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Subject: back/lumbar pain

   
   Dtsch Med Wochenschr 1999 Jan 29;124(4):79-82
   
[Marked hemosiderosis in myelodysplastic syndrome].

   [Article in German]
   
    Klinz C
    
   Abteilung Innere Medizin, Bundeswehrkrankenhaus Hamburg.
   
   HISTORY AND ADMISSION FINDINGS: A 68-year-old man was admitted because
   of symptoms of lumbar pain. He was known to have chronic anemia with
   ring sideroblasts and diabetes melitus and to be in heart failure.
   Three months before he had been given 7 units of red cell concentrate.
   On admission the outstanding features were brown discoloration of the
   skin, absent body hair, tachycardia, hepatomegaly and small testicles.
   INVESTIGATIONS: He had a normocytic anemia, hyperglycemia and raised
   transaminases, hypogonadism and vitamin D3 deficiency. The serum
   levels of iron, transferrin saturation and feritin were markedly
   elevated. Liver iron content/g dried liver was 4.2 g (by
   biomagnetometer). Radiology of the lumbar vertebrae showed
   osteoporosis and sonography confirmed hepatomegaly. DIAGNOSIS,
   TREATMENT AND COURSE: The known myelodysplastic syndrome (MDS) had fed
   to secondary hemosiderosis with heart failure, liver involvement,
   diabetes mellitus, hypogonadism and osteoporosis. Symptomatic
   treatment was unsuccessfully complemented by desferoxamine (up to 4
   g/12 h) to release iron. But very good iron excretion was then
   achieved with deferiprone (3 x 1 g/d). The patient later died of the
   sequelae of hemosiderosis. CONCLUSION: Even when they have not
   required transfusions, patients with long-standing MDS should be
   examined regularly for the possible development of secondary
   hemosiderosis so that iron-chelating agents can be administered as
   needed.
   
   PMID: 10071604, UI: 99170998
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