Excessive iron storage in a patient with Wilson's disease

We report on an otherwise healthy female, mother of two children, with severe decompensated liver cirrhosis due to an iron overload and Wilson's disease. The patient was considered heterozygote for hemochromatosis on the basis of the autosomal recessive inheritance for hemochromatosis, the frequency of the hemochromatosis gene, and the laboratory parameters defining her iron overload. The case is interesting because of the coincidence of Wilson's disease and excessive iron storage. Correspondence to: D. Haussinger     

Spectral electroencephalographic correlates of iron status: Tired blood revisited

For some time, clinical reports have described impairment of affective and cognitive functions in iron deficient persons. Recent studies suggest that both brain biochemistry and cognitive performance capacity may be disrupted by inadequate intake of dietary iron, but the relationship of the possible neurophysiological effects to psychological ones is unclear. To examine the relationship of iron status to simultaneous measures of cortical activation and cognitive performance, 8 channels of electroencephalographic (EEG) data were recorded during a resting period and during the performance of several cognitive tasks in two groups of men. The EEG data were spectrally analyzed, and measures of total power and frequency of peak power in each of several bands of the power spectrum for each channel were used as predictors in multiple regression analyses with serum iron and serum ferritin as alternative criteria. Measures of power in the delta frequency in the resting period appeared relevant to iron status in both groups, perhaps indicating alertness or arousal level. Consistently in these regressions, the asymmetry of the EEG appeared relevant to iron and ferritin. These findings suggest that the combination of EEG and performance measures may help characterize the neuropsychological effects of trace element nutrition.     

磁共振成像(T2*)检测重型β-地中海贫血患儿心脏、肝脏铁负荷及左心室射血分数的研究

目的观察我院重型β-地中海贫血(β-TM)患儿血清铁蛋白(SF)和体内铁沉积状况及对心脏功能的影响。方法检测我院28例重型β-TM患儿SF水平,并由我院放射科运用磁共振成像T2*(MRI T2*)技术检测心脏及肝脏铁沉积状况及左室射血分数(LVEF)。结果本组28例患儿中男16例,女12例,中位年龄11.2岁(7岁1个月~16岁11个月)。28例患儿中SF轻度升高者4例(14.3%),中度升高者8例(28.6%),高度升高者16例(57.1%)。肝脏MRI T2*检测结果 :肝铁轻度沉积2例(7.1%),中度沉积8例(28.6%),重度沉积18例(54.8%);心脏MRI T2*检测结果 :心铁正常16例(57.1%),轻度铁沉积4例(14.3%),中度铁沉积4例(14.3%),重度铁沉积4例(14.3%);LVEF降低者19例(67.9%),4例心脏重度铁沉积患儿中有3例(75%)LVEF明显降低(≤55%)。本组患儿SF水平与肝脏T2*值(r=-0.467,P=0.036)、心脏T2*值(r=-0.486,P=0.01)呈明显负相关;SF与输血量呈正相关(r=0.634,P=0.043;r=0.067,P=0.124)而与去铁治疗呈负相关(r=-0.526,P=0.043),SF和心脏T2*值与LVEF均无相关性(r=-0.154,P=0.306;r=0.067,P=0.124)。结论重型β-TM患儿SF增高及肝脏重度铁沉积发生率高,虽然心脏重度铁沉积患儿发生率不高,但心脏重度铁沉积患儿多有LVEF明显降低。     

西宁地区冠心病患者血浆铁蛋白血脂水平测定的意义

目的 :探讨血浆铁蛋白及血脂水平在西宁地区冠心病诊治中的价值。方法 :西宁地区经临床确诊的冠心病患者 6 5例 ,其中冠心病合并高血压 30例 ,采清晨空腹静脉血 5ml,应用日立7170s全自动生化仪测定血浆铁蛋白、血脂 (TCh、TG、HDL -c、LDL -c)。 30例健康查体者为对照组。结果 :本地区冠心病患者血浆铁蛋白水平较对照组明显降低 (P <0 .0 1) ,LDL -C水平较对照组增高 (P <0 .0 5 )。结论 :高海拔地区冠心病患者血浆铁蛋白浓度显著低于正常对照组。较低的铁蛋白水平提示存在着较高的血清游离铁水平 ,促进了LDL的脂质氧化 ,加快了动脉粥样硬化斑块的形成     

CEA、AFP、CA199、FERR联合检测对肝癌的诊断意义

目的 探讨血清癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原199(CA199)和铁蛋白(FERRitin,FERR)联合检测在肝癌(LC)中的诊断意义。方法 选取2016-01～12在延安大学附属医院就诊的110例原发性肝癌患者(PHC),41例转移性肝癌患者(MHC),124例肝良性病变患者(良性组),及同期50例体检者(对照组),采用电化学发光技术检测PHC、MHC、良性组及对照组血清中的CEA、AFP、CA199、FERR的水平,并进行4组间单项及联合检测阳性率的比较。结果 MHC血清中CEA、CA199的水平最高,差异具有统计学意义(P＜0.05);PHC组血清中AFP的水平最高,差异具有统计学意义(P＜0.05);四项联合检测的阳性率在PHC与MHC差异无统计学意义(P＞0.05);PHC与MHC四项联合测定阳性率均高于良性组及对照组,差异具有统计学意义(P＜0.01);良性组四项联合测定的阳性率高于对照组,差异具有统计学意义(P＜0.01)。结论 CEA、CA199对MHC诊断具有重要意义,AFP对PHC诊断具有重要意义,CEA、AFP、CA199、FERR四项联合检测可提高肝癌诊断的阳性率,有利于肝癌的早期诊断和治疗。     

