Iron deficiency decreases hemolysis in sickle cell anemia

Castro, Oswaldo; Medina, Adriana; Gaskin, Peter; Kato, Gregory J.

doi:10.1590/s1516-84842009005000009

Cited by 5 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2009, Castro et al reported the case of a woman with SCA and longstanding iron deficiency secondary to gynecologic pathology. 53 Treatment with oral iron supplementation was followed by increases in hemoglobin levels, reticulocyte counts, mean corpuscular hemoglobin (MCH), and MCHC, but the patient also demonstrated evidence of markedly increased hemolysis. Specifically, she experienced a 370% increase in lactate dehydrogenase (LDH) levels, a 66% increase in bilirubin concentration, and a nearly 10% decrease in RBC count.…”

Section: Iron Deficiency and Iron Treatment In Patients With Scd-obse...mentioning

confidence: 99%

“…Following 6 weeks of oral iron therapy and a partial exchange transfusion, a marked increase in sickled cells (2.2%) was observed. In 2009, Castro et al reported the case of a woman with SCA and longstanding iron deficiency secondary to gynecologic pathology 53 . Treatment with oral iron supplementation was followed by increases in hemoglobin levels, reticulocyte counts, mean corpuscular hemoglobin (MCH), and MCHC, but the patient also demonstrated evidence of markedly increased hemolysis.…”

Section: Iron Deficiency and Iron Treatment In Patients With Scd—obse...mentioning

confidence: 99%

“…Given the above evidence, strategies that induce a state of relative iron deficiency in patients with SCD may be beneficial. Despite multiple calls for controlled trials to evaluate this hypothesis, 23,53,56 data are scant and published reports are only observational in nature. To date, the only mechanisms of iron restriction examined in humans have been phlebotomy and apheresis (automated RBC removal without replacement with normal RBCs).…”

Section: Induction Of Iron Restriction In Patients With Scdmentioning

confidence: 99%

See 2 more Smart Citations

Iron restriction in sickle cell disease: When less is more

Castro,

De Franceschi,

Ganz

et al. 2024

American J Hematol

Self Cite

View full text Add to dashboard Cite

Primum non nocere! Can iron deficiency, an abnormality that causes anemia, benefit people with sickle cell disease (SCD) who already have an anemia? The published literature we review appears to answer this question in the affirmative: basic science considerations, animal model experiments, and noncontrolled clinical observations all suggest a therapeutic potential of iron restriction in SCD. This is because SCD's clinical manifestations are ultimately attributable to the polymerization of hemoglobin S (HbS), a process strongly influenced by intracellular HbS concentration. Even small decrements in HbS concentration greatly reduce polymerization, and iron deficiency lowers erythrocyte hemoglobin concentration. Thus, iron deficiency could improve SCD by changing its clinical features to those of a more benign anemia (i.e., a condition with fewer or no vaso‐occlusive events). We propose that well‐designed clinical studies be implemented to definitively determine whether iron restriction is a safe and effective option in SCD. These investigations are particularly timely now that pharmacologic agents are being developed, which may directly reduce red cell hemoglobin concentrations without the need for phlebotomies to deplete total body iron.

show abstract

Section: Iron Deficiency and Iron Treatment In Patients With Scd-obse...mentioning

confidence: 99%

Section: Iron Deficiency and Iron Treatment In Patients With Scd—obse...mentioning

confidence: 99%

Section: Induction Of Iron Restriction In Patients With Scdmentioning

confidence: 99%

See 1 more Smart Citation