(HOME) Subject: siderosis/lung/kidney
Semin Hematol 1998 Jan;35(1):77-86
Secondary iron overload disorders.
Bottomley SS
Department of Medicine, University of Oklahoma College of Medicine,
Oklahoma City, USA.
Diverse clinical disorders distinct from hereditary hemochromatosis
are associated with accumulation of excess body iron in heterogeneous
patterns and through various mechanisms. A deranged iron turnover
somehow relates to the altered physiological barrier for iron
absorption in several defined chronic anemias with ineffective
erythropoiesis. Unexcretable excess iron acquired from transfusions
provides a therapeutic challenge. Genetic defects of proteins
essential for transport of iron into and out of cells (transferrin and
ceruloplasmin) deprive the erythron of the metal and cause its
accumulation in other vital organs. The hemochromatosis alleles
predictably contribute to an iron burden from other causes, commonly
facilitate the expression of porphyria cutanea tarda, and their
clinical expression may be accelerated by hereditary hemolytic
anemias. Even minimal iron excess in liver disease may contribute to
the hepatocellular injury from factors such as alcohol and viruses.
Uniquely localized siderosis occurs in the lung and kidney where iron
cannot turn over and causes variable tissue damage. The most
devastating iron overload disorder, neonatal hemochromatosis, is
understood least of all.
Publication Types:
* Review
* Review, tutorial
PMID: 9460811, UI: 98122143
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