Cases A, Kelly J, Sabater F, Torras A, Griño M C, Lopez-Pedret J, Revert L
Nephrology Service, Hospital Clinic i Provincial, Barcelona, Spain.
Nephron. 1990;56(1):19-23. doi: 10.1159/000186094.
During an 18-month period of study 41 hemodialyzed patients receiving desferrioxamine (10-40 mg/kg BW/3 times weekly) for the first time were monitored for detection of audiovisual toxicity. 6 patients presented clinical symptoms of visual or auditory toxicity. Moreover, detailed ophthalmologic and audiologic studies disclosed abnormalities in 7 more asymptomatic patients. Visual toxicity was of retinal origin and was characterized by a tritan-type dyschromatopsy, sometimes associated with a loss of visual acuity and pigmentary retinal deposits. Auditory toxicity was characterized by a mid- to high-frequency neurosensorial hearing loss and the lesion was of the cochlear type. Desferrioxamine withdrawal resulted in a complete recovery of visual function in 1 patient and partial recovery in 3, and a complete reversal of hearing loss in 3 patients and partial recovery in 3. This toxicity appeared in patients receiving the higher doses of desferrioxamine or coincided with the normalization of ferritin or aluminium serum levels. The data indicate that audiovisual toxicity is not an infrequent complication in hemodialyzed patients receiving desferrioxamine. Periodical audiovisual monitoring should be performed on hemodialyzed patients receiving the drug in order to detect adverse effects as early as possible.
在为期18个月的研究期间，对41例首次接受去铁胺（10 - 40mg/kg体重/每周3次）治疗的血液透析患者进行了视听毒性检测监测。6例患者出现视觉或听觉毒性的临床症状。此外，详细的眼科和听力检查发现另外7例无症状患者存在异常。视觉毒性源于视网膜，其特征为蓝色觉异常型色觉障碍，有时伴有视力丧失和视网膜色素沉着。听觉毒性的特征为中高频神经感觉性听力损失，病变为耳蜗型。停用去铁胺后，1例患者视觉功能完全恢复，3例部分恢复，3例患者听力损失完全逆转，3例部分恢复。这种毒性出现在接受较高剂量去铁胺的患者中，或与铁蛋白或血清铝水平正常化同时出现。数据表明，视听毒性在接受去铁胺治疗的血液透析患者中并非罕见并发症。应对接受该药物治疗的血液透析患者进行定期视听监测，以便尽早发现不良反应。
