Pediatric Hematology Unit, Mubarak Al-Kabeer Hospital, Jabriya, Kuwait.
Department of Pediatric Surgery, Ibn Sina, Sabah, Kuwait.
Hemoglobin. 2021 Sep;45(5):335-337. doi: 10.1080/03630269.2021.2021937. Epub 2022 Jan 3.
The oral iron chelator, deferasirox (DFX), is commonly associated with mild gastrointestinal (GI) complaints, but GI hemorrhage and ulcers have occasionally been reported. However, perforated duodenal ulcer (PDU) has been previously reported in only one patient with β-thalassemia major (β-TM) on Exjade (DFXE). We hereby report the second case of a 5-year-old Syrian patient, who recently presented with PDU while on DFXE. She was not on any other ulcerogenic medication and was negative for and Celiac disease. She had a surgical repair and has done well. She is back on DFX, but with the film-coated tablet, Jadenu or DFXJ. Perforated duodenal ulcer should be suspected in patients with severe GI symptoms, abdominal distension and tenderness while on DFXE, especially at high doses (30+ mg/kg).
口服铁螯合剂地拉罗司（DFX）通常与轻度胃肠道（GI）不适相关，但偶尔也会出现 GI 出血和溃疡。然而，以前仅在一名 Exjade（DFXE）治疗的β-地中海贫血重型（β-TM）患者中报告过十二指肠溃疡穿孔（PDU）。我们在此报告第二例 5 岁叙利亚患者，她最近在服用 DFXE 时出现 PDU。她没有服用任何其他致溃疡药物，且 、乳糜泻均为阴性。她接受了手术修复，恢复良好。她已重新开始服用 DFX，但采用了薄膜包衣片 Jadenu 或 DFXJ。在服用 DFXE 时出现严重胃肠道症状、腹胀和压痛的患者，尤其是在高剂量（30+mg/kg）时，应怀疑发生 PDU。
