Noriyuki Iwamoto a , Toshihiko Ono a , Satoru Yamazaki a , Toyofumi Fukuda a , Morihiro Kondo a , Noriyuki Yamamoto a , Yasusuke Hiratake a , Yoshiko Masugi a , Yasunori Kubo a , Megumu Hino b , Chohei Shigeno b , Itsuo Yamamoto b
04 December 2008
We encountered 11 patients with aluminum-associated bone disease (AABD), and treated them with deferoxamine (DFO). In 3 patients, a second bone biopsy was done during DFO treatment. Clinical features of AABD were compared with surgically proven secondary hyperparathyroidism (2°HPT) with osteitis fibrosa on X-ray. Patients with AABD had disabling bone pain. This disease showed radiological signs ranging from normal, localized bone atrophy, to multiple fractures. It was characterized by increased soft tissue activity and localized abnormal uptake of <sup>99m</sup>Tc-MDP, detected by skeletal scintigrams. Patients with AABD had low levels of parathyroid hormone and alkaline phosphatase, but high aluminum (Al) levels compared to those with 2°ΗPT. Serum Al increased after DFO administration, and the patients improved both clinically and histologically. 1-α-Hydroxyvitamin D<sub>3</sub> (1-α-OH D<sub>3</sub>) was not effective for AABD. We concluded that the administration of antacids containing Al should be minimized in dialysis patients.