title: Transfusion-dependent thalassaemic patients with renal Fanconi syndrome due to deferasirox use.
abstract: OBJECTIVE
  Deferasirox is a new oral iron chelating agent with several cases reporting renal adverse events in recent years. Our aim was to identify the incidence of deferasirox-related Fanconi syndrome (FS) and its risk factors.
  
  
  METHODS
  All transfusion-dependent thalassaemic patients who received deferasirox at the outpatient department of the National Taiwan University Hospital (NTUH) from January 2006 to February 2014 were evaluated.
  
  
  RESULTS
  This cohort study included 57 patients, and mean age of deferasirox initiation was 18.2 ± 7.7 years. After 6.9 ± 1.8 years of follow-up, 5 in 57 (8.8%) thalassaemic patients had FS. Age of starting deferasirox negatively correlated with incidence of FS (correlation coefficient -0.892, P = 0.008). Other factors were not significantly associated with FS. Serum creatinine level at the start of deferasirox compared to at the end of study or onset of FS did not show significant change (P = 0.277). All the deferasirox-related FS manifested with proximal renal tubular acidosis and hypophosphataemia, which needed specific treatment or withdrawal of deferasirox use.
  
  
  CONCLUSIONS
  We recommend that children, especially of young age, who regularly use deferasirox should undergo routine urinalysis and blood testing for early detection of FS.
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Gwo-Tsann
authors.initials: GT
authors.lastname: Chuang
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: I-Jung
authors.initials: IJ
authors.lastname: Tsai
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Yong-Kwei
authors.initials: YK
authors.lastname: Tsau
authors.affiliation: Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Meng-Yao
authors.initials: MY
authors.lastname: Lu
mesh_terms: D000141:Acidosis, Renal Tubular / Q000139:chemically induced; D000293:Adolescent; D001565:Benzoates / Q000009:adverse effects*; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D000077588:Deferasirox; D005198:Fanconi Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006785:Hospitals, University; D006801:Humans; D017674:Hypophosphatemia / Q000139:chemically induced; D015994:Incidence; D007502:Iron Chelating Agents / Q000009:adverse effects*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D013789:Thalassemia / Q000097:blood / Q000175:diagnosis / Q000628:therapy*; D014230:Triazoles / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D001565:Benzoates; D007502:Iron Chelating Agents; D014230:Triazoles; D000077588:Deferasirox
keywords: Fanconi syndrome; Thalassaemia; deferariox; hypophosphataemia; renal tubular acidosis