Evidence for the Role of Active Oxygen in Guanidine Synthesis in Haemodialysis Patients and In Vitro

This study clarifies the correlation between guanidino compoundsand other laboratory findings including peroxidative markersin the sera of patients undergoing regular haemodialysis. Theconcentration of guanidine, for example, correlates significantlywith iron, ferritin, and malondialdehyde. Guanidine is synthesizedfrom various guanidino compounds such as arginine, guanidinoaceticacid, creatinine, creatine, methylguanidine, guanidinosuccinicacid, and canavanine in vitro by the hydroxyl radical. Theseresults suggest that guanidine is synthesized as a result ofactive oxygen, and demonstrates the importance of guanidineas an indicator of the peroxidative state in patients with uraemia.     

Relationship between serum ferritin,alcohol intake,and social status in 2235 Danish men and women

 The objective was to examine the relationships between serum ferritin, alcohol intake, and socioeconomic factors (school education, occupational education, occupation, income, marital status, cohabitation status, housing, social class) in a population survey performed in Copenhagen County during 1982–1984. The participants were selected at random from the census register and comprised 2235 healthy Danish individuals, non-blood donors (1044 men, 1191 women) in cohorts being 30, 40, 50, and 60 years old. The participants gave a detailed social and medical history and had a clinical examination including blood samples. In all age-groups, men had significantly higher serum ferritin and alcohol intake than women. In men, there was no relationship between serum ferritin and social class. Significant relationships were observed between ferritin and occupation (unemployed and self-employed men had higher ferritin than those with other occupations) and ferritin and income (in younger men, ferritin displayed a steady increase with income). None of the social variables were related to the prevalence of iron deficiency or iron overload. Alcohol intake was related to occupation and income, but not to social class. In women, none of the social variables showed any significant relationship to ferritin levels or iron overload. The prevalence of small iron stores (serum ferritin ≤30 μg/l) was lower and the intake of alcohol was higher in women from high social classes. In both men and women, serum ferritin displayed highly significant positive correlations with alcohol intake. Likewise, the prevalence of iron overload (serum ferritin >90th percentile) was closely correlated to alcohol intake. In conclusion, socioeconomic factors per se had a minor influence on serum ferritin levels and iron status in Danes. The distinct association between alcohol intake and serum ferritin levels should be considered in future iron status surveys. Received: 24 July 1995 / Accepted: 13 December 1995     

Iron status in 268 Danish women aged 18–30 years: influence of menstruation, contraceptive method, and iron supplementation

 The aim of the present study was to evaluate the influence of menstruation, method of contraception, and iron supplementation on iron status in young Danish women, and to assess whether iron deficiency could be predicted from the pattern of menstruation. Iron status was examined by measuring serum (S-) ferritin and hemoglobin (Hb) in 268 randomly selected, healthy, menstruating, nonpregnant Danish women aged 18–30 years. Iron deficiency (S-ferritin <16 μg/l) was observed in 9.7% of the women, iron deficiency anemia (S-ferritin <13 μg/l and Hb <121 g/l) in 2.2%. Iron supplementation, predominantly as vitamin-mineral tablets containing 14–20 mg of ferrous iron was used by 35.1%. The median serum ferritin was similar in non-iron users and in iron users, whereas the prevalence of iron deficiency was 12.6% in nonusers vs. 4.3% in users, the prevalence of iron deficiency anemia 3.4% in nonusers vs. 0% in users (p=0.17) In non-iron-supplemented women, S-ferritin levels were inversely correlated with the duration of menstrual bleeding (r _s=–0.25, p<0.001) and with the women's assessment of the intensity of menstrual bleeding (r _s=–0.27, p<0.001), whereas no such correlations were found in iron-supplemented women. The results demonstrate that even moderate daily doses of ferrous iron can influence iron status in women with small iron stores. Women using hormonal contraceptives had menstrual bleeding of significantly shorter duration than those using intrauterine devices (IUD) or other methods. There was a high prevalence of small and absent body iron stores in young women, suggesting that preventive measures should be focused on those women whose menstruation lasts 5 days or longer, who have menstrual bleeding of strong intensity, who use an IUD without gestagen, and who are blood donors. Received: December 10, 1998 / Accepted: May 22, 1998     

Leucocyte migration inhibition and leucocyte adherence inhibition studies, using ferritin as 'antigen', in patients with malignant lymphoma

