PEDIATRICS Vol. 78 No. 4 October 1986, pp. 651-655
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Aluminum Intoxication in a Child: Treatment With lntraperitoneal Desferrioxamine

Bradley A. Warady MD1, Douglas M. Ford MD1, Charlotte E. Gaston RN1, Aileen B. Sedman MD1, William E. Huffer MD1, and Gary M. Lum MD1

1 From the Department of Pediatric Nephrology, Children's Mercy Hospital, Kansas City, Missouri, and the Department of Pediatrics, University of Colorado Health Sciences Center, Denver

We report the successful chelation of aluminum and the clinical resolution of severe aluminum intoxication in an infant receiving chronic peritoneal dialysis through the use of intraperitoneal desferrioxamme. Following the introduction of desferrioxamine, urine and dialysate fluid aluminum levels exceeded those noted without the chelating agent, thus demonstrating enhanced removal of aluminum. As a result of therapy, plasma and bone aluminum levels decreased markedly, and previously noted histomorphometric abnormalities on bone biopsy resolved. Clinically, the aluminum-associated osteomalacia and microcytic hypochromic anemia completely reversed. Moderate developmental delay has also improved slightly but persists. Our experience suggests that intraperitoneal chelation therapy with desferrioxamine may be helpful to reverse aluminum intoxication in children with chronic renal failure. However, limited exposure to aluminum should remain a primary goal.

Key Words: aluminum • chelation • desferrioxamine • peritoneal dialysis

Submitted on December 9, 1985
Accepted on March 18, 1986