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What is new in iron overload?

Vermylen C - Eur. J. Pediatr. (2007)

Bottom Line: At the present time, new iron chelators that can be given orally are available.In conclusion, iron overload can be measured more accurately with noninvasive methods such as MRI.Deferasirox is a once-daily oral therapy for treating transfusional iron overload, which improves patient compliance and quality of life.

View Article: PubMed Central - PubMed

Affiliation: Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B 1200, Brussels, Belgium. vermylen@pedi.ucl.ac.be

ABSTRACT
Children with severe chronic hemolytic anemia or congenital erythroblastopenia are transfusion dependent. Long-term transfusion therapy prolongs life but results in a toxic accumulation of iron in the organs. The human body cannot actively eliminate excess iron. Therefore, the use of a chelating agent is required to promote excretion of iron. So far, iron chelation has been done by subcutaneous infusion of deferoxamine given over 10 h, 5-6 days per week. Compliance is poor and chelation often insufficient. Ferritin measurements and sometimes liver biopsies are used to evaluate the iron burden in the body. At the present time, new iron chelators that can be given orally are available. Furthermore, magnetic resonance imaging (MRI) assessment of tissue iron is a noninvasive and highly reproducible method, which is able to quantitate organ iron burden. In conclusion, iron overload can be measured more accurately with noninvasive methods such as MRI. Deferasirox is a once-daily oral therapy for treating transfusional iron overload, which improves patient compliance and quality of life.

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Related in: MedlinePlus

Gradient echo images of liver collected by J. Wood [13] at four different echo times. The top four images were collected from a patient having a liver iron of 6 mg/g. The bottom four images were collected from a normal volunteer. All images darken as the echo time (TE) lengthens, but the iron-heavy tissue darkens faster. The half-life of this process is called T2* and the rate is called R2* (R2* = 1,000/T2*)
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Fig2: Gradient echo images of liver collected by J. Wood [13] at four different echo times. The top four images were collected from a patient having a liver iron of 6 mg/g. The bottom four images were collected from a normal volunteer. All images darken as the echo time (TE) lengthens, but the iron-heavy tissue darkens faster. The half-life of this process is called T2* and the rate is called R2* (R2* = 1,000/T2*)

Mentions: MRI measures tissue iron concentration indirectly by detecting the paramagnetic influences of storage iron (ferritin and hemosiderin) on proton resonance behavior. With MRI, the transmitted signal is a microwave, which excites water protons in the body to higher magnetic energy states. As these water protons relax back to the unexcited state, they emit microwaves that are received and interpreted by the scanner. Iron deposits act like little magnets when placed in a strong magnetic field, disrupting coherence among the protons and darkening the image more quickly (Fig. 2) [13]. LIC determined using MRI shows excellent correlation with that obtained from liver biopsy. Furthermore, MRI has the ability to evaluate the entire organ and gives more accurate measurement of LIC, particularly in patients with heterogeneous iron content (Fig. 3). It requires a dedicated imaging method and equipment operator [13].Fig. 2


What is new in iron overload?

Vermylen C - Eur. J. Pediatr. (2007)

Gradient echo images of liver collected by J. Wood [13] at four different echo times. The top four images were collected from a patient having a liver iron of 6 mg/g. The bottom four images were collected from a normal volunteer. All images darken as the echo time (TE) lengthens, but the iron-heavy tissue darkens faster. The half-life of this process is called T2* and the rate is called R2* (R2* = 1,000/T2*)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2254659&req=5

Fig2: Gradient echo images of liver collected by J. Wood [13] at four different echo times. The top four images were collected from a patient having a liver iron of 6 mg/g. The bottom four images were collected from a normal volunteer. All images darken as the echo time (TE) lengthens, but the iron-heavy tissue darkens faster. The half-life of this process is called T2* and the rate is called R2* (R2* = 1,000/T2*)
Mentions: MRI measures tissue iron concentration indirectly by detecting the paramagnetic influences of storage iron (ferritin and hemosiderin) on proton resonance behavior. With MRI, the transmitted signal is a microwave, which excites water protons in the body to higher magnetic energy states. As these water protons relax back to the unexcited state, they emit microwaves that are received and interpreted by the scanner. Iron deposits act like little magnets when placed in a strong magnetic field, disrupting coherence among the protons and darkening the image more quickly (Fig. 2) [13]. LIC determined using MRI shows excellent correlation with that obtained from liver biopsy. Furthermore, MRI has the ability to evaluate the entire organ and gives more accurate measurement of LIC, particularly in patients with heterogeneous iron content (Fig. 3). It requires a dedicated imaging method and equipment operator [13].Fig. 2

Bottom Line: At the present time, new iron chelators that can be given orally are available.In conclusion, iron overload can be measured more accurately with noninvasive methods such as MRI.Deferasirox is a once-daily oral therapy for treating transfusional iron overload, which improves patient compliance and quality of life.

View Article: PubMed Central - PubMed

Affiliation: Université Catholique de Louvain, Cliniques Universitaires Saint Luc, Avenue Hippocrate 10, B 1200, Brussels, Belgium. vermylen@pedi.ucl.ac.be

ABSTRACT
Children with severe chronic hemolytic anemia or congenital erythroblastopenia are transfusion dependent. Long-term transfusion therapy prolongs life but results in a toxic accumulation of iron in the organs. The human body cannot actively eliminate excess iron. Therefore, the use of a chelating agent is required to promote excretion of iron. So far, iron chelation has been done by subcutaneous infusion of deferoxamine given over 10 h, 5-6 days per week. Compliance is poor and chelation often insufficient. Ferritin measurements and sometimes liver biopsies are used to evaluate the iron burden in the body. At the present time, new iron chelators that can be given orally are available. Furthermore, magnetic resonance imaging (MRI) assessment of tissue iron is a noninvasive and highly reproducible method, which is able to quantitate organ iron burden. In conclusion, iron overload can be measured more accurately with noninvasive methods such as MRI. Deferasirox is a once-daily oral therapy for treating transfusional iron overload, which improves patient compliance and quality of life.

Show MeSH
Related in: MedlinePlus