Acute renal failure following deferoxamine overdose.
A 17-year-old patient with sickle cell-beta thalassemia undergoing treatment with home iron chelation therapy inadvertently received ten times the recommended dose of intravenous deferoxamine. Acute renal failure (ARF) developed within hours. Immediate treatment with high-efficiency hemodialysis resulted in the prompt return of renal function after only one hemodialysis session. No long-term nephrotoxic effects of the deferoxamine overdose developed after more than 1 year of follow-up. Children with sickle cell disease who are on intravenous deferoxamine and their parents should be cautioned about the possibility of ARF with overdose due to malfunction of the pump and/or inadequate monitoring during treatment. ARF, should it occur in such children, appears to respond well to treatment with high-efficiency hemodialysis.
Prasannan
Latha
L
Division of Pediatric Hematology and Oncology, University of Michigan, Ann Arbor, MI 48106, USA. prasannan.latha@marshfieldclinic.org
Flynn
Joseph T
JT
Levine
John E
JE
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000628:therapy; D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000188:drug therapy; D003676:Deferoxamine / Q000506:poisoning*; D062787:Drug Overdose; D006801:Humans; D007502:Iron Chelating Agents / Q000506:poisoning*; D008297:Male; D006435:Renal Dialysis; D017086:beta-Thalassemia / Q000188:drug therapy
D007502:Iron Chelating Agents; D003676:Deferoxamine