Abstract
The patient was a 45-year-old woman who had received regular hemodialysis three times a week without any complications since April, 1976. In 1985, her condition gradually deteriorated with the development of speech disturbance, epileptic convulsion and encephalographic change. In March, 1985, she was admitted to our hospital in a semicomatose state. Brain CT revealed no organic change and her serum aluminum was elevated above 60μg/l. Combined treatment with desferrioxamine (1, 000mg/day), regular hemodialysis (5h/day) and plasma exchange (2, 600ml/day) was performed three times a week. The dialysis water supply in our unit had a low aluminum content of less than 10μg/l. After three sessions of this therapy, the convulsion attacks disappeared and the patient's mental status began to improve. We briefly discussed the effect of desferrioxamine on the kinetics of aluminum and emphasized the use of plasma exchange as an initial treatment in rapidly progressive cases such as this one.
