Aluminum toxicity following intravesical alum irrigation for hemorrhagic cystitis.
Mental status changes in an immunosuppressed child can be due to a variety of causes; aluminum toxicity is rarely considered. We report a teenage girl with acute lymphoblastic leukemia who developed mental status changes, speech disturbance, coarse tremor, and abnormal EEG findings following intravesical 1% alum irrigation and administration of aluminum-containing antacids. Her serum aluminum levels were mildly elevated (14-22 milligram(s), normal 0-6 milligram(s)), and bone marrow biopsy specimens demonstrated aluminum deposition on special staining (Krueger's method). All abnormalities resolved after a nine-week course of intravenous deferoxamine.
Kanwar
V S
VS
Department of Hematology Oncology, St. Jude Children's Research Hospital, Mcmphis, TN 38101-0318, USA.
Jenkins
J J
JJ
Mandrell
B N
BN
Furman
W L
WL
D000293:Adolescent; D000534:Alum Compounds / Q000008:administration & dosage* / Q000009:adverse effects*; D000535:Aluminum / Q000009:adverse effects* / Q000097:blood; D000931:Antidotes / Q000627:therapeutic use; D003556:Cystitis / Q000150:complications / Q000188:drug therapy*; D003676:Deferoxamine / Q000627:therapeutic use; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006470:Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D009422:Nervous System Diseases / Q000097:blood / Q000139:chemically induced*; D007507:Therapeutic Irrigation
D000534:Alum Compounds; D000931:Antidotes; C041524:aluminum sulfate; D000535:Aluminum; D003676:Deferoxamine