Document Detail


Unexplained iron deficiency in idiopathic and heritable pulmonary arterial hypertension.
MedLine Citation:
PMID:  21297151     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Anaemia is common in left heart failure and is associated with a poorer outcome. Many patients with pulmonary arterial hypertension (PAH) are anaemic or iron-deficient. This study was performed to investigate the prevalence of iron deficiency in PAH and to identify possible causes.
METHODS: All patients with idiopathic or heritable PAH diagnosed in 1995-2008 were identified. Controls were selected from patients with chronic thromboembolic pulmonary hypertension (CTEPH). Full blood counts were examined and any abnormality was investigated. Patients were excluded if they had a cause for iron deficiency. The prevalence study was based on 85 patients with idiopathic PAH and 120 with CTEPH. A separate group of 20 patients with idiopathic PAH and 24 with CTEPH with matching haemodynamics were prospectively investigated for serum factors affecting iron metabolism.
RESULTS: The prevalence study identified a point prevalence of unexplained iron deficiency of 50% in premenopausal women with idiopathic PAH compared with 8% in premenopausal women with CTEPH (p=0.002); 14% in postmenopausal women with idiopathic PAH compared with 6% in postmenopausal women with CTEPH (p=0.16); 28% in men with idiopathic PAH men compared with 2% in men with CTEPH (p=0.002); and 60% in patients with heritable PAH. The serum study showed that patients with idiopathic PAH had lower serum iron and transferrin saturations than those with CTEPH. Interleukin-6 levels correlated with iron levels (r=-0.6, p=0.006) and transferrin saturations (r=-0.68, p=0.001) in idiopathic PAH but not in CTEPH.
CONCLUSIONS: The prevalence of unexplained iron deficiency is significantly higher in idiopathic PAH than in CTEPH. This may be linked to interleukin-6.
Authors:
Elaine Soon; Carmen M Treacy; Mark R Toshner; Robert MacKenzie-Ross; Vijay Manglam; Mark Busbridge; Mark Sinclair-McGarvie; Jayantha Arnold; Karen K Sheares; Nicholas W Morrell; Joanna Pepke-Zaba
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-02-05
Journal Detail:
Title:  Thorax     Volume:  66     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-22     Completed Date:  2011-05-17     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  326-32     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anemia, Iron-Deficiency / blood,  etiology*
Epidemiologic Methods
Female
Ferritins / blood
Humans
Hypertension, Pulmonary / blood,  complications
Interleukin-6 / blood
Iron / blood
Male
Middle Aged
Postmenopause / blood
Premenopause / blood
Grant Support
ID/Acronym/Agency:
G0802261//Medical Research Council; //British Heart Foundation; //Medical Research Council
Chemical
Reg. No./Substance:
0/Interleukin-6; 9007-73-2/Ferritins; E1UOL152H7/Iron

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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