Iron Chelation in Transfusion-Dependent Thalassemia with Chronic Hepatitis

Abstract

In this study maximum urinary iron elimination with continuous desferrioxamine subcutaneous infusion was obtained in thalassemia major patients with chronic persistent or active hepatitis with lower doses (60 mg/kg) than those necessary in patients without hepatitis (80 mg/kg). Since dose-response curves were highly variable the treatment schedule should be tailored to the individual needs of each patient. Both groups may achieve iron balance but chronic hepatitis patients have more frequently a net urinary iron excretion. In patients with chronic hepatitis no correlation was found between serum ferritin levels or serum ferritin/aspartate aminotransferase ratios and transfusional iron overload while serum ferritin/aspartate aminotransferase ratios were seen to be correlated with liver iron stores.

Internal Distribution of Excess Iron and Sources of Serum Ferritin in Patients with Thalassaemia

“…In our group of subjects, the S-ferritin to ALT ratio was less useful than measurement of S-ferritin alone in evaluating the liver iron load. This seems to be not valid in patients who also have chronic hepatitis (De Virgiliis et al 1982). In these cases, liver biopsy with quantification of liver iron is probably necessary to reliable evaluate parenchymal iron overload.…”

Διερευνηση Παθογενειας Του Σακχαρωδη Διαβητη Σε Ατομα Πασχοντα Απο Ομοζυγη Β-Μεσογειακη Αναιμια

“…Η λεμφοκυττάρωση που μπορεί να παρατηρηθεί μετά σπληνεκτομή οφείλεται στην αύξηση των ωρίμων Β-λεμφοκυττάρων. Η διαταραχή του λόγου Τ4/Τ8 λόγω αύξησης των Τ8 και όχι ελάττωσης των Τ4 βοηθητικών κυττάρων κατά διαφόρους ερευνητάς δεν προκαλεί ιδιαίτερη επιρρέπεια σε λοιμώξεις [13], ενώ αντίθετα η σπληνεκτομή στους ίδιους ασθενείς με ομόζυγη β-μεσογειακή αναιμία τους καθιστά ευάλωτους σε λοιμώξεις [14,15,16]. χρησιμοποιηθεί και η S-φερριτίνη σαν δείκτης ιστικής φόρτισης σε Fe [18].…”