Intravenous infusions of deferoxamine mesylate may be associated with a pulmonary syndrome with features of a hypersensitivity pneumonitis.


Patient selection: continuous intravenous infusion of deferoxamine mesylate


Onset 5 to 10 days after starting the infusion


Clinical findings:

(1) tachypnea

(2) hypoxemia

(3) restrictive pulmonary function pattern

(4) potentially respiratory failure


Imaging studies:

(1) diffuse interstitial pattern


Lung biopsy:

(1) diffuse alveolar damage

(2) interstitial inflammation with eosinophils, mast cells and lymphocytes

(3) interstitial fibrosis


The diagnosis is supported by:

(1) exclusion of other causes (pulmonary hypertension, infection, etc)

(2) resolution upon discontinuation of the infusion (although this may take time)

(3) relapse on re-exposure

(4) The condition is reported to be dose-dependent.


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