title: Hyperchloraemic metabolic acidosis induced by the iron chelator deferasirox: a case report and review of the literature.
abstract: OBJECTIVE
  Deferasirox is a new treatment of iron overload that is administered orally once-a-day, resulting in better acceptance in patients. Deferasirox-induced renal tubular dysfunction has been reported on very rare occasions.
  
  
  METHODS
  A 17-year-old adolescent with β-thalassaemia on deferasirox 30 mg/kg daily presented with isolated hyperchloraemic metabolic acidosis (bicarbonate 12·9 mM, sodium 137 mM, chloride 111 mM, potassium 3·6 mM). Acidosis resolved after withdrawing deferasirox. Naranjo adverse drug reaction scale suggested that the likelihood that deferasirox was responsible for acidosis was probable. Eight cases of metabolic acidosis have been reported in patients treated with deferasirox. In most cases, acidosis was associated with further features of renal tubular dysfunction.
  
  
  CONCLUSIONS
  We describe herein a case of metabolic acidosis in the setting of treatment with the deferasirox. Our case and the literature indicate a potential risk of kidney toxicity on this agent.
authors: Integrated Department of Pediatrics, Ente Ospedaliero Cantonale Ticinese, University of Berne, Berne, Switzerland.
authors: V G
authors: VG
authors: Dell'Orto
authors: M G
authors: MG
authors: Bianchetti
authors: P
authors: P
authors: Brazzola
mesh_terms: D000138:Acidosis / Q000097:blood* / Q000139:chemically induced*; D000141:Acidosis, Renal Tubular / Q000139:chemically induced / Q000378:metabolism; D000293:Adolescent; D001565:Benzoates / Q000009:adverse effects* / Q000627:therapeutic use; D002713:Chlorine / Q000097:blood*; D000077588:Deferasirox; D005260:Female; D006801:Humans; D007502:Iron Chelating Agents / Q000009:adverse effects* / Q000627:therapeutic use; D014230:Triazoles / Q000009:adverse effects* / Q000627:therapeutic use; D017086:beta-Thalassemia / Q000097:blood / Q000188:drug therapy
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D002713:Chlorine; D000077588:Deferasirox
keywords: adverse effects; deferasirox; metabolic acidosis