
- La administración excesiva de hierro puede provocar sobrecarga de hierro y daño orgánico.
- El isomaltósido de hierro, una formulación más nueva de hierro IV, también puede presentar un riesgo de sobrecarga de hierro.
Objetivo del estudio:
- Reportar el primer caso de sobrecarga de hierro iatrogénica causada por terapia con isomaltósido de hierro.
- Destacar la importancia del monitoreo de los niveles de hierro durante el tratamiento con hierro IV.
Principales métodos:
- Un paciente con lupus eritematoso sistémico recibió 7500 mg de isomaltósido de hierro durante 5 semanas.
- El diagnóstico de sobrecarga de hierro se confirmó mediante ferritina sérica elevada y RM que mostraba depósito de hierro en el hígado y el bazo.
- El tratamiento implicó quelación de hierro con deferasirox.
Principales resultados:
- Los niveles de ferritina sérica disminuyeron de 4336,47 ng/mL a 1236,2 ng/mL después de 8 meses de tratamiento con deferasirox.
- El paciente experimentó mejoría en la hiperpigmentación y la fatiga.
- El deferasirox fue bien tolerado con una función renal estable.
Conclusiones:
- Este caso subraya el riesgo de sobrecarga de hierro por isomaltósido de hierro IV excesivo y no monitorizado.
- Es esencial un monitoreo vigilante del metabolismo del hierro para prevenir complicaciones.
- La detección temprana y la terapia de quelación de hierro pueden manejar eficazmente la sobrecarga de hierro.
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