铁超负荷与Ⅱ型糖尿病关系的研究

目的探讨铁超负荷与Ⅱ型糖尿病（Diabetes Mellitus，DM）之间的关系。方法采用放射免疫方法测定血清中的铁蛋白（Serum Ferritin，SF）和胰岛素（INS）含量，用全自动生化分析仪测定血清铁（Serum Iron，SI）和血糖的浓度。结果与对照组相比，Ⅱ型糖尿病患者SF水平和胰岛素抵抗指数（Homeostasis Model Assessment-Insulin Resistatice，HOMA—IR）显著升高（P〈0．01）。结论Ⅱ型糖尿病存在铁超负荷，造成IR。铁超负荷可能是Ⅱ型糖尿病的一种重要风险因子。     

Ferritin in bone marrow and serum in iron deficiency and iron overload

Summary Nonheme iron and ferritin in the bone marrow and serum ferritin was investigated in patients with iron deficiency anaemia or iron overload. As controls served patients without any disturbance of the iron metabolism.There is a precise correlation between the nonheme iron and ferritin in the bone marrow of patients with and without disturbance of iron metabolism. A correlation was also found between the ferritin in the bone marrow and the serum. Nonheme iron and ferritin in the bone marrow and serum ferritin was decreased in patients with iron deficiency anaemia. Conversely, the same parameters were increased in patients with iron overload.     

Biochemistry tests in hospitalized COVID-19 patients: Experience from a Canadian tertiary care centre

BackgroundCoronavirus Disease 2019 (COVID-19) has variable clinical presentation, from asymptomatic to severe disease leading to death. Biochemical markers may help with management and prognostication of COVID-19 patients; however, their utility is still under investigation.MethodsA retrospective study was conducted to evaluate alanine aminotransferase, C-reactive protein (CRP), ferritin, lactate, and high sensitivity troponin T (TnT) levels in 67 patients who were admitted to a Canadian tertiary care centre for management of COVID-19. Logistic, cause-specific Cox proportional-hazards, and accelerated failure time regression modelling were performed to assess the associations of initial analyte concentrations with in-hospital death and length of stay in hospital; joint modelling was performed to assess the associations of the concentrations over the course of the hospital stay with in-hospital death.ResultsInitial TnT and CRP concentrations were associated with length of stay in hospital. Eighteen patients died (27%), and the median initial TnT concentration was higher in patients who died (55 ng/L) than those who lived (16 ng/L; P < 0.0001). There were no survivors with an initial TnT concentration > 64 ng/L. While the initial TnT concentration was predictive of death, later measurements were not. Only CRP had prognostic value with both the initial and subsequent measurements: a 20% increase in the initial CRP concentration was associated with a 14% (95% confidence interval (CI): 1–29%) increase in the odds of death, and the hazard of death increased 14% (95% CI: 5–25%) for each 20% increase in the current CRP value. While the initial lactate concentration was not predictive of death, subsequent measurements were.ConclusionCRP, lactate and TnT were associated with poorer outcomes and appear to be useful biochemical markers for monitoring COVID-19 patients.     

Effect of Hepatic Isoferrttins from Iron Overloaded Rats on Lymphocyte Proldzerative Response: Role of Ferritin Iron Content

Abstract

Iron and ferritin impair a variety of immunological functions. To evaluate the effect of ferritin iron content on rat lymphocyte proliferative response, isoferritins that differ in their iron content and isoelectric point (pI) were isolated from iron overload rat livers by ultracentrifugation (isoferritins with high iron content and low pI) or crystallization (isoferritins with low iron content and high pI) methods. Additionally, commercial horse splenic ferritin (with a lower pI and higher iron content than rat isoferritins) was also tested. Proliferative response to Con A was decreased in a dose-dependent manner in all assays in which spleen cells were incubated with rat and horse isoferritins. However, isoferritins with higher iron contents (rat isoferritin obtained by ultracentrifugation and horse ferritin) caused a greater decrease of proliferative response at 5 and 25 μ/ml than the others. Rat and horse apoferritins showed no inhibitory effect on lymphocyte proliferative response, suggesting that the effect is due to iron probably through the damaging effect of reactive oxygen species generated by iron released by the isoferritins on lymphocyte functions.

Additionally, the role of serum ferritin level on proliferative response was studied in an experimental model of iron overload in rats. An inverse relationship between the proliferative response and serum ferritin levels was observed.

Our results suggest that the inhibitory effect of the isoferritins on lymphocyte proliferative response is due, at least partially, to the iron content of this protein and not exclusively to variation in pi as suggested by other authors. These results are in agreement with the possible immunosuppressor role of ferritin in vivo.