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Iron Overload

MedGen UID:
79398
•Concept ID:
C0282193
•
Disease or Syndrome
Synonym: Overload, Iron
SNOMED CT: Iron overload (60737008); Increased storage iron (60737008); Iron excess (60737008)

Definition

Accumulation of iron in the tissues. It may be a manifestation of an inherited disorder (e.g., hemochromatosis) or acquired (in patients with repeated blood transfusions). Symptoms include hepatomegaly, arthritis, diabetes mellitus, and bronzed skin. If untreated it has a progressive course and may lead to death. [from NCI]

Professional guidelines

PubMed

EASL Clinical Practice Guidelines on haemochromatosis.
European Association for the Study of the Liver
J Hepatol 2022 Aug;77(2):479-502. Epub 2022 Jun 1 doi: 10.1016/j.jhep.2022.03.033. PMID: 35662478
Current status of beta-thalassemia and its treatment strategies.
Ali S, Mumtaz S, Shakir HA, Khan M, Tahir HM, Mumtaz S, Mughal TA, Hassan A, Kazmi SAR, Sadia, Irfan M, Khan MA
Mol Genet Genomic Med 2021 Dec;9(12):e1788. Epub 2021 Nov 5 doi: 10.1002/mgg3.1788. PMID: 34738740Free PMC Article
ACG Clinical Guideline: Hereditary Hemochromatosis.
Kowdley KV, Brown KE, Ahn J, Sundaram V
Am J Gastroenterol 2019 Aug;114(8):1202-1218. doi: 10.14309/ajg.0000000000000315. PMID: 31335359

Recent clinical studies

Etiology

The IRONy in Athletic Performance.
Kardasis W, Naquin ER, Garg R, Arun T, Gopianand JS, Karmakar E, Gnana-Prakasam JP
Nutrients 2023 Nov 28;15(23) doi: 10.3390/nu15234945. PMID: 38068803Free PMC Article
Clinical Complications and Their Management.
Bou-Fakhredin R, Motta I, Cappellini MD, Taher AT
Hematol Oncol Clin North Am 2023 Apr;37(2):365-378. doi: 10.1016/j.hoc.2022.12.007. PMID: 36907609
Iron chelation therapy.
Bruzzese A, Martino EA, Mendicino F, Lucia E, Olivito V, Bova C, Filippelli G, Capodanno I, Neri A, Morabito F, Gentile M, Vigna E
Eur J Haematol 2023 May;110(5):490-497. Epub 2023 Feb 8 doi: 10.1111/ejh.13935. PMID: 36708354
Iron and the Pathophysiology of Diabetes.
Harrison AV, Lorenzo FR, McClain DA
Annu Rev Physiol 2023 Feb 10;85:339-362. Epub 2022 Sep 22 doi: 10.1146/annurev-physiol-022522-102832. PMID: 36137277Free PMC Article
Alpha- and Beta-thalassemia: Rapid Evidence Review.
Baird DC, Batten SH, Sparks SK
Am Fam Physician 2022 Mar 1;105(3):272-280. PMID: 35289581

Diagnosis

Haemochromatosis.
Adams PC, Jeffrey G, Ryan J
Lancet 2023 May 27;401(10390):1811-1821. Epub 2023 Apr 27 doi: 10.1016/S0140-6736(23)00287-8. PMID: 37121243
Iron chelation therapy.
Bruzzese A, Martino EA, Mendicino F, Lucia E, Olivito V, Bova C, Filippelli G, Capodanno I, Neri A, Morabito F, Gentile M, Vigna E
Eur J Haematol 2023 May;110(5):490-497. Epub 2023 Feb 8 doi: 10.1111/ejh.13935. PMID: 36708354
Iron overload disorders.
Hsu CC, Senussi NH, Fertrin KY, Kowdley KV
Hepatol Commun 2022 Aug;6(8):1842-1854. Epub 2022 Jun 14 doi: 10.1002/hep4.2012. PMID: 35699322Free PMC Article
The Evaluation of Iron Deficiency and Iron Overload.
Gattermann N, Muckenthaler MU, Kulozik AE, Metzgeroth G, Hastka J
Dtsch Arztebl Int 2021 Dec 10;118(49):847-856. doi: 10.3238/arztebl.m2021.0290. PMID: 34755596Free PMC Article
Hemochromatoses.
Brissot P, Loréal O
J Hepatol 2021 Sep;75(3):723-724. Epub 2021 Jul 11 doi: 10.1016/j.jhep.2021.04.001. PMID: 34261579

Therapy

Cardiac magnetic resonance biomarkers as surrogate endpoints in cardiovascular trials for myocardial diseases.
Benz DC, Gräni C, Antiochos P, Heydari B, Gissler MC, Ge Y, Cuddy SAM, Dorbala S, Kwong RY
Eur Heart J 2023 Dec 1;44(45):4738-4747. doi: 10.1093/eurheartj/ehad510. PMID: 37700499Free PMC Article
Emerging Therapies in β-Thalassemia.
Bou-Fakhredin R, Kuo KHM, Taher AT
Hematol Oncol Clin North Am 2023 Apr;37(2):449-462. doi: 10.1016/j.hoc.2022.12.010. PMID: 36907614
Iron chelation therapy.
Bruzzese A, Martino EA, Mendicino F, Lucia E, Olivito V, Bova C, Filippelli G, Capodanno I, Neri A, Morabito F, Gentile M, Vigna E
Eur J Haematol 2023 May;110(5):490-497. Epub 2023 Feb 8 doi: 10.1111/ejh.13935. PMID: 36708354
Optic neuropathy in iron overload and iron chelation therapy.
Melachuri S, Lim CC, Winters J
Am J Hematol 2022 May;97(5):670-672. Epub 2022 Feb 25 doi: 10.1002/ajh.26511. PMID: 35179250
Milk thistle in liver diseases: past, present, future.
Abenavoli L, Capasso R, Milic N, Capasso F
Phytother Res 2010 Oct;24(10):1423-32. doi: 10.1002/ptr.3207. PMID: 20564545

