Because these subjects lacked kidney function, they failed to produce the erythropoietin needed for
erythropoiesis and therefore suffered with anaemia of renal failure.
They also had evidence of iron-restricted
erythropoiesis, as shown by a combination of low TSAT levels and high serum ferritin levels.
Novel
erythropoiesis stimulating protein (NESP) for the treatment of anaemia of chronic disease associated with cancer.
Continuous
erythropoiesis receptor activator (CERA) is a third-generation ESA with a methoxy polyethylene glycol-epoietin beta composition which alters the receptor binding capacity.
In addition, substantial evidence exists on the capability of identifying past use of r-HuEPO, based on the unique combination of high Hct (or Hb), suppressed
erythropoiesis (low reticulocyte count), and reduced endogenous serum EPO (OFF model) (10,11).
Serum ferritin levels should be used to measure iron stores, and transferrin saturation (TSAT) or reticulocyte Hgb content (CHr) should be used to measure adequacy of iron availability for
erythropoiesis. One key difference between the 2001 and 2006 guidelines was the increase in the lower limit for target serum ferritin in patients on hemodialysis, from 100 ng/mL to 200 ng/mL, reflecting new efficacy data for IV iron therapy (NKF, 2002, 2006).
This marker may be increased in patients who display hyperproliferative
erythropoiesis (12,13).
Hepcidin synthesis is directed by numerous elements apart from inflammation, including iron stores, hypoxia and
erythropoiesis, and hepcidin release into the peripheral circulation is regulated by other proteins, including HJV, hereditary haemochromatosis protein, transferrin receptor 2, matriptase-2 and neogenin.39,40 Pathologic modifications of hepcidin regulation are dominant in many disorders of iron metabolism, together with iron-loading anaemia, hereditary haemochromatosis, and anaemia of inflammation.2
The absence of any other possible known prothrombotic factor supports the notion that thrombosis could be associated with splenectomy and the component of ineffective
erythropoiesis in our patient (carrier of a-icaria mutation).
The microcytic RBCs in Figure 2 are the result of iron deficient
erythropoiesis caused by reduced cellular Hb levels.
KEY WORDS: Curcumin; Erythropoietin;
Erythropoiesis; Iron; Ferritin; Hepcidin
It is thought that growth differentiation factor 15 excreted from late and apoptotic erythroid precursors due to ineffective
erythropoiesis, twisted gastrulation protein homolog 1 excreted from early erythroid precursors and increasing hypoxia-inducible factors due to chronic anaemia and hypoxia lead to a decrease in the synthesis of hepcidin (3-5).
