Yaqoob M, Ahmad R, Roberts N, Helliwell T
Department of Renal Medicine, Royal Liverpool/Sefton General Hospital, UK.
Nephrol Dial Transplant. 1991;6(7):484-6. doi: 10.1093/ndt/6.7.484.
Bone biopsy in an invasive method of diagnosing aluminium related bone disease (ABD). Toxic side-effects have been reported with the currently used 'high-dose Desferrioxamine (DFO) tests.' A low-dose DFO test was evaluated for the diagnosis of ABD in 28 symptomatic patients (13 male) on regular haemodialysis treatment. DFO 0.5 g diluted in 100 ml of 0.9% sodium chloride was given intravenously during the first 2 h of dialysis. Aluminium estimation before (t1) and 48 h after DFO challenge (t2) were made by DC plasma emission spectrometry. Following the DFO test bone biopsy was performed and the specimen stained for aluminium using soluchrome zurine. The DFO test was considered positive if the t2 concentration was 150 micrograms/l or treble the amount of t1. Nineteen patients (8 male) fell into this group and all except two had ABD. Of the nine remaining patients (5 male) who had a negative DFO test none had ABD. We conclude that ABD can be diagnosed safely in the majority of patients using a low-dose DFO test, thereby avoiding toxic side-effects.
骨活检是诊断铝相关性骨病（ABD）的一种侵入性方法。目前使用的“高剂量去铁胺（DFO）试验”已报告有毒副作用。对28例有症状的患者（13例男性）进行了低剂量DFO试验，这些患者均接受定期血液透析治疗以诊断ABD。在透析的前2小时内静脉注射稀释于100 ml 0.9%氯化钠溶液中的0.5 g DFO。通过直流等离子体发射光谱法测定DFO激发前（t1）和激发后48小时（t2）的铝含量。DFO试验后进行骨活检，并使用铝试剂对标本进行铝染色。如果t2浓度为150微克/升或为t1的三倍，则DFO试验被认为是阳性。19例患者（8例男性）属于该组，除2例患者外均患有ABD。其余9例DFO试验阴性的患者（5例男性）均未患ABD。我们得出结论，使用低剂量DFO试验可以在大多数患者中安全地诊断ABD，从而避免毒副作用。
