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Toxicidad ocular de dosis altas de desferrioxamina por vía intravenosa
Lancet (London, England)
|July 23, 1983
Resumen
El tratamiento con dosis altas de desferrioxamina para la beta talasemia mayor en pacientes con sobrecarga de hierro causó anormalidades de la retina. Estos problemas de visión mejoraron después de suspender la terapia de quelación de hierro.
Área de la Ciencia:
- Hematología Hematología.
- Oftalmología Oftalmología.
- Farmacología Farmacología.
Sus antecedentes:
- La beta talasemia mayor requiere frecuentes transfusiones de sangre, lo que lleva a una sobrecarga de hierro.
- La sobrecarga de hierro plantea riesgos significativos, incluido el daño potencial de órganos.
Objetivo del estudio:
- Para evaluar la eficacia y seguridad de dosis intravenosas de desferrioxamina más altas de lo habitual.
- Evaluar el impacto de la quelación intensiva del hierro en pacientes dependientes de transfusiones.
- Para identificar los posibles efectos adversos del tratamiento con dosis altas de desferrioxamina.
Principales métodos:
- Cuatro pacientes con beta talasemia mayor recibieron desferrioxamina por vía intravenosa en dosis aumentadas.
- Tratamiento destinado a contrarrestar la sobrecarga significativa de hierro inducida por la transfusión.
- El monitoreo clínico incluyó exámenes oftalmológicos para detectar efectos adversos.
Principales resultados:
- Dos pacientes desarrollaron anomalías de la retina, caracterizadas por ceguera nocturna y defectos en el campo visual.
- Estos hallazgos oftalmológicos se asociaron con la administración de dosis altas de desferrioxamina.
- La retirada de la desferrioxamina condujo a la mejora de las anomalías de la retina y los síntomas visuales.
Conclusiones:
- La desferrioxamina intravenosa, incluso en dosis altas, puede inducir toxicidad retiniana reversible en pacientes con talasemia beta mayor.
- Un cuidadoso monitoreo oftalmológico es crucial durante la terapia intensiva de quelación de hierro.
- El ajuste de la dosis o el cese del medicamento pueden ser necesarios para manejar los trastornos visuales inducidos por la desferrioxamina.
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