デフェロキサミンに関連した感音難聴の文献的考察

Abstract

Deferoxamine mesylate (DFO) has been used as an iron-chelating agent since the 1960s. In the 1980s, it was demonstrated that intensive high-dose chelation therapy can induce cochlear impairment or aural symptoms, although adverse effects from initial mild therapy were unclear. This article reviewed reports regarding DFO-associated hearing loss and the ototoxicity of DFO, and those written to alert the otolaryngologist.The incidence of DFO ototoxicity varied from 3.8 to 57%. The majority of the sensorineural hearing loss (SNHL) occurred at high frequencies similar to that of other ototoxic drugs. The audiometric threshold in some patients with severe SNHL exceeded 50 dB at all frequencies, indicating a ‘flat’ type of loss. The DFO-induced SNHL is, in most cases, accompanied by positive recruitment, and does not show any abnormality on ABR tests. However, the site of DFO activity in the auditory pathway remains controversial.There are only a few experimental studies regarding DFO ototoxicity available. The generation mechanism of DFO ototoxicity remains unclear because an animal model for ototoxicity has not yet been established. It is expected that an animal model of DFO ototoxicity will be established soon, allowing the mechanism to be elucidated.