Abstract
Ten patients with active rheumatoid arthritis were given a total dose infusion of iron dextran for anaemia. One had an immediate anaphylactoid reaction; the other nine had a brief exacerbation of arthralgia and joint dysfunction of up to seven days' duration. The erythrocyte sedimentation rate rose by an average of 23 mm. in one hour (Westergren), but this often took longer than seven days to settle to the preinfusion level.
It is suggested that this response is probably not due to an exacerbation of rheumatoid arthritis but to a delayed hypersensitivity reaction to the dextran portion of the iron dextran complex. This treatment is potentially dangerous in rheumatoid arthritis; we recommend a preliminary test dose and that the infusion be started very slowly under supervision.
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Selected References
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- Brisman R., Parks L. C., Haller J. A., Jr Anaphylactoid reactions associated with the clinical use of dextran 70. JAMA. 1968 May 27;204(9):824–825. [PubMed] [Google Scholar]
- CLAY B., ROSENBERG B., SAMPSON N., SAMUELS S. I. REACTIONS TO TOTAL DOSE INTRAVENOUS INFUSION OF IRON DEXTRAN (IMFERON). Br Med J. 1965 Jan 2;1(5426):29–31. doi: 10.1136/bmj.1.5426.29. [DOI] [PMC free article] [PubMed] [Google Scholar]
- GETZEN J. H., SPEIGGLE W. ANAPHYLACTIC REACTION TO DEXTRAN. A CASE REPORT. Arch Intern Med. 1963 Aug;112:168–170. doi: 10.1001/archinte.1963.03860020066006. [DOI] [PubMed] [Google Scholar]
- Groden B. M., Whitelaw J., Will G. The treatment of iron-deficiency anaemia by iron-dextran infusion, with special reference to the effect on blood-grouping, coagulation, sedimentation and haemolysis. Postgrad Med J. 1968 Jun;44(512):433–437. doi: 10.1136/pgmj.44.512.433. [DOI] [PMC free article] [PubMed] [Google Scholar]
- KABAT E. A., BERG D. Dextran; an antigen in man. J Immunol. 1953 Jun;70(6):514–532. [PubMed] [Google Scholar]
- KABAT E. A., TURINO G. M., TARROW A. B., MAURER P. H. Studies on the immunochemical basis of allergic reactions to dextran in man. J Clin Invest. 1957 Jul;36(7):1160–1170. doi: 10.1172/JCI103512. [DOI] [PMC free article] [PubMed] [Google Scholar]
- MAURER P. H. Dextran, an antigen in man. Proc Soc Exp Biol Med. 1953 Aug-Sep;83(4):879–884. doi: 10.3181/00379727-83-20521. [DOI] [PubMed] [Google Scholar]
- Mehta B. C., Patel J. C. Iron-dextran. Total dose infusion in the treatment of iron deficiency anemia. Indian J Med Sci. 1968 Jan;22(1):1–19. [PubMed] [Google Scholar]
- RICHMOND J., ROY L. M., DUTHIE J. J., GARDNER D. L., ALEXANDER W. R. Nature of anaemia in rheumatoid arthritis. IV. Effects of the intravenous administration of saccharated oxide of iron. Ann Rheum Dis. 1958 Dec;17(4):406–415. doi: 10.1136/ard.17.4.406. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reddy P. S., Lewis M. The adverse effect of intravenous iron-dextran in rheumatoid arthritis. Arthritis Rheum. 1969 Aug;12(4):454–457. doi: 10.1002/art.1780120413. [DOI] [PubMed] [Google Scholar]
- Ricketts C. R. Molecular composition of transfusion dextran. A report to the Medical Research Council's Blood Transfusion Research Committee. Br Med J. 1966 Dec 10;2(5527):1423–1426. doi: 10.1136/bmj.2.5527.1423. [DOI] [PMC free article] [PubMed] [Google Scholar]
- SHEPHARD D. A., VANDAM L. D. ANAPHYLAXIS ASSOCIATED WITH THE USE OF DEXTRAN. Anesthesiology. 1964 Mar-Apr;25:244–246. [PubMed] [Google Scholar]
- TARROW A. B., PULASKI E. J. Reactions in man from infusion with dextran. Anesthesiology. 1953 Jul;14(4):359–366. doi: 10.1097/00000542-195307000-00005. [DOI] [PubMed] [Google Scholar]
- TARROW A. B. The plasma volume expanders. Anesthesiology. 1955 Jul;16(4):598–605. doi: 10.1097/00000542-195507000-00015. [DOI] [PubMed] [Google Scholar]
- Thaman O. P., Dogra K. N. Total dose parenteral iron therapy in children. Indian J Pediatr. 1968 Jan;35(240):1–5. doi: 10.1007/BF02752982. [DOI] [PubMed] [Google Scholar]