医学
铁质沉着
转铁蛋白饱和度
铁蛋白
胃肠病学
血清铁
内科学
肝活检
转铁蛋白
可溶性转铁蛋白受体
免疫学
内分泌学
活检
贫血
缺铁
血清铁蛋白
铁状态
作者
Päivi Halonen,Jouni Mattila,Pauli Suominen,Tarja Ruuska,Matti K. Salo,Anne Mäkipernaa
出处
期刊:Pediatrics
[American Academy of Pediatrics]
日期:2003-01-01
卷期号:111 (1): 91-96
被引量:53
标识
DOI:10.1542/peds.111.1.91
摘要
To evaluate a secondary liver iron overload and its fate in children who are treated conventionally for acute lymphoblastic leukemia and to assess whether serum soluble transferrin receptor (sTfR) is useful in detecting iron load.Liver siderosis was estimated histologically from liver biopsy specimens of 30 children (aged 2.6-17.6 years) close to or at the end of therapy using total iron score (TIS). Serum iron parameters and sTfR were measured at the same time and in 22 patients 1 to 3 years after therapy.In 19 (63%) of 30 patients, liver TIS was >15, indicating at least moderate iron overload. Serum ferritin, iron, and transferrin iron saturation levels were highest and transferrin level lowest in the patients with the highest liver iron content. Serum sTfR levels did not differ significantly between the patients with varying amounts of liver iron. TIS correlated most significantly positively with serum ferritin (r(S) = 0.899), transferrin iron saturation (r(S) = 0.764), and the amount of transfused red blood cells (r(S) = 0.783). Serum iron parameters normalized in most patients during the follow-up. In 3 (14%) of 22 patients, serum ferritin level remained high (>1000 microg/L).Long-term iron overload is detected in at least 14% of children after therapy for acute lymphoblastic leukemia. Serum sTfR is an inappropriate marker for liver iron overload, whereas ferritin seems to be the most useful serologic marker for it.
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