Chelation of gadolinium with deferoxamine in a patient with nephrogenic systemic fibrosis

Abstract

A 65-year-old female with biopsy-confirmed nephrogenic systemic fibrosis (NSF) received a kidney transplantation. Despite good kidney function, her symptoms continued to progress. Deferoxamine was administered intramuscularly at 500 mgday and later 1000 mgday after 1 week with no adverse effects. Urine excretion of gadolinium increased from 6.0 μgday to 11.6 μgday and subsequently to 13.0 μgday with 500 mgday and 1000 mgday of deferoxamine, respectively. Serum levels, however, remain unchanged from 1.7 ngml to 1.4 ngml. Although chelation therapy may have a role in the treatment of NSF, deferoxamine is too weak and a stronger chelator is needed. © The Author [2009].