Isoelectric focusing of ferritin prepared from three spleens involved by Hodgkin's disease demonstrated only minor differences from normal spleen ferritin. The leucocyte migration inhibition (LMI) and leucocyte adherence inhibition (LAI) assays were used to assess sensitization to Hodgkin's disease spleen ferritin and its component acidic and basic isoferritins in patients with malignant lymphoma compared to patients with other malignancies and control subjects. A difference in response to ferritin was demonstrated in both tests with patients with malignant lymphoma compared to controls, and in LMI test compared to patients with other malignancies. There were also significant differences in responses in, patients with malignant lymphoma compared to controls, against acidic and basic isoferritins in both tests, in lymphoma patients versus patients with other malignancies against acidic isoferritins in both tests, lymphoma versus other malignancy against basic isoferritins in the LMI test only. However, no significant differences, within each group, between responses with acidic and with basic isoferritins were demonstrated, and there was no correlation between individual patients' responses in the two tests.     

T2* magnetic resonance imaging of the liver in thalassemic patients in Iran

AIM: To investigate the accuracy of T2*-weighted magnetic resonance imaging (MRI T2*) in the evaluation of iron overload in beta-thalassemia major patients. METHODS: In this cross-sectional study, 210 patients with beta-thalassemia major having regular blood transfusions were consecutively enrolled. Serum ferritin levels were measured, and all patients underwent MRI T2* of the liver. Liver biopsy was performed in 53 patients at an interval of no longer than 3 mo after the MRIT2* in each patient. The amount ...     

The epidemiology of hyperferritinaemia

INTRODUCTIONFerritin is a protein with a molecular mass of 450 kilo Dal-tons (kD) and is composed of 24 subunits[1]. These subu-nits form a hollow sphere, which can contain up to 4000 atoms of iron stored as ferric oxyhydroxide phosphate; haemosiderin is …     

Familial hemophagocytic lymphohistiocytosis

A 45-day-old infant presented with hepatosplenomegaly and fever since 15 days. Hemogram revealed bicytopenia and bone marrow aspirate showed hemophagocytosis. With the history of death of two siblings, the baby was diagnosed with hemophagocytic lymphohistiocytosis (HLH), likely to be of familial origin.     

Ferritin for the clinician

Ferritin, a major iron storage protein, is essential to iron homeostasis and is involved in a wide range of physiologic and pathologic processes. In clinical medicine, ferritin is predominantly utilized as a serum marker of total body iron stores. In cases of iron deficiency and overload, serum ferritin serves a critical role in both diagnosis and management. Elevated serum and tissue ferritin are linked to coronary artery disease, malignancy, and poor outcomes following stem cell transplantation. Ferritin is directly implicated in less common but potentially devastating human diseases including sideroblastic anemias, neurodegenerative disorders, and hemophagocytic syndrome. Additionally, recent research describes novel functions of ferritin independent of iron storage.     

Twice‐Monthly Administration of a Lower Dose of Epoetin Beta Pegol Can Maintain Adequate Hemoglobin Levels in Hemodialysis Patients

Epoetin beta pegol is a continuous erythropoietin receptor activator (CERA) with a long half‐life. Although CERA has been shown to maintain adequate hemoglobin (Hb) levels at prolonged dosing intervals, the optimal dosing schedule remains unclear. We therefore compared the efficacy of maintaining hemoglobin levels with administration of twice‐monthly CERA (TWICE) versus once‐monthly CERA (ONCE). Twenty hemodialysis patients receiving epoetin beta (EPO) were enrolled in this crossover study. Patients were assigned to either the TWICE or the ONCE group based on matching Hb levels and EPO doses. After 6 months of treatment, the CERA dosage was interchanged between the groups and the study was continued for an additional 6 months. The effect of the different regimens on iron metabolism was also assessed during the first 6 months of the study. Hb levels significantly increased in the TWICE group, allowing for a reduction in CERA dosage, while the dose of CERA required to maintain Hb levels in the ONCE group remained unchanged. After the interchange, a decrease in Hb levels with incremental increase in CERA dosage was observed in the TWICE→ONCE group, with the opposite effect observed in the ONCE→TWICE group. Although increases in ferritin and hepcidin‐25 levels in the ONCE group were noted at one month, they disappeared at 6 months. Although Hb levels were maintained in both the ONCE and TWICE groups, a twice‐monthly administration was advantageous, as it required a lower dose of CERA.