title: Iron chelation therapy in aceruloplasminaemia: study of a patient with a novel missense mutation.
abstract: We describe a novel missense mutation of ceruloplasmin in a patient with aceruloplasminaemia causing the replacement of a neutral amino acid (phenylalanine) with a polar one (serine) at position 198, probably leading to abnormal folding and secretion of the protein. The patient showed mild microcytic anaemia, mild hepatic iron overload, and marked brain iron overload. Six months of therapy with deferiprone was ineffective in removing iron from the tissues. Deferoxamine was more efficient in removing excess iron from the liver but aggravated the disease related anaemia. After more than one year of chelation treatment, the brain magnetic resonance imaging signal did not change. Overall, these findings indicate that treatment of iron overload in aceruloplasminaemia is a difficult challenge and that new iron chelators, more efficient in crossing the blood-brain barrier, are needed.
authors.affiliation: Clinica Medica, Azienda Ospedaliera San Gerardo, Università Milano-Bicocca, Monza, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Mariani
authors.forename: C
authors.initials: C
authors.lastname: Arosio
authors.forename: S
authors.initials: S
authors.lastname: Pelucchi
authors.forename: M
authors.initials: M
authors.lastname: Grisoli
authors.forename: A
authors.initials: A
authors.lastname: Piga
authors.forename: P
authors.initials: P
authors.lastname: Trombini
authors.forename: A
authors.initials: A
authors.lastname: Piperno
mesh_terms: D000328:Adult; D002570:Ceruloplasmin / Q000235:genetics*; D015913:Chelation Therapy / Q000379:methods; D000077543:Deferiprone; D003676:Deferoxamine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007502:Iron Chelating Agents / Q000627:therapeutic use*; D019190:Iron Overload / Q000188:drug therapy / Q000235:genetics*; D020125:Mutation, Missense; D010375:Pedigree; D011728:Pyridones / Q000627:therapeutic use
chemical_list: D007502:Iron Chelating Agents; D011728:Pyridones; D000077543:Deferiprone; D002570:Ceruloplasmin; D003676:Deferoxamine