Document Detail

Quantification of siderophages in bronchoalveolar fluid in transfusional and primary pulmonary hemosiderosis.
MedLine Citation:
PMID:  16871595     Owner:  NLM     Status:  MEDLINE    
Transfusional iron overload may occur in the lungs. We hypothesized that quantitating siderophages in the bronchoalveolar fluid (BALF) of heavily transfused patients may prove to be a useful tool in determining lung iron overload in transfusion-dependent patients. The study included six patients (7-20 years) with thalassemia major (TM) who had received multiple blood transfusions, one with hereditary spherocytosis (four blood transfusions) and one with sickle cell disease (never transfused); they were compared to three children with idiopathic pulmonary hemosiderosis (IPH) (2.5-7.0 years) as positive controls. Fiberoptic bronchoscopy with bronchoalveolar lavage was performed in seven patients under general anesthesia for elective surgery and the rest were bronchoscoped electively under sedation. Spirometry was also performed in eight patients. There was no significant difference between children with TM and IPH in siderophages as percentage of total count (95% CI -31.0 to 1.5, P = 0.068). There were positive relationships between both mean serum ferritin values during the preceding year and the total number of units of transfused blood, and percent siderophage count among multiply transfused patients (P = 0.010, P = 0.052, respectively); similar findings were noted for the Golde score (P = 0.001, P = 0.031, respectively). None of the patients showed lung function impairment. In conclusion, in this small study, we found that the BALF of multiply transfused patients with benign hematological disorders contain similar numbers of siderophages to that of patients with IPH; this is strongly suggestive of secondary pulmonary hemosiderosis. The correlation between the patients' serum ferritin, and the BALF siderophages suggests that the later may serve as a marker of pulmonary iron overload in patients requiring blood transfusion and appear to be more sensitive than standard pulmonary function tests.
Kostas N Priftis; Michael B Anthracopoulos; Constantina Tsakanika; Georgia Tapaki; Vassilis Ladis; Andrew Bush; Polyxeni Nicolaidou
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric pulmonology     Volume:  41     ISSN:  8755-6863     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2006 Oct 
Date Detail:
Created Date:  2006-09-04     Completed Date:  2007-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  972-7     Citation Subset:  IM    
Copyright Information:
(c) 2006 Wiley-Liss, Inc.
Department of Allergy-Pneumonology, Penteli Children's Hospital, P. Penteli, Greece.
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MeSH Terms
Biological Markers / analysis
Bronchoalveolar Lavage Fluid / cytology*
Child, Preschool
Erythrocyte Transfusion / adverse effects
Ferritins / blood
Hemosiderin / analysis*
Hemosiderosis / diagnosis,  etiology,  pathology*
Linear Models
Macrophages, Alveolar / chemistry*,  metabolism
Multivariate Analysis
Respiratory Function Tests
beta-Thalassemia / pathology*,  physiopathology
Reg. No./Substance:
0/Biological Markers; 9007-73-2/Ferritins; 9011-92-1/Hemosiderin

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