Hemosiderosis In Patients Research Articles

Urinary neutrophil gelatinase-associated lipocalin—an early biomarker for renal injury in patients with beta-thalassemia major

INTRODUCTION : The iron overload and the development of secondary hemosiderosis in patients with β-thalassemia major (β-TM) lead to organ damages, including kidney disorders from early childhood. Contemporary urinary markers such as neutrophil gelatinase-association lipocalin (NGAL), β2-microglobulin (β2-MG), and N-acetyl-β-D-glucosaminidase (NAG) could be a useful tool for clinicians in diagnosis of early tubular lesions. AIM : The aim of this article is to make an assessment of contemporary urine biomarkers β2-microglobulin, neutrophil gelatinase-associated lipocalin, and N-acetyl-beta-D-glucosaminidase in the diagnosis of early renal injury in patients with β-TM. MATERIALS AND METHODS : The current study was conducted by examining 44 patients with β-thalassemia major and 30 controls. All participants were tested for NGAL, β2-MG, and NAG in the first sample morning urine using ELISA method. RESULTS : The results show statistically significant differences between the two examined groups in urinary NGAL. CONCLUSION : Urinary NGAL indicates subclinical kidney injury when the tubular reabsorption of molecules is impaired.

Anatomical hemispherectomy revisited-outcome, blood loss, hydrocephalus, and absence of chronic hemosiderosis.

To evaluate microsurgical trans-sylvian trans-ventricular anatomical hemispherectomy with regard to seizure outcome, risk of hydrocephalus, blood loss, and risk of chronic hemosiderosis in patients with intractable seizures selected for surgery using current preoperative assessment techniques. Out of 86 patients who underwent hemispherectomy between February 2000 and April 2019, by a single surgeon, at a tertiary care referral center, 77 patients (ages 0.2-20years; 40 females) who had an anatomical hemispherectomy were analyzed. Five of these were 'palliative' surgeries. One-stage anatomical hemispherectomy was performed in 55 children, two-stage anatomical hemispherectomy after extraoperative intracranial monitoring in 16, and six hemispherectomies were done following failed previous resection. Mean follow-up duration was 5.7years (range 1-16.84years). Forty-six patients had postoperative MRI scans. Ninety percent of children with non-palliative hemispherectomy achieved ILAE Class-1 outcome. Twenty-seven patients were no longer taking anticonvulsant medications. Surgical failures (n = 4) included one patient with previous meningoencephalitis, one with anti-GAD antibody encephalitis, one with idiopathic neonatal thalamic hemorrhage, and one with extensive tuberous sclerosis. There were no failures among patients with malformations of cortical development. Estimated average blood loss during surgery was 387ml. Ten (21%) children developed hydrocephalus and required a shunt following one-stage hemispherectomy, whereas 10 (50%) patients developed hydrocephalus among those who had extraoperative intracranial monitoring. Only 20% of the shunts malfunctioned in the first year. Early malfunctions were related to the valve and later to fracture disconnection of the shunt. One patent had a traumatic subdural hematoma. None of the patients developed clinical signs of chronic 'superficial cerebral hemosiderosis' nor was there evidence of radiologically persistent chronic hemosiderosis in patients who had postoperative MRI imaging. Surgical results of anatomical hemispherectomy are excellent in carefully selected cases. Post-operative complications of hydrocephalus and intraoperative blood loss are comparable to those reported for hemispheric disconnective surgery (hemispherotomy). The rate of shunt malfunction was less than that reported for patients with hydrocephalus of other etiologies Absence of chronic 'superficial hemosiderosis', even on long-term follow-up, suggests that anatomical hemispherectomy should be revisited as a viable option in patients with intractable seizures and altered anatomy such as in malformations of cortical development, a group that has a reported high rate of seizure recurrence related to incomplete disconnection following hemispheric disconnective surgery.

