Vnitr Lek 1993, 39(5):459-463

[Aluminum osteopathy--experience with therapy].

S Sulková: Interní oddĕlení Strahov, I. LF UK, Praha.

The author discusses the problem of aluminium osteopathy as one of the clinical manifestations of aluminium intoxication in dialyzed patients. She describes the case-histories of three patients treated on account of aluminium intoxication with desferrioxamine. The disease was manifested by pain in the bones and joints and muscular weakness, in two patients also with symptoms of encephalopathy. The diagnosis was assessed only after a special examination of bone trepanobiopsy (staining with aurintricarboxyl acetic acid) and confirmed by assessment of the aluminium serum concentration. While treatment of the first patient in 1986 was not successful, in another two female patients it proved possible by combined treatment (desferrioxamine and haemofiltration treatment) to eliminate the aluminium from the organism and to improve the symptoms. At present no longer aluminium hydroxide is prescribed as a routine binding agent of phosphates in the digestive tract. Therefore cases of aluminium intoxication are rare. Nevertheless it is important to pay attention to the problem of aluminium accumulation as its early diagnosis facilitates treatment. In the author's opinion the method of choice for elimination of aluminium from the organism is one-line haemofiltration combined with desferrioxamine.