Rapid excretion of gallium-67 isotope in an iron-overloaded patient receiving high-dose intravenous deferoxamine
A 23 year-old black male with homozygous sickle cell disease (Hb SS disease) and transfusional iron overload was admitted for evaluation of response to intravenous deferoxamine (DFO) therapy. Soon after admission, the patient suffered an intraventricular hemorrhage and during his subsequent hospitalization developed a persistent fever of undetermined origin (f.u.o.). Included in the diagnostic evaluation of fever was a gallium 67 scan (Ga-67), which was initially nondiagnostic because of Ga-67 citrate's preferential chelation by DFO. After DFO was discontinued, a repeat scan demonstrated a lesion above the left kidney. To our knowledge the unusual interaction in vivo of DFO with Ga-67 citrate has not been reported in the clinical literature. With the anticipated increased use of chelation therapy for patients with transfusional iron overload, this interaction may be encountered more frequently. DFO should be discontinued before the use of Ga-67 scanning in this clinical situation, or an alternative isotopic scan, such as indium-labelled white cells, should be considered.
- Research Organization:
- Children's Hospital of Philadelphia, PA (USA)
- OSTI ID:
- 6579696
- Journal Information:
- Am. J. Hematol.; (United States), Vol. 29:4, Issue 4
- Country of Publication:
- United States
- Language:
- English
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Related Subjects
62 RADIOLOGY AND NUCLEAR MEDICINE
DEFEROXAMINE
BIOCHEMICAL REACTION KINETICS
GALLIUM 67
METABOLISM
ANEMIAS
CITRATES
DATA COVARIANCES
FEVER
HEMORRHAGE
INTRAVENOUS INJECTION
IRON
PATIENTS
RADIOISOTOPE SCANNING
TRANSFUSIONS
AMINES
BETA DECAY RADIOISOTOPES
CARBOXYLIC ACID SALTS
CHELATING AGENTS
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
ELEMENTS
GALLIUM ISOTOPES
HEMIC DISEASES
INJECTION
INTAKE
INTERMEDIATE MASS NUCLEI
ISOTOPES
KINETICS
METALS
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
PATHOLOGICAL CHANGES
RADIOISOTOPES
REACTION KINETICS
SYMPTOMS
THERAPY
TRANSITION ELEMENTS
560161* - Radionuclide Effects
Kinetics
& Toxicology- Man
550601 - Medicine- Unsealed Radionuclides in Diagnostics