The Measurement of Reticuloendothelial Iron Release using Iron–Dextran

Abstract

An index of reticuloendothelial cell release of iron for erythropoiesis can be derived from simultaneous measurements of iron—dextran and transferrin‐bound iron utilization. Reticuloendothelial iron release was found to be reduced in patients with Hodgkins disease, chronic renal failure and some cases of rheumatoid arthritis. It was increased in patients with iron deficiency.

Parenteral Iron: Pharmacology and Clinical Use

“…Extent and rate of response to intravenous iron in patients with progressive chronic renal failure may depend on the amount of residual glomerular filtration, and thus the responsiveness may diminish as the patients progressively loose renal function [12, 30]. In fact, continued administration of parenteral iron in some patients with advanced chronic renal failure may fail to increase their hematocrit [12], thereby risking iron overload.…”

“…Factors that determine the rate of release of iron-dextran from macrophages in patients with iron deficiency are not well known [9, 30, 35, 40, 41, 42]. Release of iron from macrophages slows after the initial 2–3 weeks following iron-dextran injection despite persistent anemia [9, 35].…”

“…The pharmacokinetics of parenteral iron was elucidated in studies that employed total-dose injections of 500 mg or greater of iron-dextran [2, 3, 9, 30, 35, 36, 39]. After intramuscular injection, mobilization of iron-dextran from the injection site is very slow [36].…”

“…(2) Since chronic renal failure may be a chronic ‘acute-phase state’ [29, 30], is iron release from macrophages to marrow considerably reduced as compared with normal renal function (masquerading as absolute iron deficiency) [30]? (3) Finally, is oral iron absorption increased by stimulated iron deficiency but then limited by the ceiling imposed by gastrointestinal regulation?…”

The usefulness of serum transferrin receptor and ferritin for assessing anemia in rheumatoid arthritis: comparison with bone marrow iron study

“…In chronic in¯ammatory diseases, iron retention is increased by the mononuclear phagocyte system [29,30] and iron utilization is impaired secondary to decreased iron uptake by erythroblasts [31]. As shown in Table 3, ESR was higher in the iron nondepleted subgroup than in``iron depleted.''…”