Iron medication-induced gastric mucosal injury

Zhang, Xuchen; Ouyang, Jie; Wieczorek, Rosemary; Desoto, Fidelina

doi:10.1016/j.prp.2008.12.013

Cited by 29 publications

(29 citation statements)

References 10 publications

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“… 11 , 12 However, therapeutic doses of ferrous salts have been shown to cause severe gastric and esophageal injury. 13 – 15 In IBD patients, FS has been shown to worsen the inflammatory state in the colon 16 and has been suggested to trigger ulcerative colitis. 17 Similarly, FF has been shown to worsen the symptoms in patients affected by Crohn’s disease.…”

Section: Introductionmentioning

confidence: 99%

Ferrous sulfate, but not iron polymaltose complex, aggravates local and systemic inflammation and oxidative stress in dextran sodium sulfate-induced colitis in rats

Toblli¹,

Cao²,

Angerosa³

2015

DDDT

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Background and aimsIron deficiency is common in inflammatory bowel disease, yet oral iron therapy may worsen the disease symptoms and increase systemic and local oxidative stress. The aim of this study was to compare the effects of oral ferrous sulfate and iron polymaltose complex on inflammatory and oxidative stress markers in colitic rats.MethodsAnimals were divided into four groups with ten animals each. Rats of three groups received dextran sodium sulfate to induce colitis and animals of two of these groups received 5 mg iron/kg of body weight a day, as ferrous sulfate or iron polymaltose complex, for 7 days. Gross colon anatomy, histology of colon and liver, stainings of L-ferritin, Prussian blue, hepcidin, tumor necrosis factor-α, and interleukin-6, as well serum levels of liver enzymes, inflammatory markers, and iron markers, were assessed.ResultsBody weight, gross anatomy, crypt injury and inflammation scores, inflammatory parameters in liver and colon, as well as serum and liver hepcidin levels were not significantly different between colitic animals without iron treatment and colitic animals treated with iron polymaltose complex. In contrast, ferrous sulfate treatment caused significant worsening of these parameters. As opposed to ferrous sulfate, iron polymaltose complex caused less or no additional oxidative stress in the colon and liver compared to colitic animals without iron treatment.ConclusionIron polymaltose complex had negligible effects on colonic tissue erosion, local or systemic oxidative stress, and local or systemic inflammation, even at high therapeutic doses, and may thus represent a valuable oral treatment of iron deficiency in inflammatory bowel disease.

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Section: Introductionmentioning

confidence: 99%

Ferrous sulfate, but not iron polymaltose complex, aggravates local and systemic inflammation and oxidative stress in dextran sodium sulfate-induced colitis in rats

Toblli¹,

Cao²,

Angerosa³

2015

DDDT

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“… 4 , 6 , 8 , 14 The corrosive nature of iron can lead to hemorrhagic necrosis, ulceration and even perforation resulting in shock from hemorrhage and fluid loss. 4 , 6 , 8 , 17 In addition, iron can cause mucosal injury in the form of epithelial distortion and ischemia. 6 The ischemia has been found to occur due to submucosal venous thrombosis.…”

Section: Resultsmentioning

confidence: 99%

“… 6 The ischemia has been found to occur due to submucosal venous thrombosis. 4 , 8 The iron, in these cases, deposits in necrotic membranes, blood vessels and within thrombi. 6 , 8 Reissman et al 17 found that in their study of iron toxicity in a dog model, there was less necrosis found in the intestinal membranes as compared to prior studies of children who ingested toxic doses.…”

Section: Resultsmentioning

confidence: 99%

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Gastric siderosis: An under-recognized and rare clinical entity

et al. 2016

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The increased deposition of iron in gastric mucosa is known as gastric siderosis. It is believed that the only regulated step of the iron metabolism cycle occurs during absorption in the small intestine. Once this system becomes overwhelmed due to either local or widespread iron levels, then iron can be absorbed very quickly by a passive concentration-dependent mechanism. This excess iron is initially stored in the liver but later can be found in the pancreas, heart and joints. Excess iron is not expected to deposit in the gastric mucosa. This gastric deposition has been found in association with hemochromatosis, oral iron medications, alcohol abuse, blood transfusions, hepatic cirrhosis and spontaneous portacaval shunt with esophageal varices. The precise mechanism of this iron deposition in gastric epithelial and stromal cells is still not well understood; thus, identification of iron in gastric mucosa raises many questions. On histology, the pattern of deposition is variable, and recognition of the pattern is often useful to choose the appropriate workup for the patient and to diagnose and possibly treat the cause of iron overload. In this article, we have described a well-referenced review of this rare clinical entity with different histological patterns, diagnostic tests and the clinical significance of the different patterns of iron deposition.

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“…26 However, gastrointestinal diseases, including mucosal necrosis, ulceration, and gastric erosive injury, following iron overdose have been reported. [27][28][29][30] In addition, gastrointestinal disorder, which is a common syndrome in patients with CKD on hemodialysis, 31 leads to decreased physiological function of the gastrointestinal tract. Subcutaneous sesame oil was both prophylactic and therapeutic for iron intoxication in mice.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic and Therapeutic Effects of a Subcutaneous Injection of Sesame Oil Against Iron‐Induced Acute Renal Injury in Mice

Chien

Chu

et al. 2011

J Parenter Enteral Nutr

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Background: Iron intoxication causes acute nephrotoxicity in animals and humans. Sesame oil, a healthful food, increases resistance to lipid peroxidation and protects against multiple organ injury in various animal models. The authors examined the prophylactic and therapeutic effects of a subcutaneous injection of sesame oil against iron‐induced acute renal injury in mice. Methods: Iron intoxication in mice was induced with an intraperitoneal injection (2 mg/kg) of ferric‐nitrilotriacetate (Fe‐NTA). Various doses of sesame oil (0, 1, 2, and 4 mL/kg, subcutaneously) were given immediately after (prophylactic) or 30 minutes after (therapeutic) the Fe‐NTA injection. Renal injury was assessed by the rise in serum blood urea nitrogen (BUN) and creatinine (CRE) levels 3 hours after the Fe‐NTA injection. Results: One hour after the Fe‐NTA injection, serum BUN and CRE levels were significantly higher in Fe‐NTA‐treated mice than in saline‐treated controls; 3 and 6 hours after the Fe‐NTA injection, they were dose‐dependently and significantly lower in all sesame oil–treated groups than in the group treated only with Fe‐NTA and saline. Conclusion: A subcutaneous injection of sesame oil had both prophylactic and therapeutic effects against iron‐induced acute renal injury in mice.

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Iron medication-induced gastric mucosal injury

Cited by 29 publications

References 10 publications

Ferrous sulfate, but not iron polymaltose complex, aggravates local and systemic inflammation and oxidative stress in dextran sodium sulfate-induced colitis in rats

Ferrous sulfate, but not iron polymaltose complex, aggravates local and systemic inflammation and oxidative stress in dextran sodium sulfate-induced colitis in rats

Gastric siderosis: An under-recognized and rare clinical entity

Prophylactic and Therapeutic Effects of a Subcutaneous Injection of Sesame Oil Against Iron‐Induced Acute Renal Injury in Mice

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