Vitamin D Insufficiency and Liver Iron Concentration in Transfusion Dependent Hemoglobinopathies in British Columbia

@inproceedings{Ezzat2015VitaminDI,
  title={Vitamin D Insufficiency and Liver Iron Concentration in Transfusion Dependent Hemoglobinopathies in British Columbia},
  author={Hatoon M. Ezzat and John K Wu and Heather McCartney and Heather A. Leitch},
  year={2015}
}
Patients with thalassemia major (TM) and other chronically transfused hereditary anemias are at increased risk of complications including endocrinopathies and bone disease due to iron overload. Vitamin D is important for bone health. Vitamin D deficiency is common in patients with transfusional iron overload, and the mechanism remains unclear. The first step in vitamin D metabolism, hydroxylation, occurs in the liver and liver iron overload may interfere with this step. This study investigates… 
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24 References

Low serum levels of 25-hydroxy vitamin D in adults affected by thalassemia major or intermedia.

Serum ferritin levels and endocrinopathy in medically treated patients with β thalassemia major

Endocrinopathy is common in TM patients treated with desferrioxamine therapy, especially in patients with serum ferritin levels >2,500 μg/l or those splenectomized, which is a cross-sectional study of 382 TM patients treating with regular transfusions and desferRIoxamine at the Thalassemia Center in Dubai.

Low serum 25-hydroxyvitamin D in hereditary hemochromatosis: relation to iron status.

Metabolic and endocrinologic complications in beta-thalassemia major: a multicenter study in Tehran

High prevalence of complications among thalassemics signifies the importance of more detailed studies along with therapeutic interventions, and shows significant association with lumbar but not femoral BMD.

Hepatic iron concentration combined with long‐term monitoring of serum ferritin to predict complications of iron overload in thalassaemia major

The data show that quantitation of liver iron from a single liver biopsy has little value in long‐term monitoring of iron stores, and most complications can be avoided if ferritin levels can be brought down to <1500 μg/l.

Value of hepatic iron measurements in early hemochromatosis and determination of the critical iron level associated with fibrosis

It is concluded that chemical measurement of hepatic iron concentration, when corrected for the age of the subject, reliably distinguishes early hemochromatosis from alcoholic siderosis, and that there appears to be a threshold level of Hepatic iron above which there is a high risk of fibrosis.

Osteomalacia, vitamin D deficiency and cholestasis in chronic liver disease.

It is suggested that patients with chronic liver disease with cholestasis for at least a year are at risk from osteomalacia and that those likely to have this complication may be identified by plasma 25-hydroxyvitamin D and/or fasting urine hydroxyproline/creatinine ratio measurements.

Differences in the prevalence of growth, endocrine and vitamin D abnormalities among the various thalassaemia syndromes in North America

Compared to patients with other thalassemia syndromes, those with beta TM suffered from higher rates of multiple endocrinopathies, abnormal calcium metabolism and hypercalciuria, and vitamin D abnormalities were high among adolescents.

Vitamin D deficiency, cardiac iron and cardiac function in thalassaemia major

Vitamin D deficiency may be associated with cardiac iron uptake and ventricular dysfunction in thalassaemia major patients and vitamin D25‐OH levels decreased with age and with liver iron.

Management of transfusional iron overload – differential properties and efficacy of iron chelating agents

Chelation therapy is used to prevent iron loading, remove excess accumulated iron, detoxify iron, and reverse some of the iron-related complications, and must be individualized, taking into account patient preferences, toxicities, ongoing transfusional iron intake, and the degree of cardiac and hepatic iron loading.