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Heavy metal levels in patients with ineffective erythropoiesis
Authors:Turan Bayhan  Şule Ünal  Eyüp Çırak  Onur Erdem  Cemal Akay  Orhan Gürsel  İbrahim Eker  Erdem Karabulut  Fatma Gümrük
Affiliation:1. Department of Pediatric Hematology, Hacettepe University, Ankara 06100, Turkey;2. Department of Toxicology, Gulhane Military Medical Academy, Ankara 06010, Turkey;3. Department of Pediatric Hematology, Gulhane Military Medical Academy, Ankara 06010, Turkey;4. Department of Biostatistics, Hacettepe University, Ankara, Turkey
Abstract:

Objectives

Iron is taken into enterocytes at the duodenum via apical divalent metal-ion transporter 1 protein. Besides iron, divalent metal-ion transporter 1 also transports other divalent metals. We aimed to investigate blood heavy metal levels in patients with ineffective erythropoiesis.

Methods

Blood levels of heavy metals including Pb, Al, Cd, Cr, Co, Cu, and Zn were measured in patients with thalassemia major (TM), thalassemia intermedia (TI), congenital dyserythropoietic anemia (CDA), and age- and sex-matched healthy controls.

Results

Blood samples were obtained from 68 patients (51 patients with TM, 8 with TI, 9 with CDA), and a control group that included 65 volunteers. Patients with TM were found to have lower Al, Pb, and Zn, and higher Cd levels compared with the control group. The patients treated with deferasirox were further analyzed and Pb and Zn levels were found lower compared with the control group.

Discussion

Patients with TM had tendency to have elevated levels of plasma cadmium; however, the median level was not at a toxic level. Increased metal-ion transporter 1 activity may cause heavy metal accumulation, but deferasirox chelation may be protective against heavy metals besides iron.
Keywords:CDA  congenital dyserythropoietic anemia  DMT1  divalent metallo protein 1  GI  gastrointestinal  IE  ineffective erythropoiesis  TI  thalassemia intermedia  TM  thalassemia major  Cadmium  Heavy metals  Ineffective erythropoiesis  Thalassemia
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