Deferiprone
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Deferiprone Arthritis: 5 case reports Two boys and three women developed arthritis during treatment with oral deferiprone for transfusion-dependent thalassaemia [dosages not stated; not all outcomes stated]. These patients were retrospectively identified A 9-year-old boy developed arthritis involving both hips and knees after 1.2 years of deferiprone therapy. His rheumatoid factor level was elevated, and juvenile idiopathic arthritis was considered. Treatment with steroids was unsuccessful, but his arthritis resolved after deferiprone discontinuation and treatment was permanently switched to a different chelator. A 22-year-old woman presented with acute swelling of her right knee, pain and erythema after 6.5 years of deferiprone therapy. Septic arthritis was excluded following joint aspiration. Her symptoms improved after deferiprone cessation, and did not recur after its reintroduction. A 13-year-old boy presented with arthritis of his interphalangeal joints after 4.9 years of deferiprone therapy. The drug was withdrawn, and his symptoms improved. Deferiprone re-initiation was associated with arthritis involving his ankle joint, and the drugs was permanently replaced with a different chelating agent. A 26-year-old woman presented with pain and swelling of both knees and elbows after an unspecified duration of deferiprone therapy. Deferiprone was discontinued, and her pain improved. A 37-year-old woman presented with right ankle swelling after 1.7 years of deferiprone therapy. chronic inflammatory changes were evident on joint aspiration, and deferiprone was stopped. Her joint swelling improved, but symptoms recurred after deferiprone was restarted. Author comment: "[O]ur findings suggest a possible association of arthritis to deferiprone therapy." Jamuar SS, et al. Use of deferiprone for iron chelation in patients with transfusiondependent thalassaemia. Journal of Paediatrics and Child Health 47: 812-817, No. 11, Nov 2011. Available from: URL: http://dx.doi.org/10.1111/ 803066674 j.1440-1754.2011.02031.x - Singapore
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Reactions 4 Feb 2012 No. 1387
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