Microcytic anemia in dialysis patients: reversible marker of aluminum toxicity |
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| Authors: | R Swartz J Dombrouski M Burnatowska-Hledin G Mayor |
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| Affiliation: | 1. Institute of Materials Science and Engineering, School of Mechanical and Electronic Control Engineering, Beijing Jiaotong University, Beijing 100044, China;2. Tangshan Research Institute of Beijing Jiaotong University, Tangshan 063000, China;1. Department of Internal Medicine, Kutahya Health Sciences University Faculty of Medicine, Kutahya, Turkey;2. Department of Endocrinology and Metabolism, Kutahya Health Sciences University Faculty of Medicine, Kutahya, Turkey;3. Department of Medical Pharmacology, Kutahya Health Sciences University Faculty of Medicine, Kutahya, Turkey;1. School of Power and Mechanical Engineering, Wuhan University, Wuhan 430072, China;2. Key Laboratory of Hydraulic Machinery Transients (Wuhan University), Ministry of Education, Wuhan 430072, China;3. School of Mechanical Engineering, Wuhan Polytechnic University, Wuhan 430023, China |
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| Abstract: | Improvement of microcytic anemia after deferoxamine treatment is described in eight long-term dialysis patients with high serum aluminum concentration and other clinical signs of aluminum toxicity. Hematocrit increase of 3 to 19 vol% was associated with correction of microcytosis, significant reduction in abnormal levels of free erythrocyte protoporphyrins, and amelioration of the bone-related symptoms and neurologic signs of aluminum intoxication. Increase in hematocrit, reversal of microcytosis, and reduction in protoporphyrin levels all correlated with the aluminum burden as indicated by the pretreatment serum aluminum levels and by the peak serum aluminum levels during mobilization with deferoxamine. Furthermore, deferoxamine resulted in marked improvement in anemia despite significant reduction in serum ferritin levels. This reversal of microcytosis with deferoxamine provides objective evidence verifying the toxicity of aluminum, and suggests that microcytosis may be an easily detected marker for both clinical diagnosis as well as response to treatment in some cases of aluminum intoxication. |
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