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Tytuł pozycji:

Iron overload and iron chelating agent exposure in anemia-associated outer retinal degeneration: a case report and review of the literature.

Tytuł:
Iron overload and iron chelating agent exposure in anemia-associated outer retinal degeneration: a case report and review of the literature.
Autorzy:
Belmouhand M; Department of Ophthalmology, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark. .; Department of Clinical Medicine, Faculty of Healthy and Medical Science, University of Copenhagen, Copenhagen, Denmark. .
Eckmann-Hansen C; Department of Ophthalmology, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark.; Department of Clinical Medicine, Faculty of Healthy and Medical Science, University of Copenhagen, Copenhagen, Denmark.
Ilginis T; Department of Ophthalmology, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark.
Leinøe EB; Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Mortensen BK; Department of Hematology, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark.
Larsen M; Department of Ophthalmology, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark.; Department of Clinical Medicine, Faculty of Healthy and Medical Science, University of Copenhagen, Copenhagen, Denmark.
Źródło:
BMC ophthalmology [BMC Ophthalmol] 2021 Jul 13; Vol. 21 (1), pp. 277. Date of Electronic Publication: 2021 Jul 13.
Typ publikacji:
Case Reports; Journal Article; Review
Język:
English
Imprint Name(s):
Original Publication: London : BioMed Central, [2001-
MeSH Terms:
Iron Overload*/chemically induced
Iron Overload*/complications
Iron Overload*/drug therapy
Retinal Degeneration*/chemically induced
beta-Thalassemia*
Deferoxamine/adverse effects ; Humans ; Iron Chelating Agents/adverse effects ; Retinal Pigment Epithelium
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Grant Information:
E-23334-02 Rigshospitalet; 19-B-0063 Helsefonden; 18-10-0698 Aase og Ejnar Danielsens Fond; 19-2-3490 Beckett-Fonden; 500028 Einar Willumsen Foundation; 19102 P. Carl Petersens Fond; 780989 H2020 European Research Council
Contributed Indexing:
Keywords: Anemia; Case report; Deferoxamine; Iron chelation; Iron overload; Retinopathy
Substance Nomenclature:
0 (Iron Chelating Agents)
J06Y7MXW4D (Deferoxamine)
Entry Date(s):
Date Created: 20210714 Date Completed: 20210715 Latest Revision: 20210717
Update Code:
20240105
PubMed Central ID:
PMC8278719
DOI:
10.1186/s12886-021-02030-1
PMID:
34256738
Czasopismo naukowe
Background: Deferoxamine retinopathy is the informally designated term used to describe a characteristic pattern of outer retinal degeneration in iron-overloaded chronic anemia patients who are treated with deferoxamine. We hypothesize that insufficiently treated iron overloading and not only deferoxamine is the cause of the retinal degeneration. Our case report is based on exposure histories of two anemia patients and literature review.
Case Presentation: Both anemia patients presented with bilateral visual loss secondary to photoreceptor and retinal pigment epithelium degeneration. Chart review showed that visual loss came after a year-long slow, and rather monotonous rise in plasma ferritin concentrations, with no obvious relation to iron chelator exposure. In one patient, the onset of symptomatic visual loss came after a bout of fever followed by two additional febrile episodes, all accompanied by plasma ferritin spikes. Adjustment of iron chelation therapy did not improve visual function. Experimental studies clearly show that both systemic and intraocular exposure to iron ions can induce retinal degeneration.
Conclusion: The available evidence indicates that retinal degeneration in chronic anemia patients treated by deferoxamine is cause by insufficient iron chelation, not by deferoxamine. The actual role of iron chelating agents may be to promote a long enough survival to allow the slow development of retinal siderosis.
(© 2021. The Author(s).)

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