title: Renal iron load in sickle cell disease is influenced by severity of haemolysis.
abstract: Spin density projection-assisted R2-magnetic resonance imaging (R2-MRI; FerriScan(®)) scans from 40 chelation-naïve sickle cell patients were used to assess renal iron load by measuring renal R2 (R-R2). Clinical data were collected retrospectively for the 2-year period preceding the scan. R-R2 showed no significant correlation with transfusional iron load (assessed by liver iron concentration), but correlated significantly with serum bilirubin (R = 0·61, P < 0·0001) and lactate dehydrogenase (R = 0·58, P < 0·0001). Mean (±standard deviation) R-R2 was higher (P = 0·02) in patients with renal hyperfiltration (29·8 ± 10·3/s) than those without (23·11 ± 6·6/s). Five patients had significantly lower signal intensity in the renal cortex, as compared to the medulla. These patients had a significantly higher (P < 0·0001) mean R-R2 than those showing no cortico-medullary difference. We postulate that the increased R-R2 is associated with haemolysis rather than transfusional iron load in sickle cell disease.
authors.affiliation: King's College London School of Medicine, Molecular Haematology, London, UK.
authors.forename: Nisha
authors.initials: N
authors.lastname: Vasavda
authors.forename: Lucía
authors.initials: L
authors.lastname: Gutiérrez
authors.forename: Michael J
authors.initials: MJ
authors.lastname: House
authors.forename: Emma
authors.initials: E
authors.lastname: Drašar
authors.forename: Tim G
authors.initials: TG
authors.lastname: St Pierre
authors.forename: Swee L
authors.initials: SL
authors.lastname: Thein
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000628:therapy; D005260:Female; D006461:Hemolysis; D006801:Humans; D007501:Iron / Q000378:metabolism; D019190:Iron Overload / Q000175:diagnosis / Q000209:etiology*; D007668:Kidney / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D065227:Transfusion Reaction; D055815:Young Adult
chemical_list: D007501:Iron