Antioxidant therapy for severe cardiac failure induced by iron overload secondary to dyserythropoietic anaemia.
We present a case of a patient with longstanding transfusion-dependent congenital dyserythropoietic anaemia (CDA) who developed cardiomyopathy despite iron chelation therapy. She presented with severe heart failure that responded poorly to conventional therapy, recovering only when therapy was augmented with metabolic agents including antioxidants and with increased iron chelation. The present case gives support to the concept of treating oxidatively induced heart failure with metabolic and antioxidant therapy. This therapy may have wider application in refractory heart failure and in the prevention of cardiomyopathy in patients receiving regular red cell transfusions who are at risk of transfusional haemosiderosis.
van der Merwe
Juliana
J
Department of Cardiothoracic Surgery, Melbourne, Victoria, Australia.
Leong
Jee-Yoong
JY
Kaye
David
D
Opat
Stephen
S
Bergin
Peter J
PJ
Taylor
Andrew J
AJ
Rosenfeldt
Franklin
F
D000742:Anemia, Dyserythropoietic, Congenital / Q000150:complications* / Q000188:drug therapy*; D000975:Antioxidants / Q000627:therapeutic use*; D002648:Child; D003067:Coenzymes / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D005293:Ferritins / Q000097:blood; D006333:Heart Failure / Q000188:drug therapy* / Q000209:etiology*; D006801:Humans; D007502:Iron Chelating Agents / Q000627:therapeutic use; D015227:Lipid Peroxidation / Q000187:drug effects; D012720:Severity of Illness Index; D014451:Ubiquinone / Q000031:analogs & derivatives / Q000097:blood
D000975:Antioxidants; D003067:Coenzymes; D007502:Iron Chelating Agents; D014451:Ubiquinone; D005293:Ferritins; C024989:coenzyme Q10