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Renal iron load in sickle cell disease is influenced by severity of haemolysis
Author(s) -
Vasavda Nisha,
Gutiérrez Lucía,
House Michael J.,
Drašar Emma,
St Pierre Tim G.,
Thein Swee L.
Publication year - 2012
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.2012.09093.x
Subject(s) - haemolysis , medicine , lactate dehydrogenase , magnetic resonance imaging , gastroenterology , sickle cell anemia , urology , bilirubin , endocrinology , cardiology , disease , chemistry , radiology , immunology , enzyme , biochemistry
Summary Spin density projection‐assisted R 2‐magnetic resonance imaging ( R 2‐ MRI ; F erriScan ® ) scans from 40 chelation‐naïve sickle cell patients were used to assess renal iron load by measuring renal R 2 ( R ‐ R 2). Clinical data were collected retrospectively for the 2‐year period preceding the scan. R ‐ R 2 showed no significant correlation with transfusional iron load (assessed by liver iron concentration), but correlated significantly with serum bilirubin ( R = 0·61, P < 0·0001) and lactate dehydrogenase ( R = 0·58, P < 0·0001). Mean (±standard deviation) R ‐ R 2 was higher ( P = 0·02) in patients with renal hyperfiltration (29·8 ± 10·3/s) than those without (23·11 ± 6·6/s). Five patients had significantly lower signal intensity in the renal cortex, as compared to the medulla. These patients had a significantly higher ( P < 0·0001) mean R ‐ R 2 than those showing no cortico‐medullary difference. We postulate that the increased R ‐ R 2 is associated with haemolysis rather than transfusional iron load in sickle cell disease.