title: Reversal of desferrioxamine induced auditory neurotoxicity during treatment with Ca-DTPA.
abstract: 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.
authors.affiliation: Department of Haematology, Whittington Hospital, London.
authors.forename: B
authors.initials: B
authors.lastname: Wonke
authors.forename: A V
authors.initials: AV
authors.lastname: Hoffbrand
authors.forename: M
authors.initials: M
authors.lastname: Aldouri
authors.forename: D
authors.initials: D
authors.lastname: Wickens
authors.forename: D
authors.initials: D
authors.lastname: Flynn
authors.forename: M
authors.initials: M
authors.lastname: Stearns
authors.forename: P
authors.initials: P
authors.lastname: Warner
mesh_terms: 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
chemical_list: D004369:Pentetic Acid; D005293:Ferritins; D003676:Deferoxamine; D015032:Zinc