Question of the Week

Question :

Posted On : 01 Feb 2007

I have a few patients with cardiomyopathy secondary to cardiac siderosis {B thal patients}. I am planning to start them on continuous infusion of desferral since they are in heart failure. What would be the method to do that?

Expert Answer :

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Answer Discussion :

pediatriconcall

Deferoxamine 25-50 mg-kg over 8-12 hours as a subcutaneous infusion at least 5 nights per week is recommended. 2.5-3.0 gm is probably the maximal tolerated amount for subcutaneous infusion. Each 500 mg of Desferral should be diluted in a minimum of 2 ml preservative free water. DF should be given in areas with the most subcutaneous fat, such as the abdomen, thighs, upper arms, or buttocks. Infusion sites should be rotated to a different place each day. To avoid bone infections, thin individuals should avoid inserting the needle near bony prominences. The infusion needle should be inserted at a 45 degree angle.

Vitamin C {ascorbic acid} mobilizes iron from tissues. Doses More than 500 mg-day have been associated with worsening of cardiac dysfunction in patients with severe iron overload.
For heart involvement, intravenous desferral is recommended in the dose of 50mg-kg-day diluted in 50 cc normal saline given over 8 hours. Also give zinc and pyridoxien when giving desferral.

18 years ago

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