Iron overload of spleen, liver and kidney as a consequence of hemolytic anaemia

Solecki, Rafał; Zglinicki, Th. v.; Müller, Hans‐Michael; Clausing, Peter

doi:10.1016/s0232-1513(83)80062-0

Cited by 12 publications

(7 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In contrast to iron deposition within the liver, spleen and pancreas, iron loading within the kidney depends almost entirely on cell free haemoglobin and haeme species, rather than on transfusional iron‐laden macrophages or labile plasma iron. Filtered haemoglobin binds to megalin and cubulin receptors and is taken up by endocytosis into the proximal and distal convoluted tubules of the kidney (Gburek et al , ), creating the classic cortical loading pattern observed by MRI (Solecki et al , ; Schein et al , ). In our cohort, kidney R2* correlated most strongly with LDH (positive association) and baseline haemoglobin level (negative).…”

Section: Discussionmentioning

confidence: 99%

Organ iron accumulation in chronically transfused children with sickle cell anaemia: baseline results from the TWiTCH trial

et al. 2015

View full text Add to dashboard Cite

Summary TCD (transcranial doppler) With Transfusions Changing to Hydroxyurea (TWiTCH) trial is a randomized, open-label comparison of hydroxycarbamide (also termed hydroxyurea) versus continued chronic transfusion therapy for primary stroke prevention in patients with sickle cell anaemia (SCA) and abnormal TCD. Severity and location of iron overload is an important secondary outcome measure. We report the baseline findings of abdominal organ iron burden in 121 participants. At enrolment, patients were young (9.8 ± 2.9 years), predominantly female (60:40), and previously treated with transfusions (4.1 ± 2.4 years) and iron chelation (3.1 ± 2.1 years). Liver iron concentration (LIC; 9.0 ± 6.6 mg/g dry weight) and serum ferritin were moderately elevated (2696 ± 1678 μg/l), but transferrin was incompletely saturated (47.2 ± 23.6%). Spleen R2* was 509 ± 399 Hz (splenic iron ∼13.9 mg/g) and correlated with LIC (r2 = 0.14, p=0.0008). Pancreas R2* was increased in 38.3% of patients but not to levels associated with endocrine toxicity. Kidney R2* was increased in 80.7% of patients; renal iron correlated with markers of intravascular haemolysis and was elevated in patients with increased urine albumin-creatinine ratios. Extra-hepatic iron deposition is common among children with SCA who receive chronic transfusions, and could potentiate oxidative stress caused by reperfusion injury and decellularized haemoglobin.

show abstract

Section: Discussionmentioning

confidence: 99%

Organ iron accumulation in chronically transfused children with sickle cell anaemia: baseline results from the TWiTCH trial

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Decellularized hemoglobin (also known as plasma free hemoglobin) is filtered at the glomerulus and actively taken up by megalin-cubulin receptors in the proximal and distal convoluted tubules[61]. This creates a characteristic cortical darkening on MRI images, with complete sparing of the medulla[62]. Global kidney R2* values can reach 200 Hz, with cortical values more than 1000 Hz, and are correlated with surrogates of hemolysis such as LDH[63].…”

Section: Measurement Of Non-hepatic Iron Storesmentioning

confidence: 99%

Use of Magnetic Resonance Imaging to Monitor Iron Overload

Wood

2014

Hematology/Oncology Clinics of North America

View full text Add to dashboard Cite

SYNOPSIS Treatment of iron overload requires robust estimates of total body iron burden and its response to iron chelation therapy. Compliance with chelation therapy varies considerably among patients and individual reporting is notoriously unreliable. Even with perfect compliance, intersubject variability in chelator effectiveness is extremely high, necessitating reliable iron estimates to guide dose titration. In addition, each chelator has a unique profile with respect to clearing iron stores from different organs. This chapter will present the tools available to clinicians monitoring their patients, focusing on non-invasive magnetic resonance imaging methods because they have become the de-facto standard of care.

show abstract

“…The kidney is another site of iron accumulation in SCD and thalassemia(8–10). Unlike in the other organs, it is unclear whether kidney iron results solely from intravascular hemolysis, chronic transfusion therapy, or both(10–13).…”

Section: Introductionmentioning

confidence: 99%

“…Unlike in the other organs, it is unclear whether kidney iron results solely from intravascular hemolysis, chronic transfusion therapy, or both(10–13). Further, while iron accumulation in the heart and liver is well known to lead to life-threatening complications such as cardiomyopathy and cirrhosis, the significance of iron in the kidney is poorly understood(2,8–10,14–20). …”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance detection of kidney iron deposition in sickle cell disease: A marker of chronic hemolysis

Schein

Enriquez

Coates

et al. 2008

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Purpose: To study the pattern, etiology, and significance of renal iron accumulation in chronically transfused sickle cell disease (SCD) and thalassemia major (TM) patients using magnetic resonance imaging (MRI). Materials and Methods:Magnetic resonance imaging (MRI) was performed in 75 SCD patients, 73 TM patients, and 16 healthy controls. Multiecho gradient echo protocols were used to measure T2* reciprocals (R2*) in the kidney, liver, and heart. Kidney R2* was compared to tissue iron estimates, serum iron markers, and surrogates of intravascular hemolysis by univariate regression.Results: Mean R2* in SCD patients was 55.3 Ϯ 45.3 Hz, compared with 22

show abstract

Iron overload of spleen, liver and kidney as a consequence of hemolytic anaemia

Cited by 12 publications

References 10 publications

Organ iron accumulation in chronically transfused children with sickle cell anaemia: baseline results from the TWiTCH trial

Organ iron accumulation in chronically transfused children with sickle cell anaemia: baseline results from the TWiTCH trial

Use of Magnetic Resonance Imaging to Monitor Iron Overload

Magnetic resonance detection of kidney iron deposition in sickle cell disease: A marker of chronic hemolysis

Contact Info

Product

Resources

About