DEFEROXAMINE-INDNCED PLATYSPONDYLY IN HYPERTRANSFUSED THALASSEMIC PATIENTS

Deferoxamine chelation therapy (widely used to reduce iron overload in hypertransfused thalassemic patients) has been implicated in causing skeletal growth abnormalities (rachitic-like changes in the long bones and vertebral body flattening), particularly when used in early infan cy and at high dose levels. Radiographs of seven hypertransfused and w ell-chelated patients with thalassemia were reviewed. For two patients , serial films of the spine from the early 1970s to the present reveal ed a sequence of changes in the vertebral bodies, beginning with norma l bodies that became bulbous and subsequently flattened, These two pat ients had begun deferoxamine chelation therapy early in infancy. The b one changes, though slightly reminiscent of post-radiation changes, ar e milder and result in a final Scheuermann-like picture.