iron overload


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overload

 [o´ver-lōd]
an excess over what is normal or needed.
iron overload an excess of iron in the body; see hemochromatosis, hemosiderosis, and siderosis.
sensory overload a condition in which an individual receives an excessive or intolerable amount of sensory stimuli, as in a busy hospital or clinic or an intensive care unit; the effects of sensory overload are similar to those of sensory deprivation, including confusion and hallucination.

transfusion reaction

Blood transfusion reaction, incompatibility reaction Transfusion medicine Any untoward response to the transfusion of non-self blood products, in particular RBCs, which evokes febrile reactions that are either minor–occurring in 1:40 transfusions and attributed to nonspecific leukocyte-derived pyrogens, or major–occurring in 1:3000 transfusions and caused by a true immune reaction, which is graded according to the presence of urticaria, itching, chills, fever and, if the reaction is intense, collapse, cyanosis, chest and/or back pain and diffuse hemorrhage Note: If any of above signs appear in a transfusion reaction, or if the temperature rises 1ºC, the transfusion must be stopped; most Pts survive if < 200 ml has been transfused in cases of red cell incompatibility-induced transfusion reaction; over 50% die when 500 ml or more has been transfused; TF mortality is ± 1.13/105 transfusions Clinical Flank pain, fever, chills, bloody urine, rash, hypotension, vertigo, fainting
Transfusion reactions
Immune, non-infectious transfusion reactions  
• Allergic Urticaria with immediate hypersensitivity
• Anaphylaxis Spontaneous anti-IgA antibody formation, occurs in ± 1:30 of Pts with immunoglobulin A deficiency, which affects 1:600 of the general population–total frequency: 1/30 X 1/600 = 1/18,000
• Antibodies to red cell antigens, eg antibodies to ABH, Ii, MNSs, P1, HLA
• Serum sickness Antibodies to donor's immunoglobulins and proteins
Non-immune, non-infectious transfusion reactions  
• Air embolism A problem of historic interest that occurred when air vents were included in transfusion sets
• Anticoagulant Citrate anticoagulant may cause tremors and EKG changes
• Coagulation defects Depletion of factors VIII and V; this 'dilutional' effect requires massive transfusion of 10 + units before becoming significant
• Cold blood In ultra-emergent situations, blood stored at 4º C may be tranfused prior to reaching body temperature at 37º C; warming a unit of blood from 4 to 37º C requires 30 kcal/L of energy, consumed as glucose; cold blood slows metabolism, exacerbates lactic acidosis, ↓ available calcium, ↑ hemoglobin's affinity for O2 and causes K+ leakage, a major concern in cold hemoglobinuria
• Hemolysis A phenomenon due to blood collection trauma, a clinically insignificant problem
• Hyperammonemia and lactic acid Both molecules accumulate during packed red cell storage and when transfused, require hepatorenal clearance, of concern in Pts with hepatic or renal dysfunction, who should receive the freshest units possible
• Hyperkalemia Hemolysis causes an ↑ of 1 mmol/L/day of potassium in a unit of stored blood, of concern in Pts with poor renal function, potentially causing arrhythmia
• Iron overload Each unit of packed RBCs has 250 mg iron, potentially causing hemosiderosis in multi-transfused Pts
Microaggregates Sludged debris in the pulmonary vasculature causing ARDS may be removed with micropore filters
Pseudoreaction Transfusion reaction mimics, eg anxiety, anaphylaxis related to a drug being administered at the same time as the transfusion
Infections transmitted by blood transfusion
• Viruses B19, CMV, EBV, HAV, HBV, HCV, HDV, HEV, Creutzfeldt-Jakob disease, Colorado tick fever, tropical viruses–eg Rift Valley fever, Ebola, Lassa, dengue, HHV 6, HIV-1, HIV-2, HTLV-I, HTLV-II
• Bacteria Transmission of bacterial infections from an infected donor is uncommon and includes brucellosis and syphilis in older reports; more recent reports include Lyme disease and Yersinia enterocolitica  Note: Although virtually any bacteria could in theory be transmitted in blood, the usual cause is contamination during processing rather than transmission from an infected donor
• Parasites Babesiosis, Leishmania donovani, L tropica, malaria, microfilariasis–Brugia malayi, Loa loa, Mansonella perstans, Mansonella ozzardi, Toxoplasma gondii, Trypanosoma cruzi

iron over·load

(ī'ŏrn ō'vĕr-lōd)
Variable level of toxicity due to nonphysiologic or intolerable levels of iron within the body.

Iron overload

A side effect of frequent blood transfusions in which the body accumulates abnormally high levels of iron. Iron deposits can form in organs, particularly the heart, and cause life-threatening damage.
References in periodicals archive ?
A population based cross-sectional study is needed where prevalence of BTT, iron deficiency, coexisting BTT and iron deficiency, and coexisting BTT and iron overload can be determined.
The frequency of iron overload related complications in patients of thalassemia major in our setting was different from their incidence reported internationally.
To determine whether iron overload affected hematological profile, the value resulted from hematology analyzer (18 indices) was analyzed.
(13) Soltanpour et al,12 emphasize the importance of cardiac T2*MRI in the assessment of iron overload in patients with TDT.
Iron removal by chelation therapy is considered important line of treatment strategy in iron overload and toxicity conditions.
Hemosiderosis was attributed to secondary iron overload, considering the numerous risk factors for this complication presenting before and after the retransplant (multiple blood transfusions, kidney injury, and CMV infection).
Despite the above findings, more evidence is needed to determine if iron overload impairs hematopoietic function by enhancing oxidative stress and how DFX and NAC exert their protective effects in vivo.
Unfortunately, iron overload is significantly underreported.
Etiology of growth retardation is based on a number of factors like disease itself, toxic effects of the drugs used for chelation therapy (Caruso et al., 1998; De Sanctis et al., 1996), toxicity of iron overload and malnutrition and endocrine complications (Fuchs et al., 1997).
Moreover; in response to iron overload in mice, hepatic hepcidin expression (Pigeon et al., 2001) and liver HAMP mRNA (Krijt et al., 2012) was up-regulated.
([4,16]) The mechanisms for insulin resistance include to possibility of iron overload causing resistance directly or through hepatic dysfunction.
The main source of accumulated iron in the body is blood transfusion in patients diagnosed with TM, whereas it is the case with iron overload in patients with TI.