Document Detail


The importance of spleen, spleen iron and splenectomy for determining total body iron load, ferrikinetics and iron toxicity in thalassemia major patients.
MedLine Citation:
PMID:  23039902     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Abstract The importance of spleen iron and splenectomy has been investigated in 28 male and 19 female β-thalassemia major (β-ΤΜ), adult patients. In one study an increase from about five (615g;19.5 × 11.0 × 6.0 cm) to twenty (2030g; 25.0 × 17.5 × 12.0 cm) times higher than the normal size and weight of spleen has been observed in twenty patients following splenectomy. In a second study the mean size for the liver (19.4cm, range 13.5-26.0 cm) and spleen (15.6 cm, range 7.0-21.0 cm) measured by magnetic resonance imaging (MRI) and by ultrasound imaging for spleen (15.1 cm, range 9.0-21.0 cm) of sixteen patients indicated that on average the spleen is about 80% of the size of the liver. In the third study, comparison of the iron load using MRI T2* and iron grading of stained biopsies indicated that substantial but variable amounts of excess iron are stored in the spleen (0-40%) in addition to that in the liver. Following splenectomy, total body iron storage capacity is reduced, whereas serum ferritin (P= 0.0085) and iron concentration in other organs appears to increase despite the reduction in the rate of transfusions (P=0.0001). Spleen iron seems to be cleared faster than liver iron using effective chelation protocols. Spleen iron is a major constituent of the total body iron load in β-ΤΜ patients and should be regularly monitored and targeted for chelation. Normalization of the body iron stores at an early age could maintain the spleen in near normal capacity and secondary effects such as cardiac and other complications could be avoided.
Authors:
Annita Kolnagou; Michaelides Yiannis; Christina N Kontoghiorghe; George J Kontoghiorghes
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-6
Journal Detail:
Title:  Toxicology mechanisms and methods     Volume:  -     ISSN:  1537-6524     ISO Abbreviation:  Toxicol. Mech. Methods     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101134521     Medline TA:  Toxicol Mech Methods     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Postgraduate Research Institute of Science, Technology, Environment and Medicine, Limassol, Cyprus.
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