Iron Chelation with Deferoxamine in Hepatic Disease

Use of diethylenetriamine penta-acetic acid (D.T.P.A.) in the clinical assessment of total body iron stores

“…3). Similar findings were observed with desferrioxamine by Walsh, Mass, Smith, and Lange (1965). However, this observation may not necessarily mean that the amount of iron chelated by D.T.P.A.…”

“…In one patient with grade 3 iron deposition in the liver (Table II, patient 17) a total of 11 g. of iron was removed by venesection, and in three other patients with grade 2 iron deposition the amount of iron removed by venesection was 2-5, 21, and 19 mg. respectively. Patients with alcoholic cirrhosis may have moderate haemosiderosis of the liver (grades 2 to 3) with only a slight increase in chelatable body iron (Powell, 1965;Walsh et al, 1965) and normal or slightly increased amounts (1 0 to 2 5 g.) of iron mobilizable by venesections (Conrad, Berman, and Crosby, 1962;Williams, Williams, Scheuer, Pitcher, Loiseau, and Sherlock, 1967). Quantitative tests of iron storage using iron-chelating agents can provide useful additional information about the degree of iron excess.…”

Changing concepts in haemochromatosis

“…Clinically, the distinction between haemochromatosis and cirrhosis with haemosiderosis can usually be made on the basis of the response to chelating agents and repeated venesections. In contrast to patients with haemochromatosis, those with cirrhosis and secondary haemosiderosis have usually only a slight increase in chelatable body iron (Walsh et al, 1965;Powell & Thomas, 1967) and normal or slightly increased amounts (1 0-2.5 g) of iron mobilizable by venesections (Conrad et al, 1962;Williams et al, 1967). Further information still may be obtained from family studies.…”

Iron Chelation in Acute Iron Poisoning and Chronic Hypersiderosis

“…14 At what stage in the patient's course should iron be removed? The per cent iron saturation of transferrin is a helpful clue, since high values (> 7°%) correlate with good urinary iron excretion after DF administration.--,, 19 The measurement of 24-hour urine iron levels after test doses of 500 and 1,000 mg. DF intramuscularly are good determining factors. Patients who consistently excrete more than 10 mg. of iron daily are choice condidates for prolonged daily treatment.…”