Increased levels of carboxyhemoglobin and serum iron as an indicator of increased red cell turnover in preeclampsia |
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| Authors: | S S Entman J R Kambam C A Bradley J B Cousar |
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| Affiliation: | 1. Department of Obstetrics and Gynecology, Vanderbilt University School of Medicine Nashville, Tennessee USA.;2. Department of Anesthesiology, Vanderbilt University School of Medicine Nashville, Tennessee USA.;3. Department of Pathology, Vanderbilt University School of Medicine Nashville, Tennessee USA.;1. Microbiologist, Department of Pathology and Microbiology, Poona Hospital and Research Center, 27, Sadashiv Peth, Pune 30, India;2. HOD Laboratory, Department of Pathology and Microbiology, Poona Hospital and Research Center, 27, Sadashiv Peth, Pune 30, India;3. Microbiologist, Golwilkar Metropolis Health Services Pvt. Ltd., 786/189-B, Bhandarkar Road, Pune 04, India;4. Pathologist, Department of Pathology and Microbiology, Poona Hospital and Research Center, 27, Sadashiv Peth, Pune 30, India;1. Department of Molecular and Cellular Biochemistry, School of Medicine, Kangwon National University, Chuncheon, Kangwon-do 200-701, Republic of Korea;2. Department of Neurobiology, School of Medicine, Kangwon National University, Chuncheon, Kangwon-do 200-701, Republic of Korea;3. Department of Biochemistry, College of Natural Sciences, Kangwon National University, Chuncheon, Kangwon-do 200-702, Republic of Korea;4. Department of Biological Sciences, College of Natural Sciences, Kangwon National University, Chuncheon, Kangwon-do 200-702, Republic of Korea;5. Department of Biochemistry, College of Life Science and Biotechnology, Yonsei University, Seoul 120-752, Republic of Korea;1. Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;2. Clinical Epidemiology and Trials Organization Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;3. Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;1. Department of Ophthalmology, The Chinese People''s Liberation Army General Hospital, Beijing, China;2. Medical Department, The First Hospital Affiliated to General Hospital of the Chinese People''s Liberation Army, Beijing, China;3. Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing, China;4. Medical School, Nankai University, Tianjin, China;1. Department of Anatomy, Histology and Embryology, Faculty of Medicine, Semmelweis University, Budapest, Hungary;2. Heart and Vascular Center, Semmelweis University, Budapest, Hungary;3. 1st Department of Pathology and Experimental Cancer Research, Faculty of Medicine, Semmelweis University, Budapest, Hungary;4. 2nd Department of Pathology, Faculty of Medicine, Semmelweis University, Budapest, Hungary;1. Department of Biopharmaceutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Chuo-ku, 862-0973 Kumamoto, Japan,;2. Faculty of Pharmaceutical Sciences, Sojo University, 4-22-1 Ikeda, Nishi-ku, 860-0082 Kumamoto, Japan,;3. Center for Clinical Pharmaceutical Sciences, Graduate School of Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Chuo-ku, 862-0973 Kumamoto, Japan,;4. DDS Research Institute, Sojo University, 4-22-1 Ikeda, Nishi-ku, 860-0082 Kumamoto, Japan, |
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| Abstract: | Patients with severe preeclampsia are reported to have microangiopathic hemolytic anemia. This study demonstrates that increased red cell turnover with heme catabolism is also common in mild preeclampsia. Heme catabolism results in equimolar production of carboxyhemoglobin, iron, and bilirubin. A concomitant rise in these constituents of venous blood would support this hypothesis. Patients with antepartum preeclampsia had mean carboxyhemoglobin concentrations (2.72% total hemoglobin) greater than those of control patients (0.65%) (p less than 0.001) and serum iron concentrations (98.5 micrograms/dl) greater than those of control patients (66.1 micrograms/dl) (p less than 0.01). Bilirubin concentrations were not different. Post partum, carboxyhemoglobin and iron concentrations returned toward normal (1.38% and 50.2 micrograms/dl, respectively). Disparity in the magnitude of increase of heme catabolites produced in equimolar proportion is explained by differences in the kinetics of clearance. The data are most consistent with increased destruction of maternal red cells, even in mild preeclampsia. Potential implications of elevated carboxyhemoglobin on maternal and fetal oxygenation are discussed. |
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