Improvement of microcytic
anemia after
deferoxamine treatment is described in eight long-term dialysis patients with high serum
aluminum concentration and other clinical signs of
aluminum toxicity. Hematocrit increase of 3 to 19 vol% was associated with correction of microcytosis, significant reduction in abnormal levels of free erythrocyte
protoporphyrins, and amelioration of the bone-related symptoms and
neurologic signs of
aluminum intoxication. Increase in hematocrit, reversal of microcytosis, and reduction in
protoporphyrin levels all correlated with the
aluminum burden as indicated by the pretreatment serum
aluminum levels and by the peak serum
aluminum levels during mobilization with
deferoxamine. Furthermore,
deferoxamine resulted in marked improvement in
anemia despite significant reduction in serum
ferritin levels. This reversal of microcytosis with
deferoxamine provides objective evidence verifying the toxicity of
aluminum, and suggests that microcytosis may be an easily detected marker for both clinical diagnosis as well as response to treatment in some cases of
aluminum intoxication.