Clinical and Laboratory Studies on the Action of Desferrioxamine

Abstract

Summary. Most of the published literature on the iron chelating agent desferrioxamine (DFA) relates to urinary excretion of iron following its administration. In the present study, six patients suffering from various iron storage diseases were maintained on a fixed dietary intake of iron and a basal value for faecal iron excretion was obtained. In all cases the faecal iron content rose significantly after treatment with desferrioxamine (P <0.05). The increase in faecal iron after DFA was between 30 and 50 per cent (mean 40 per cent) of the total increase in both urinary and faecal iron excretion. This finding has a relevance to the correct interpretation of tests using DFA for the assessment of body iron stores. The serum ferritin levels of another group of patients suffering from various iron storage diseases, but also including one patient with iron deficiency, were measured before and after DFA administration. In all cases the serum ferritin levels increased significantly (I) <0.001) 2 hours after administration of DFA. Quantitative studies on the ferritin protein and ferritin iron content of liver, spleen, kidney and intestinal mucosa in rats showed that DFA causes significant reductions in both these substances in liver and spleen. It was calculated that over 70 per cent of the iron removed by DFA emanated from liver and that the amount of ferritin protein released from rat liver after DFA was sufficient to bind all the iron removed. Thus the major source of the iron excreted after DFA therapy is probably liver ferritin iron.

Intensive Iron-Chelation Therapy with Desferrioxamine in Iron-Loading Anaemias

“…Particular atten tion has been paid to both the individual variability and the kinetics of iron removal in order to determine which method of administration is both most efficient and causes least inconvenience to patients. A report that up to 50% of the iron chelated in response to desferrioxamine appears in faeces (Cumming, Millar, Smith & Goldberg, 1969) may mean that our measurement of urinary iron excretion is an underestimate.…”

Advances in the treatment of porphyria cutanea tarda. Effectiveness of slow subcutaneous desferoxamine infusion

“…Urinary iron excretion, ranging from 100 to 200 pg/24 h before therapy, increased to 2-5 mg/ 24 h during DFX infusion, even if 30-40% of DFX is excreted in the bile and lost in the stool (18).…”

Further accumulation of Cd in renal cellular membranes caused by administration of desferrioxamine to Cd-burdened rats

“…Concerning this finding, the greater part of metals bound to DFO in plasma is excreted into urine. 25,26 Since DFO has a smaller molecular weight (MW, 656.8) than MTs (MW, 6600), it is surmised that Cd bound to DFO (DFO-Cd) is more easily filtered through the glomeruli than MTs-Cd. Of note, in relation to DFO administration, when Cd was administered as an MTs-bound form (MTs-Cd), the MTs-Cd was filtered through the glomeruli and preferentially accumulated in the apical portion of the proximal tubules.…”