Functional iron deficiency in patients on hemodialysis: prevalence, nutritional assessment, and biomarkers of oxidative stress and inflammation

Introduction:Anemic patients with chronic kidney disease (CKD) can be divided into anemic patients without or with functional iron deficiency (FID). The increase in the number of cases of hemosiderosis in patients on hemodialysis (HD) attributed to excessive intravenous iron replacement has called for the investigation of the factors involved in the genesis of FID.Objectives:This study aimed to describe the prevalence of FID in patients with CKD on HD, characterize the included individuals in terms of clinical and workup parameters, and assess their nutritional, oxidative stress, and inflammation statuses. This cross-sectional study assembled a convenience sample of 183 patients with CKD on HD treated in Southern Brazil. Patients meeting the inclusion and exclusion criteria were divided into two groups, one with anemic subjects with FID and one with anemic patients without FID. Participants answered a questionnaire probing into socio-epidemiological factors, underwent anthropometric measurements, and were tested for markers of anemia, oxidative stress, inflammation, and nutrition.Statistical analysis:The date sets were treated on software package GraphPad InStat version 3.1. Variables were tested with the Kolmogorov-Smirnov, chi-square, Student’s t, and Mann-Whitney tests. Statistical significance was attributed to differences with a p < 0.05.Results:Markers of inflammation were not statistically different between the two groups. Markers of anemia and nutrition were significantly lower in patients with FID. Patients with FID were prescribed higher doses of parenteral iron (p < 0,05).Discussion:FID was associated with lower nutritional marker levels, but not to increased levels of markers of inflammation or oxidative stress, as reported in the literature. Additional studies on the subject are needed.

Iron overload in patients with myelodysplastic syndromes: An updated overview.

Myelodysplastic syndromes (MDS) encompass a heterogeneous group of clonal hematopoietic stem cell disorders characterized by a broad clinical spectrum related to ineffective hematopoiesis leading to unilineage or multilineage cytopenias, with a high propensity for transformation to acute myeloid leukemia. Iron overload has been recently identified as one of the important conditions complicating the management of these diverse disorders. The accumulation of iron is mainly related to chronic transfusions; however, evidence suggests a possible role for ineffective erythropoiesis and increased intestinal absorption of iron, related to altered hepcidin and growth differentiation factor-15 levels in the development of hemosiderosis in patients with MDS. In addition to its suggested role in the exacerbation of ineffective erythropoiesis, multiple reports have identified a prognostic implication for the development of iron overload in patients with MDS, with an improvement in overall survival after the initiation of iron chelation therapy. This review includes a detailed discussion of iron overload in patients with MDS whether they are undergoing supportive therapy or curative hematopoietic stem cell transplantation, with a focus on the mechanism, diagnosis, and effect on survival as well as the optimal management of this highly variable complication.

Incidents Caused by Hemosiderosis in Patients with Hematologic Diseases: Results from the Spanish Haemovigilance System at National and Regional Level (Andalusia)

Incidents Caused by Hemosiderosis in Patients with Hematologic Diseases: Results from the Spanish Haemovigilance System at National and Regional Level (Andalusia)

Screening for hemosiderosis in patients receiving multiple red blood cell transfusions.

The dramatic impact of hemosiderosis on survival in chronically transfused patients with hereditary anemia is well known. We evaluated whether patients receiving multiple red blood cell (RBC) transfusions are adequately screened for hemosiderosis. We retrospectively assessed hemosiderosis screening and prevalence in adult patients that received over twenty RBC units in the University Medical Centre Utrecht from 2010 till 2015. Hemosiderosis was defined as ferritin ≥1000μg/L. Adequate screening for chronically transfused patients was defined as any ferritin determined up to 3months before or any moment after the last transfusion, while for patients that received all transfusions within 3months (bulk transfusion), ferritin had to be determined after at least twenty transfusions. Of 471 patients, only 38.6% was adequately screened and hemosiderosis prevalence was 46.7%. Hemosiderosis prevalence was 47% in the chronic transfusion group and 12% in the bulk transfusion group. In patients transfused because of hematological malignancy or cardiothoracic surgery, respectively, 74% and 31% were adequately screened and hemosiderosis prevalence was 53% and 13%, respectively. Hemosiderosis screening in our routine practice is suboptimal. Hemosiderosis is not an exclusive complication of multiple transfusions in the hematology ward. We recommend screening for hemosiderosis in all patients receiving multiple transfusions.

Profile of deferasirox for the treatment of patients with non-transfusion-dependent thalassemia syndromes.

