Arizono K, Fukui H, Miura H, Hayano K, Otsuka Y, Tajiri M
Nihon Jinzo Gakkai Shi. 1989 Jan;31(1):99-103.
Deferoxamine (DFO) has been widely used in the treatment of aluminum toxicity in patients on chronic dialysis. Mucormycosis is an opportunistic infection caused by fungi of the Mucorales order and some reports suggested a role for DFO in the precipitation of this infection. A 50-year-old man had been on hemodialysis for 16 years. 6 weeks before admission, he was begun on DFO because of aluminum toxicity. 2 weeks before admission, general fatigue and fever developed and followed by headache and loss of vision. He was admitted to this hospital with disturbed consciousness. His clinical course and a CT scan of the head suggested cerebral infarction. Within 24 hours he required ventilatory support and died 5 days after the admission. On autopsy, rhino-cerebral mucormycosis was demonstrated with a mycotic thrombus involving the left middle cerebral artery. Dialysis-related mucormycosis has recently appeared in the literature. We feel that hemodialysis patients on DFO may be at risk for potentially fatal mucormycosis infections. With a possible relationship between DFO treatment and this fatal opportunistic infection, caution should be given before using this drug and the indications should be definitive.
去铁胺（DFO）已被广泛用于治疗慢性透析患者的铝中毒。毛霉菌病是由毛霉目真菌引起的一种机会性感染，一些报告表明DFO在这种感染的发生中起一定作用。一名50岁男性已接受血液透析16年。入院前6周，因铝中毒开始使用DFO。入院前2周，出现全身乏力和发热，随后出现头痛和视力丧失。他因意识障碍入住本院。他的临床病程和头部CT扫描提示脑梗死。24小时内他需要呼吸机支持，并在入院后5天死亡。尸检显示为鼻脑毛霉菌病，有一个真菌性血栓累及左大脑中动脉。透析相关的毛霉菌病最近已出现在文献中。我们认为接受DFO治疗的血液透析患者可能有发生潜在致命性毛霉菌感染的风险。鉴于DFO治疗与这种致命的机会性感染之间可能存在关联，在使用该药前应谨慎，且适应证应明确。
