Griswold W R, Reznik V, Mendoza S A, Trauner D, Alfrey A C
Pediatrics. 1983 Jan;71(1):56-8.
A child with renal insufficiency was treated with the oral phosphate binder aluminum hydroxide from age 6 to 31 months. The prescribed dose of elemental aluminum varied from 31 to 108 mg/kg/d. Concurrently the patient developed vitamin D-resistant osteomalacia which failed to improve with parathyroidectomy. Encephalopathy with myoclonic seizures, loss of speech, and motor impairment also occurred. Serum and bone aluminum levels were elevated at 334 micrograms/L (normal 7 +/- 3 micrograms/L) and 156 mg/kg (normal 3.3 +/- 2.9 mg/kg), respectively. This case demonstrates that aluminum may accumulate in tissue of children receiving oral aluminum hydroxide. The accumulation of aluminum may have contributed to the vitamin D-resistant osteomalacia and the encephalopathy in this patient. Children receiving aluminum-containing antacids as phosphate binders should be monitored for aluminum accumulation and signs of aluminum intoxication.
一名肾功能不全的儿童从6个月至31个月期间接受口服磷酸盐结合剂氢氧化铝治疗。元素铝的规定剂量为31至108毫克/千克/天。同时，该患者出现了维生素D抵抗性骨软化症，甲状旁腺切除术后病情仍未改善。还发生了伴有肌阵挛性癫痫、言语丧失和运动障碍的脑病。血清铝水平和骨铝水平分别升高至334微克/升（正常为7±3微克/升）和156毫克/千克（正常为3.3±2.9毫克/千克）。该病例表明，接受口服氢氧化铝的儿童组织中可能会蓄积铝。铝的蓄积可能导致了该患者的维生素D抵抗性骨软化症和脑病。接受含铝抗酸剂作为磷酸盐结合剂的儿童应监测铝蓄积情况和铝中毒迹象。
