Hypocalcemia complicating deferoxamine therapy in an infant with parenteral nutrition-associated aluminum overload: Evidence for a role of aluminum in the bone disease of infants

G. L. Klein, W. R. Snodgrass, M. P. Griffin, N. L. Miller, A. C. Alfrey

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Abstract

Aluminum (Al) contaminates total parenteral nutrition (TPN) solutions given to infants, and high levels of Al have been demonstrated in their bone, serum, and urine. However, it is uncertain whether Al at current levels of contamination of TPN solutions is harmful to bone. We report an 8-month-old infant who developed osteopenic bone disease while receiving TPN, which did not respond to large amounts of calcium, phosphate, and vitamin D2. Serum and urine Al levels were greatly elevated and fell after a short course of deferoxamine. However, shortly after treatment began, serum calcium levels fell in the absence of hypercalciuria. We postulate that chelation of Al from this patient's bone permitted increased bone calcium uptake. This would suggest that Al at current levels of contamination of TPN solutions may impair bone calcium uptake and thus contribute to the pathogenesis of exacerbation of TPN-related osteopenia.

Original languageEnglish (US)
Pages (from-to)400-403
Number of pages4
JournalJournal of Pediatric Gastroenterology and Nutrition
Volume9
Issue number3
StatePublished - 1989

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ASJC Scopus subject areas

  • Food Science
  • Medicine (miscellaneous)
  • Gastroenterology
  • Histology
  • Pediatrics, Perinatology, and Child Health

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