title: Metal accumulation in the renal cortex of a pediatric patient with sickle cell disease: a case report and review of the literature.
abstract: BACKGROUND
  Sickle cell disease (SCD) is a well-known multisystem illness characterized by vascular injury due to vasoocclusion and hemolysis, as well as infectious complications and iron overload, all of which contribute to high morbidity and mortality rates among children. In these patients, some authors have previously described iron cortical deposition in the kidney. We here report the first case in the literature of a girl affected by SCD showing an anomalous metal and rare element retention in the renal cortex.
  
  
  METHODS
  A 10-year-old white girl affected by SCD underwent a routine magnetic resonance imaging investigation that evidenced a reduced signal intensity in the renal cortex, compatible with hemosiderin precipitation. Histologic and elemental analyses of the hepatic and the renal biotic samples, performed with inductively coupled plasma mass spectrometry, revealed that concomitant with the high iron deposition, toxic and potentially carcinogenic elements such as nickel, magnesium, rubidium, and gadolinuim were anomalously retained particularly in the kidney.
  
  
  CONCLUSIONS
  The finding of rare and toxic elements in the kidney of SCD patients might be linked to the development of specific neoplastic transformations already described in this patient cohort. To be confirmed, our speculations need to be demonstrated in large sampling of patients.
authors: *Pediatric Hemato Oncology Department †Pharmacy and Clinical Pharmacology ‡Laboratory and Molecular Medicine §Department of Radiology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste ∥Department of Pathology, Ospedale Beato Papa Giovanni XXIII, Bergamo, Italy.
authors: Natalia
authors: N
authors: Maximova
authors: Davide
authors: D
authors: Zanon
authors: Lorella
authors: L
authors: Pascolo
authors: Floriana
authors: F
authors: Zennaro
authors: Massimo
authors: M
authors: Gregori
authors: Daniele
authors: D
authors: Grosso
authors: Aurelio
authors: A
authors: Sonzogni
mesh_terms: D000755:Anemia, Sickle Cell / Q000378:metabolism*; D002648:Child; D005260:Female; D006801:Humans; D007672:Kidney Cortex / Q000378:metabolism*; D008670:Metals / Q000378:metabolism*; D013054:Spectrophotometry, Atomic
chemical_list: D008670:Metals