Leung Nelson, Pittelkow Mark R, Lee Christine U, Good Jonathan A, Hanley Matthew M, Moyer Thomas P
Division of Nephrology and Hypertension.
Department of Dermatology.
NDT Plus. 2009 Aug;2(4):309-11. doi: 10.1093/ndtplus/sfp042. Epub 2009 Apr 23.
A 65-year-old female with biopsy-confirmed nephrogenic systemic fibrosis (NSF) received a kidney transplantation. Despite good kidney function, her symptoms continued to progress. Deferoxamine was administered intramuscularly at 500 mg/day and later 1000 mg/day after 1 week with no adverse effects. Urine excretion of gadolinium increased from 6.0 μg/day to 11.6 μg/day and subsequently to 13.0 μg/day with 500 mg/day and 1000 mg/day of deferoxamine, respectively. Serum levels, however, remain unchanged from 1.7 ng/ml to 1.4 ng/ml. Although chelation therapy may have a role in the treatment of NSF, deferoxamine is too weak and a stronger chelator is needed.
一名经活检确诊为肾源性系统性纤维化(NSF)的65岁女性接受了肾脏移植。尽管肾功能良好,但其症状仍持续进展。给予去铁胺肌肉注射,初始剂量为500mg/天,1周后增加至1000mg/天,未出现不良反应。使用500mg/天和1000mg/天去铁胺时,钆的尿排泄量分别从6.0μg/天增加至11.6μg/天,随后又增加至13.0μg/天。然而,血清水平保持不变,从1.7ng/ml降至1.4ng/ml。尽管螯合疗法可能在NSF治疗中发挥作用,但去铁胺的螯合作用较弱,需要更强效的螯合剂。