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Hyperchloraemic metabolic acidosis induced by the iron chelator deferasirox: a case report and review of the literature.

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  • Author(s): Dell'Orto VG;Dell'Orto VG; Bianchetti MG; Brazzola P
  • Source:
    Journal of clinical pharmacy and therapeutics [J Clin Pharm Ther] 2013 Dec; Vol. 38 (6), pp. 526-7. Date of Electronic Publication: 2013 Aug 27.
  • Publication Type:
    Case Reports; Journal Article
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Country of Publication: England NLM ID: 8704308 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-2710 (Electronic) Linking ISSN: 02694727 NLM ISO Abbreviation: J Clin Pharm Ther Subsets: MEDLINE
    • Publication Information:
      Publication: Oxford : Wiley-Blackwell Pub.
      Original Publication: Oxford : Blackwell Scientific Publications, c1987-
    • Subject Terms:
      Acidosis/*blood ; Acidosis/*chemically induced ; Benzoates/*adverse effects ; Chlorine/*blood ; Iron Chelating Agents/*adverse effects ; Triazoles/*adverse effects; Acidosis, Renal Tubular/chemically induced ; Acidosis, Renal Tubular/metabolism ; Adolescent ; Benzoates/therapeutic use ; Deferasirox ; Female ; Humans ; Iron Chelating Agents/therapeutic use ; Triazoles/therapeutic use ; beta-Thalassemia/blood ; beta-Thalassemia/drug therapy
    • Abstract:
      What Is Known and Objective: Deferasirox is a new treatment of iron overload that is administered orally once-a-day, resulting in better acceptance in patients. Deferasirox-induced renal tubular dysfunction has been reported on very rare occasions.
      Case Summary: A 17-year-old adolescent with β-thalassaemia on deferasirox 30 mg/kg daily presented with isolated hyperchloraemic metabolic acidosis (bicarbonate 12·9 mM, sodium 137 mM, chloride 111 mM, potassium 3·6 mM). Acidosis resolved after withdrawing deferasirox. Naranjo adverse drug reaction scale suggested that the likelihood that deferasirox was responsible for acidosis was probable. Eight cases of metabolic acidosis have been reported in patients treated with deferasirox. In most cases, acidosis was associated with further features of renal tubular dysfunction.
      What Is New and Conclusion: We describe herein a case of metabolic acidosis in the setting of treatment with the deferasirox. Our case and the literature indicate a potential risk of kidney toxicity on this agent.
      (© 2013 John Wiley & Sons Ltd.)
    • Contributed Indexing:
      Keywords: adverse effects; deferasirox; metabolic acidosis
    • Accession Number:
      0 (Benzoates)
      0 (Iron Chelating Agents)
      0 (Triazoles)
      4R7X1O2820 (Chlorine)
      V8G4MOF2V9 (Deferasirox)
    • Publication Date:
      Date Created: 20130829 Date Completed: 20141021 Latest Revision: 20181202
    • Publication Date:
      20250114
    • Accession Number:
      10.1111/jcpt.12095
    • Accession Number:
      23981248