Abstract

The accumulation of aluminum in the tissue, as a causative factor of encephalopathy and osteomalacia, is a serious problem in managing patients undergoing hemodialysis (HD) for a long term. In recent years, there have been some reports, supporting the effectiveness of Desferrioxamine (DFO). However, the doses of administration have not defined as yet. This paper is a case report that a patient, probably suffering from aluminum osteomalacia, was successively treated by both the infusion of DFO and protein leaking hemodialyzer (PLHD). Case; 24 years old female. She was first treated by HD in Mar. 1978 and well maintained for 5 years until 1983 when she began to complain of bone pain. In Feb. 1984, her left humerus was fractured, followed by right femur fracture 3 months later. She was managed by conventional treatment, but the course was unsatisfactory. From Oct. 1984, she was treated by DFO (1000mg) and PLHD (5 hours). Serum levels of aluminum increased 7.20±1.8 times as compared with pretreatment levels and the amounts of removal by PLHD was 71.7±5.3% (N=11). The decrease of serum aluminum level was noted 4 months after the initiation of treatment. Clinically, bone pain was disappered 1 month later and she could ambulate from Dec. 1985. As for serum level of Fe and ferritin, the level of ferritin was decreased slightly by PLHD. In conclusion, the infusion of DFO in combination with PLHD was effective against aluminum osteomalacia.