It has been clearly shown that iron overload adds progressively significant morbidity and mortality in patients with non-transfusion-dependent thalassemia (NTDT). The lack of physiological mechanisms to eliminate the excess of iron requires effective iron chelation therapy. The reduced compliance to deferoxamine and the risk of severe hematological adverse events during deferiprone treatment have limited the use of both these drugs to correct iron imbalance in NTDT. According to the principles of evidence-based medicine, following the demonstration of the effectiveness and the safety of deferasirox (Exjade®) in a prospective, randomized, controlled trial, deferasirox was approved by the US Food and Drug Administration in May 2013 for the treatment of iron overload associated with NTDT. This review, assessing the available scientific literature, will focus on the profile of DFX in the treatment of non-transfusional hemosiderosis in patients with NTDT.

384 B-type natriuretic peptide plasma levels is a good marker in estimating cardiac hemosiderosis in patients with β-thalassemia major

384 B-type natriuretic peptide plasma levels is a good marker in estimating cardiac hemosiderosis in patients with β-thalassemia major

CT Finding of Transfusional Hemosiderosis in Patients with Chronic Renal Failure: Clinical Correlation

CT Finding of Transfusional Hemosiderosis in Patients with Chronic Renal Failure: Clinical Correlation

Iron burden in sickle cell anemia

Total body iron burden was estimated by two indirect methods in 23 patients with sickle cell anemia. Concentrations of serum ferritin correlated directly and significantly with age of the patients. Eleven of 15 patients under 20 years of age had normal levels of serum ferritin. Deferoxamine-induced urinary excretion of iron was considerably less than that reported in patients with thalassemia major who were receiving regular blood transfusions. These data imply that patients with sickle cell anemia generally do not acquire excessive iron burdens during the first two decades of life. The risks of transfusional hemosiderosis in patients with sickle cell anemia who are included in hypertransfusion programs are discussed.

Renal hemosiderosis in patients with prosthetic aortic valves.

Seven patients with prosthetic aortic valves and anemia are described. In six, the Teflon valves had become incompetent as a result of perforations or tears in the prosthetic cusps, and in the seventh the valve was severely stenotic as well as regurgitant. The anemia in each patient was secondary to intravascular hemolysis resulting from damage to the erythrocytes traversing the malfunctioning valve. Severe renal hemosiderosis, the anatomic indicator of severe intravascular hemolysis, was present in each patient. Although deposits of iron in the kidney in these circumstances may be extreme, no significant renal damage nor impairment of renal function appears to occur as a result of this deposition.

Effect of magnesium sulfate on the alterations in renal dynamics induced by intravenous hemoglobin.

ArticleEffect of Magnesium Sulfate on the Alterations in Renal Dynamics Induced by Intravenous HemoglobinWilliam J. A. Demaria, and Jerome S. HarrisWilliam J. A. DemariaFrom the Departments of Pediatrics and of Biochemistry, Duke University School of Medicine, Durham, North Carolina, and Jerome S. HarrisFrom the Departments of Pediatrics and of Biochemistry, Duke University School of Medicine, Durham, North CarolinaPublished Online:01 Aug 1955https://doi.org/10.1152/ajplegacy.1955.182.2.251MoreSectionsPDF (869 KB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Previous Back to Top Next Download PDF FiguresReferencesRelatedInformation Cited BySevere falciparum malariaTransactions of the Royal Society of Tropical Medicine and Hygiene, Vol. 94Severe and complicated malariaTransactions of the Royal Society of Tropical Medicine and Hygiene, Vol. 84A rapid renal clearance methodology for dextranKidney International, Vol. 31, No. 3The effects of aortic infusion of ethylene oxide on renal function in the ratToxicology and Applied Pharmacology, Vol. 38, No. 2Magnesium metabolismMagnesium metabolism2 December 2007 | Ergebnisse der Physiologie Biologischen Chemie und Experimentellen Pharmakologie, Vol. 59, No. 1Renal Hemosiderosis in Patients with Prosthetic Aortic ValvesCirculation, Vol. 33, No. 3Acute Renal FailurePediatric Clinics of North America, Vol. 9, No. 1Acute Renal FailureNew England Journal of Medicine, Vol. 262, No. 14Die Myoglobinurien More from this issue > Volume 182Issue 2August 1955Pages 251-255 Copyright & PermissionsCopyright © 1955 by American Physiological Societyhttps://doi.org/10.1152/ajplegacy.1955.182.2.251PubMed13258796History Received 28 February 1955 Published online 1 August 1955 Published in print 1 August 1955 Metrics