Prognosis

Guidelines for the monitoring and management of iron overload in patients with haemoglobinopathies and rare anaemias.
Shah FT, Porter JB, Sadasivam N, Kaya B, Moon JC, Velangi M, Ako E, Pancham S
Br J Haematol 2022 Jan;196(2):336-350. Epub 2021 Oct 6 doi: 10.1111/bjh.17839. PMID: 34617272
Current status of beta-thalassemia and its treatment strategies.
Ali S, Mumtaz S, Shakir HA, Khan M, Tahir HM, Mumtaz S, Mughal TA, Hassan A, Kazmi SAR, Sadia, Irfan M, Khan MA
Mol Genet Genomic Med 2021 Dec;9(12):e1788. Epub 2021 Nov 5 doi: 10.1002/mgg3.1788. PMID: 34738740Free PMC Article
Changing patterns in the epidemiology of β-thalassemia.
Kattamis A, Forni GL, Aydinok Y, Viprakasit V
Eur J Haematol 2020 Dec;105(6):692-703. Epub 2020 Sep 21 doi: 10.1111/ejh.13512. PMID: 32886826Free PMC Article
Update on survival in thalassemia major.
Telfer P
Hemoglobin 2009;33 Suppl 1:S76-80. doi: 10.3109/03630260903347336. PMID: 20001636
Effect of alcohol on viral hepatitis and other forms of liver dysfunction.
Balasubramanian S, Kowdley KV
Clin Liver Dis 2005 Feb;9(1):83-101. doi: 10.1016/j.cld.2004.10.004. PMID: 15763231

Clinical prediction guides

Iron overload promotes intervertebral disc degeneration via inducing oxidative stress and ferroptosis in endplate chondrocytes.
Wang W, Jing X, Du T, Ren J, Liu X, Chen F, Shao Y, Sun S, Yang G, Cui X
Free Radic Biol Med 2022 Sep;190:234-246. Epub 2022 Aug 15 doi: 10.1016/j.freeradbiomed.2022.08.018. PMID: 35981695
Iron metabolism: pathophysiology and pharmacology.
Roemhild K, von Maltzahn F, Weiskirchen R, Knüchel R, von Stillfried S, Lammers T
Trends Pharmacol Sci 2021 Aug;42(8):640-656. Epub 2021 Jun 2 doi: 10.1016/j.tips.2021.05.001. PMID: 34090703Free PMC Article
Hereditary hemochromatosis: pathogenesis, diagnosis, and treatment.
Pietrangelo A
Gastroenterology 2010 Aug;139(2):393-408, 408.e1-2. Epub 2010 Jun 11 doi: 10.1053/j.gastro.2010.06.013. PMID: 20542038
Hereditary haemochromatosis.
Janssen MC, Swinkels DW
Best Pract Res Clin Gastroenterol 2009;23(2):171-83. doi: 10.1016/j.bpg.2009.02.004. PMID: 19414144
Clinical consequences of iron overload in hemochromatosis homozygotes.
Ajioka RS, Kushner JP
Blood 2003 May 1;101(9):3351-3; discussion 3354-8. doi: 10.1182/blood-2002-11-3453. PMID: 12707221

Recent systematic reviews

Ferroptosis in acute kidney injury following crush syndrome: A novel target for treatment.
Qiao O, Wang X, Wang Y, Li N, Gong Y
J Adv Res 2023 Dec;54:211-222. Epub 2023 Jan 24 doi: 10.1016/j.jare.2023.01.016. PMID: 36702249Free PMC Article
Macrophage Subsets and Death Are Responsible for Atherosclerotic Plaque Formation.
Li H, Cao Z, Wang L, Liu C, Lin H, Tang Y, Yao P
Front Immunol 2022;13:843712. Epub 2022 Mar 30 doi: 10.3389/fimmu.2022.843712. PMID: 35432323Free PMC Article
Burden of central nervous system complications in sickle cell disease: A systematic review and meta-analysis.
Lee S, Lucas S, Proudman D, Nellesen D, Paulose J, Sheehan VA
Pediatr Blood Cancer 2022 Apr;69(4):e29493. Epub 2022 Jan 17 doi: 10.1002/pbc.29493. PMID: 35038214
Serum or plasma ferritin concentration as an index of iron deficiency and overload.
Garcia-Casal MN, Pasricha SR, Martinez RX, Lopez-Perez L, Peña-Rosas JP
Cochrane Database Syst Rev 2021 May 24;5(5):CD011817. doi: 10.1002/14651858.CD011817.pub2. PMID: 34028001Free PMC Article
Guidelines on the diagnosis and treatment of iron deficiency across indications: a systematic review.
Peyrin-Biroulet L, Williet N, Cacoub P
Am J Clin Nutr 2015 Dec;102(6):1585-94. Epub 2015 Nov 11 doi: 10.3945/ajcn.114.103366. PMID: 26561626

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