Reversal of desferrioxamine induced auditory neurotoxicity during treatment with Ca-DTPA.
Auditory neurotoxicity occurred in 13 (26%) of 50 evaluable patients receiving long term desferrioxamine chelation. In five of these patients, all of whom were receiving high doses of desferrioxamine, the toxicity caused deafness. These five patients were treated with subcutaneous calcium diethylene triamine pentacetic acid (Ca-DTPA) with zinc supplements instead of desferrioxamine, and their hearing improved during periods of seven to 19 months. Their serum ion concentrations remained unchanged. We suggest that all patients receiving long term desferrioxamine should have audiometric assessments at 6-12 monthly intervals. Ca-DTPA with oral zinc supplements should be considered as alternative to desferrioxamine as an iron chelating treatment in patients with auditory neurotoxicity.
Wonke
B
B
Department of Haematology, Whittington Hospital, London.
Hoffbrand
A V
AV
Aldouri
M
M
Wickens
D
D
Flynn
D
D
Stearns
M
M
Warner
P
P
D000293:Adolescent; D000328:Adult; D001299:Audiometry; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D003676:Deferoxamine / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000097:blood; D034381:Hearing Loss / Q000139:chemically induced*; D006312:Hearing Loss, Bilateral / Q000139:chemically induced*; D006801:Humans; D008297:Male; D004369:Pentetic Acid / Q000627:therapeutic use*; D013789:Thalassemia / Q000378:metabolism / Q000628:therapy; D015032:Zinc / Q000378:metabolism
D004369:Pentetic Acid; D005293:Ferritins; D003676:Deferoxamine; D015032:Zinc