Specific iron chelating agent used in the treatment of hemochromatosis and acute iron poisoning.
General: anaphylactic shock
Respiratory: bronchospasm, hypersensitivity pneumonitis, laryngospasm.
Cutaneous: pruritus, urticaria.
Cutaneous testing: false positive.
No IgE antibodies excepted in lung biopsies.
Direct non-immunological activation of the dermal mast cells (subcutaneous route).
Numerous desensitization protocols have been published in adults and children; by intravenous or subcutaneous route.
For example in adults:
- Starting with a dose of 0.015 mg in 50 cc for 30 minutes, gradually increase (6 hours) to 1 500 mg in 50 cc for 30 minutes.
- Then administer 1 500 mg per day by continuous infusion for 4 days.
- Then 1 500 mg per 12 hours for 2 weeks.
- Finally, 1 500 mg every 2 days.
High dose intravenous deferoxamine delivery is highly effective, but can lead to severe hypersensitivity pneumonitis.
Other iron chelators (oral deferiprone) are under clinical evaluation.