Clinical Pharmacology and Therapeutics
Clinical Pharmacology and Therapeutics
5 years ago

A case of Fanconi syndrome due to a deferasirox overdose and a trial of plasmapheresis

A case of Fanconi syndrome due to a deferasirox overdose and a trial of plasmapheresis
L. Shah, J. J. Zaritsky, J. L. Powell
What is known and objective Deferasirox has nephrotoxic effects in the context of chronic therapy. This case report illustrates proximal tubular dysfunction (Fanconi syndrome) due to an acute deferasirox overdose. Case description In response, we trialled plasmapheresis to eliminate the drug. Deferasirox levels were obtained in the context of three rounds of plasmapheresis. Given the half-life model of decay, we concluded that plasmapheresis may not have been successful. The patient ultimately recovered normal tubular function after 2 months. What is new and conclusion This report is the first to describe acute deferasirox-induced nephrotoxicity, and the application of plasmapheresis that, ultimately, did not change the typical time to recovery. This case report illustrates proximal tubular dysfunction (Fanconi syndrome) due to an accidental acute deferasirox overdose. In response, we trialled plasmapheresis to eliminate the drug. Deferasirox levels were obtained in context of three rounds of plasmapheresis that demonstrated a half-life model of decay (R-squared of 0.9, P=.05). We, therefore, concluded that plasmapheresis may not have been successful. The patient ultimately recovered normal tubular function after two months.

Publisher URL: http://onlinelibrary.wiley.com/resolve/doi

DOI: 10.1111/jcpt.12553

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