Treatment of Dialysis Osteomalacia With Desferrioxamine

Brown, D. J.; Ham, K.; Dawborn, J K; Xipell, J.M.

doi:10.1016/s0140-6736(82)90544-x

Cited by 110 publications

(30 citation statements)

References 8 publications

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“…That DFO was able to chelate tissue-bound aluminum, and increase its subsequent removal from the body during dialysis, was suggested by a 55% reduction in the histo chemically stainable aluminum in iliac crest bone biopsy after 6 months of treatment. Our findings of a reduction in bone matrix aluminum content is in contrast to that of Brown et al [24], These authors reported remarkably similar clinical and biochemical responses in 2 patients with dialysis osteomalacia who were given DFO for com parable periods; yet they could not document a reduction in tissue aluminum. We have no explanation for this dis crepancy, although our findings are based on a reduction in aluminum as assessed by histochemical methods, whilst the measurements of Brown et al [24] utilized energy-dispersive X-ray microanalysis.…”

Section: Discussioncontrasting

confidence: 91%

Successful Treatment of Dialysis Osteomalacia and Dementia, Using Desferrioxamine Infusions and Oral 1-Alpha Hydroxycholecalciferol

Hood¹,

Clark²,

Hodsman³

et al. 1984

Am J Nephrol

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A 54-year-old patient with fracturing dialysis osteomalacia and dementia demonstrated rapid deterioration following parathyroidectomy which was performed for sustained hypercalcemia. Reduction of the total body aluminum burden was attempted using desferrioxamine (DFO) as a chelating agent. After 6 months, DFO infusion resulted in sustained clinical remission of both neurological and skeletal symptoms, associated with an improvement in the EEG and improved mineralization of bone. A reduction in total body aluminum burden was reflected by reduced skeletal aluminum content, quantitated histochemically in iliac crest bone biopsies before and after DFO therapy. Dramatic increases in serum aluminum levels were documented in the initial weeks of DFO therapy leading to increased removal of aluminum during dialysis; in vitro studies indicated that the ultrafiltrable fraction of serum aluminum increased from 17 to more than 60% after initiating DFO treatment. However, after 6 months of therapy, serum aluminum levels remained unchanged after DFO infusion. These findings suggest that the serum aluminum response to DFO infusion might be a useful reflection of the total-body aluminum burden and also a reflection of the adequacy of a chelation program designed to reduce whole-body aluminum content.

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Section: Discussioncontrasting

confidence: 91%

Successful Treatment of Dialysis Osteomalacia and Dementia, Using Desferrioxamine Infusions and Oral 1-Alpha Hydroxycholecalciferol

Hood¹,

Clark²,

Hodsman³

et al. 1984

Am J Nephrol

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“…Desferrioxamine is virtually specific for the chelation of Fe(III) ions [it can bind A13 + ions and indeed it has been used to decrease A13 + toxicity in patients undergoing blood dialysis (Brown et al, 1982), but Al3 + does not catalyse -OH formation]. Desferrioxamine can be injected subcutaneously into humans in amounts up to 50-60mg/kg (Davies et al, 1983) and it is a valuable experimental tool for investigation of the iron-catalysed Haber-Weiss reaction.…”

Section: Copper Availabilitymentioning

confidence: 99%

Oxygen toxicity, oxygen radicals, transition metals and disease

Halliwell¹,

Gutteridge²

1984

Biochemical Journal

4,851

2,185

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“…There is thus some reason to think that, both from the aspect of removing iron from the brain and of reducing lymphocyte stimulation, DFOM might merit a trial as a therapeutic agent in multiple sclerosis. The drug is relatively nontoxic, having been used for many years to treat both iron overload and iron poisoning (30,31) and, more recently, the tissue damage of long-term hemodialysis (32). Our in vitro results also suggest that drugs that remove free iron may be of general value as mild immunosuppressive agents to inhibit autoreactive, or rejection processes involving lymphocytes of the DTH/helper subset.…”

Section: Discussionmentioning

confidence: 61%

Inhibition of autoimmune neuropathological process by treatment with an iron-chelating agent.

Bowern¹,

Ramshaw²,

Clark³

et al. 1984

The Journal of Experimental Medicine

110

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Lewis rats that are primed with guinea pig spinal cord homogenized in complete Freund's adjuvant (GPSCH-CFA) develop overt symptoms of experimental allergic encephalomyelitis (EAE). Treatment with the iron-chelating agent, desferrioxamine B mesylate (DFOM), at various times before the onset of EAE, dramatically suppressed both the severity and duration of disease. When DFOM was administered to rats soon after the development of neurological signs, a rapid recovery occurred, though mild, transient symptoms could be seen approximately 1 wk after withdrawal of the drug. Treatment with DFOM was always accompanied by a diminution of T cell responsiveness on the part of the delayed-type hypersensitivity/helper subset and, on histological examination, an absence of inflammatory cells from lesions. Iron is believed to influence both the migration and function of immune effector cells. It can also act as a catalyst in the formation of free radicals, which are highly toxic agents causing tissue damage in sites of inflammation. The mechanisms underlying the effect of DFOM on the severity of EAE, and the possible implications for treatment of multiple sclerosis are discussed.

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Treatment of Dialysis Osteomalacia With Desferrioxamine

Cited by 110 publications

References 8 publications

Successful Treatment of Dialysis Osteomalacia and Dementia, Using Desferrioxamine Infusions and Oral 1-Alpha Hydroxycholecalciferol

Successful Treatment of Dialysis Osteomalacia and Dementia, Using Desferrioxamine Infusions and Oral 1-Alpha Hydroxycholecalciferol

Oxygen toxicity, oxygen radicals, transition metals and disease

Inhibition of autoimmune neuropathological process by treatment with an iron-chelating agent.

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