By Dr. Manfred Wick, Univ.-Prof. Dr. Wulf Pinggera, Dr. Paul Lehmann (auth.)
Iron is key for many different types of existence, together with people. however, iron is additionally in all likelihood poisonous. for that reason, the keep watch over of iron metabolism and upkeep of iron hemostasis is an the most important a part of many features of human overall healthiness and affliction. Iron deficiency anemia is without doubt one of the commonest illnesses world wide, yet there also are anemias linked to power illnesses, and different got or hereditary defects. realizing the keep an eye on of iron metabolism is moreover very important for knowing ailments of iron overload, like hemochromatosis. This publication is designed for physicians, scientific lab team of workers and clinical scholars. It offers an outline concerning the ideas of legislation of iron metabolism and erythropoiesis. additionally, a few of the disturbances of iron metabolism and the linked scientific findings are defined. specified concentration lies at the differential prognosis of the problems, and the techniques of remedy. eventually, a finished agenda of exams is integrated to be had for the choice of iron metabolism-related parameters in serum/plasma and blood, with indication of methodologies utilized and reference ranges.
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Extra info for Clinical Aspects and Laboratory — Iron Metabolism, Anemias: Concepts in the anemias of malignancies and renal and rheumatoid diseases
Liver cirrhosis) with a severe synthesis defect which also includes haptoglobin. A reduction in haptoglobin may also be produced, albeit less commonly, by gastrointestinal protein-loss syndromes which also non-selectively include macromolecular proteins, such as celiac disease, Whipple’ s disease. Since haptoglobin also serves as a proteinase inhibitor, its synthesis in the liver is increased during acute-phase reactions. The resultant increase in concentration may then “mask” any hemolysis which is present simultaneously (Table 5).
Suscibility to infections decreases in the presence of reduced transport iron, because bacteria and other pathogens also require iron to replicate. The reduced availability of iron therefore acts as a protective mechanism on the one hand and, on the other, it represents a major pathomechanism of the development of anemias of infection and malignancy. Apart from downregulation of transferrin production, a second cause of iron redistribution in inflammations was identified . 29 Fig. 15: Model of iron redistribution in ACD  IFN-γ, interferon γ; iNOS, inducible nitric oxide synthase; IRE, iron-responsive element; IRE/IRP high-affinity binding of iron-regulatory protein (IRP) to IREs; LPS, lipopolysaccharide; NO, nitric oxide; TNF-α, tumor necrosis factor α; ↑ and ↓ indicate increase or decrease of cellular responses; respectively.
18: Normal and pathologic forms of erythrocytes sis and cell maturation (Fig. 17). Deficiencies similarly lead to macrocytic anemia. On account of the reduced proliferation capacity, especially of the cells of erythropoiesis, the total count of erythrocytes is then significantly reduced. However, since the hemoglobin synthesis capacity is at the same time normal, the individual erythrocytes are not only abnormally large (“macrocytes”, Fig. 18) but also have elevated hemoglobin content (“hyperchromic anemia”).