ARTHROPATHY IN THALASSEMIA PATIENTS RECEIVING DEFERIPRONE

The iron chelator deferiprone (L1) reduces tissue iron stores in iron- loaded patients. Three of sixteen patients treated with deferiprone de veloped joint pain and swelling without evidence of systemic lupus ery thematosus (SLE). Articular cartilage, synovial hypertrophy and iron d eposition, and synovial lining cell proliferation, with no inflammator y or allergic reaction, were observed on synovial exploration and biop sy. Symptoms resolved partly or completely during continued drug admin istration. We hypothesise that deferiprone-induced shifts of iron to s ynovium resulted in tissue damage, accelerated by free-radical formati on during incomplete complexation of iron and this bidentate chelator. This deferiprone-associated symptom complex is not associated with dr ug-induced SLE, and does not progress in severity during continued the rapy.