Perforated Duodenal Ulcer Associated with Deferasirox in a Child with β-Thalassemia Major

Abstract

The oral iron chelator, deferasirox (DFX), is commonly associated with mild gastrointestinal (GI) complaints, but GI hemorrhage and ulcers have occasionally been reported. However, perforated duodenal ulcer (PDU) has been previously reported in only one patient with β-thalassemia major (β-TM) on Exjade (DFXE). We hereby report the second case of a 5-year-old Syrian patient, who recently presented with PDU while on DFXE. She was not on any other ulcerogenic medication and was negative for H. pylori and Celiac disease. She had a surgical repair and has done well. She is back on DFX, but with the film-coated tablet, Jadenu or DFXJ. Perforated duodenal ulcer should be suspected in patients with severe GI symptoms, abdominal distension and tenderness while on DFXE, especially at high doses (30+ mg/kg).

Keywords:

• β-Thalassemia major (β-TM)
• deferasirox (DFX)
• duodenal ulcer
• iron overload

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.