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THE USE OF DTPA IN THE DIAGNOSIS AND MANAGEMENT OF IDIOPATHIC HÆMOCHROMATOSIS
Author(s) -
WALSH R. J.,
PERKINS K. W.,
BLACKBURN C. R. B.,
SANFORD RONA,
CANTRILL SHIRLEY
Publication year - 1963
Publication title -
australasian annals of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0571-9283
DOI - 10.1111/imj.1963.12.3.192
Subject(s) - transferrin , urine , asymptomatic , medicine , chelation therapy , excretion , gastroenterology , surgery , thalassemia
SUMMARY A test to measure the extent of iron overload in patients with idiopathic hæmochromatosis was developed with the chelating agent diethylene triamine penta‐acetic acid (DTPA). One gramme of DTPA in 100 ml. of saline was injected intravenously, and the iron excreted in the urine during the next five hours was measured. Normal subjects excreted less than 0·25 mg. of iron, and six untreated patients who had been diagnosed as suffering from hæmochromatosis excreted between 4·0 and 16·1 mg. The test was also performed on 51 patients who had been treated by removal of blood for varying periods, and who were divided into three groups. Sixteen who still had saturated transferrin excreted between 0·6 and 9·4 mg. of iron in the urine. The second group of 29 patients, whose transferrin had been unsaturated for varying periods, excreted between 0 and 1·5 mg. The remaining six patients had been adequately treated, but had not attended for some time, and the transferrin had again become saturated. Only one excreted less than 0·6 mg. The DTPA test was also performed on 13 asymptomatic relatives of patients with hæmochromatosis, all of whom had saturated transferrin, and some excreted abnormal amounts of iron. It is suggested that the DTPA test provides a measure of iron overload in patients with hæmochromatosis and gives a better guide to the progress of therapy than do serum iron and transferrin values. The test is simple to perform, is safe, and causes little inconvenience to the patient.