Dose-dependent effect of parenteral iron therapy on bleomycin-detectable iron in immune apheresis patients.
BACKGROUND
Iron deficiency and anemia are commonly encountered in patients with autoimmune diseases undergoing immune apheresis. This makes erythropoietin and iron substitution necessary in most patients. However, intravenous iron therapy may result in an increase of potentially toxic nontransferrin-bound iron.


METHODS
We examined the effect of 50 mg or 100 mg of iron (III) sucrose on bleomycin-detectable iron (BDI) in immune apheresis patients. Six patients with autoimmune disorders and normal kidney function were enrolled. Before and after the injection of 50 mg or 100 mg of iron (III) sucrose, BDI was measured in serum samples at five different time points.


RESULTS
There was no BDI traceable before injection of iron (III) sucrose. BDI was present in serum of all patients after the administration of 100 mg of iron (III) sucrose in concentrations up to 0.49 micromol/L. In contrast, only one patient showed BDI at a concentration of 0.16 micromol/L after the administration of 50 mg of iron (III) sucrose.


CONCLUSIONS
We conclude that if parenteral iron is administered after apheresis treatment, despite the equal tolerability, use of 50 mg of iron (III) sucrose is superior to 100 mg of iron (III) sucrose in avoiding the formation of potentially toxic nontransferrin-bound iron.
Sengoelge
Gürkan
G
Department of Medicine III, Division of Nephrology and Dialysis, University of Vienna, Vienna, Austria. Guerkan.Sengoelge@univie.ac.at
Rainer
Verena
V
Kletzmayr
Josef
J
Jansen
Martin
M
Derfler
Kurt
K
Födinger
Manuela
M
Hörl
Walter H
WH
Sunder-Plassmann
Gere
G
D000328:Adult; D001327:Autoimmune Diseases / Q000097:blood* / Q000628:therapy*; D001761:Bleomycin; D004305:Dose-Response Relationship, Drug; D005260:Female; D005290:Ferric Compounds / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000077605:Ferric Oxide, Saccharated; D005293:Ferritins / Q000097:blood; D005937:Glucaric Acid; D006801:Humans; D007263:Infusions, Parenteral; D007501:Iron / Q000097:blood*; D000090463:Iron Deficiencies; D008875:Middle Aged; D010956:Plasmapheresis / Q000009:adverse effects / Q000379:methods*; D012709:Serum Albumin / Q000378:metabolism; D014168:Transferrin / Q000378:metabolism
D005290:Ferric Compounds; D012709:Serum Albumin; D014168:Transferrin; D001761:Bleomycin; D005293:Ferritins; D007501:Iron; D000077605:Ferric Oxide, Saccharated; D005937:Glucaric Acid