Yamagata K, Kobayashi M, Koyama A, Narita M, Amagai H, Ohno A, Yoshikawa S
Institute of Clinical Medicine, University of Tsukuba.
Nihon Jinzo Gakkai Shi. 1991 Apr;33(4):437-42.
A 32-year-old woman undergoing hemodialysis for 12 years was referred because of systemic bone pain and pathological fracture of ribs and right tibia. Her serum ferritin was 4800 ng/ml, liver CT level was extremely high and skeletal scintigram by 99 m-Tc-MDP revealed high activity of soft tissue. Her serum aluminum was elevated more than 20 micrograms/dl by deferoxamine infusion test. Osteomalacia and positive staining of both aluminum and iron was observed by bone biopsy examination. After treatment with deferoxamine as a chelating agent of iron and aluminum, bone pain was relieved and second bone biopsy specimen revealed improvement of osteomalacia. But serum aluminum was slightly reduced and serum ferritin level and liver CT level were unchanged.
一名接受血液透析12年的32岁女性因全身骨痛以及肋骨和右胫骨病理性骨折前来就诊。她的血清铁蛋白为4800 ng/ml，肝脏CT水平极高，99m-Tc-MDP骨闪烁显像显示软组织活性高。去铁胺输注试验显示她的血清铝升高超过20微克/分升。骨活检检查发现骨软化症以及铝和铁染色均呈阳性。使用去铁胺作为铁和铝的螯合剂进行治疗后，骨痛缓解，第二次骨活检标本显示骨软化症有所改善。但血清铝略有降低，血清铁蛋白水平和肝脏CT水平未变。
