Lloyd K N, Williams P
Br Med J. 1970 May 9;2(5705):323-5. doi: 10.1136/bmj.2.5705.323.
Ten patients with active rheumatoid arthritis were given a total dose infusion of iron dextran for anaemia. One had an immediate anaphylactoid reaction; the other nine had a brief exacerbation of arthralgia and joint dysfunction of up to seven days' duration. The erythrocyte sedimentation rate rose by an average of 23 mm. in one hour (Westergren), but this often took longer than seven days to settle to the preinfusion level.It is suggested that this response is probably not due to an exacerbation of rheumatoid arthritis but to a delayed hypersensitivity reaction to the dextran portion of the iron dextran complex. This treatment is potentially dangerous in rheumatoid arthritis; we recommend a preliminary test dose and that the infusion be started very slowly under supervision.
十名患有活动性类风湿性关节炎的患者因贫血接受了右旋糖酐铁的全剂量输注。一名患者立即出现类过敏反应；另外九名患者出现关节痛和关节功能障碍的短暂加重，持续时间长达七天。红细胞沉降率平均每小时上升23毫米（魏氏法），但通常需要超过七天才能恢复到输注前水平。有人认为，这种反应可能不是由于类风湿性关节炎的加重，而是对铁右旋糖酐复合物中右旋糖酐部分的迟发型超敏反应。这种治疗方法在类风湿性关节炎中具有潜在危险性；我们建议先给予试验剂量，并在监督下非常缓慢地开始输注。
