Unexpectedly high but still asymptomatic iron overload in a patient with pyruvate kinase deficiency.
Iron overload is a serious condition, which may lead to irreversible organ damage. The risk of iron accumulation in pyruvate kinase deficiency (PKD) has traditionally been regarded as low, but recent evidence has questioned this notion. We here present a case of a young PKD patient showing evidence of asymptomatic iron accumulation measured as liver iron concentration (LIC) obtained noninvasively by magnetic resonance imaging. The iron overload was not related to blood transfusions, but rather secondary to concomitant risk factors leading to increased intestinal iron absorption, such as chronic hemolysis and splenectomy. The iron status of PKD patients, preferably assessed by LIC measurements, should therefore be evaluated regularly also in asymptomatic patients. This evaluation should start already at a young age, in order to initiate iron chelation before the development of iron-induced organ damage.
Andersen
Frank D
FD
Department of Hematology, Aarhus University Hospital, Aarhus, Denmark. franka@dadlnet.dk
d'Amore
Francesco
F
Nielsen
Finn Cilius
FC
van Solinge
Wouter
W
Jensen
Finn
F
Jensen
Peter D
PD
D000328:Adult; D000745:Anemia, Hemolytic, Congenital / Q000150:complications / Q000235:genetics; D005293:Ferritins / Q000097:blood; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I / Q000235:genetics; D006801:Humans; D007408:Intestinal Absorption; D019190:Iron Overload / Q000150:complications* / Q000175:diagnosis* / Q000378:metabolism; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008565:Membrane Proteins / Q000235:genetics; D011770:Pyruvate Kinase / Q000172:deficiency* / Q000235:genetics; D015323:Pyruvate Metabolism, Inborn Errors / Q000150:complications* / Q000235:genetics; D012307:Risk Factors; D013156:Splenectomy
C103673:HFE protein, human; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins; D005293:Ferritins; D011770:Pyruvate Kinase