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Hyperchloraemic metabolic acidosis induced by the iron chelator deferasirox: a case report and review of the literature
Author(s) -
Dell'Orto V. G.,
Bianchetti M. G.,
Brazzola P.
Publication year - 2013
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.12095
Subject(s) - deferasirox , metabolic acidosis , medicine , pharmacology , chelation , chemistry , inorganic chemistry , thalassemia
Summary What is known and 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. Case summary A 17‐year‐old adolescent with β‐thalassaemia on deferasirox 30 mg/kg daily presented with isolated hyperchloraemic metabolic acidosis (bicarbonate 12·9 m m , sodium 137 m m , chloride 111 m m , potassium 3·6 m m ). 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. What is new and conclusion 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.