Wonke B, Hoffbrand A V, Aldouri M, Wickens D, Flynn D, Stearns M, Warner P
Department of Haematology, Whittington Hospital, London.
Arch Dis Child. 1989 Jan;64(1):77-82. doi: 10.1136/adc.64.1.77.
Auditory neurotoxicity occurred in 13 (26%) of 50 evaluable patients receiving long term desferrioxamine chelation. In five of these patients, all of whom were receiving high doses of desferrioxamine, the toxicity caused deafness. These five patients were treated with subcutaneous calcium diethylene triamine pentacetic acid (Ca-DTPA) with zinc supplements instead of desferrioxamine, and their hearing improved during periods of seven to 19 months. Their serum ion concentrations remained unchanged. We suggest that all patients receiving long term desferrioxamine should have audiometric assessments at 6-12 monthly intervals. Ca-DTPA with oral zinc supplements should be considered as alternative to desferrioxamine as an iron chelating treatment in patients with auditory neurotoxicity.
50例接受长期去铁胺螯合治疗的可评估患者中，13例（26%）出现听觉神经毒性。其中5例患者均接受高剂量去铁胺治疗，毒性导致耳聋。这5例患者改用皮下注射二乙三胺五乙酸钙（Ca-DTPA）并补充锌剂替代去铁胺治疗，7至19个月期间听力有所改善。他们的血清离子浓度保持不变。我们建议，所有接受长期去铁胺治疗的患者应每隔6至12个月进行听力测定评估。对于有听觉神经毒性的患者，Ca-DTPA联合口服锌剂应被视为去铁胺作为铁螯合治疗的替代方案。
