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In India, Iron deficiency anemia is one of the major causes of maternal deaths, over the past years, various oral and intra muscular & intravenous preparations of iron have been used for correction of iron muscular are associated with significant side effects; Intramuscular (Iron dextran) was used as an alternative to oral iron therapy for those who were not compliant to oral therapy. Iron dextran has a lot of side effects such as fever, arthralgia, even anaphylactic reactions extending to pulmonary edema and even death. Further it is not possible to achieve the target rise in Hemoglobin level in a limited time period, when the patient is approaching term. Whereas Intravenous (Iron sucrose complex) is a relatively new drug which is a BOON to medical therapy and is the BEST OPTION of iron therapy when used as an alternative to oral therapy as it restores iron stores more promptly and is able to raise the hemoglobin to satisfactory level .

Rationale: Iron deficiency, in the absence of anemia, is common in patients with idiopathic and heritable pulmonary arterial hypertension (PAH) and is associated with a worse clinical outcome. Oral iron absorption may be impeded by elevated circulating hepcidin concentrations. The safety and benefit of parenteral iron replacement in this patient population is unclear. Objectives: To evaluate the safety and efficacy of parenteral iron replacement in PAH. Methods: In two randomized, double-blind, placebo-controlled 12-week crossover studies, 39 patients in Europe received a single infusion of ferric carboxymaltose (Ferinject) (1,000 mg or 15 mg/kg if weight

Iron dextran is a common anti-anemia drug, and it requires low molar mass dextran as substrate. In this work, we selected 11 amino acid residues in domain A/B of DSR-MΔ2 within a 5-angstrom distance from sucrose for site-directed mutagenesis by molecular docking. Mutation of Q634 did not affect the enzyme catalytic activity, but showed an obvious impact on the ratio of low molecular weight dextran (L-dextran, 3,000–5,000 Da) and relatively higher molecular weight dextran (H-dextran, around 10,000 Da). L-dextran was the main product synthesized by DSR-MΔ2 Q634A, and its average molecular weight was 3,951 Da with a polydispersity index

A total of 306 reports of adverse reactions to veterinary medicinal products were received during the year 2017 representing an increase of 21% compared to the previous year. The majority of these reports described reactions concerning companion animals (180 dogs and 59 cats) as well as cattle (38 reports) and horses (14 reports). Most of the reported reactions were linked to the use of antiparasitics (158 reports), hormone products (30 reports) and anti-inflammatory products (25 reports). 40 reports were generated from consultations with Tox Info Suisse in Zürich and mainly involved the excessive intake of flavoured tablets and, in some cases, the use of products under the cascade regulation (applied to another species than that authorized). Nine signals were identified from the reports, resulting in revisions of the product information in the sections addressing contra-indications or adverse reactions.Im Jahr 2017 wurden 306 Meldungen zu unerwünschten Wirkungen von Tierarzneimitteln eingereicht, was einer Zunahme von 21% gegenüber dem Vorjahr entspricht. Am häufigsten wurden Reaktionen bei Kleintieren (180 Hunden und 59 Katzen) sowie bei Rindern/Kälbern (38 Meldungen) und Pferden (14 Meldungen) gemeldet. Die am häufigsten betroffenen Medikamentengruppen waren wie in früheren Jahren Antiparasitika (158 Meldungen), Hormonpräparate (30) und Entzündungshemmer (25). Von Tox Info Suisse, Zürich wurden 40 Fälle übermittelt, die mehrheitlich die Aufnahme von Tierarzneimitteln mit Aromastoffen in Überdosis sowie einige Umwidmungen betrafen. Aus den gesammelten Meldungen wurden neun Signale identifiziert, die zur Anpassung der Arzneimittelinformation der betroffenen Präparate in den Rubriken „unerwünschte Wirkungen“ oder „Kontraindikationen“ führten.En 2017, 306 annonces d’effets indésirables de médicaments vétérinaires ont été enregistrées, ce qui constitue une augmentation de 21% par rapport à l’année précédente. Des réactions ont principalement été rapportées chez les petits animaux (180 chiens et 59 chats), ainsi que chez les bovins (38 annonces) et les chevaux (14 annonces). Les groupes de médicaments les plus souvent concernés étaient, comme les années précédentes, les antiparasitaires (158 annonces), les préparations hormonales (30 annonces) et les anti-inflammatoires (25 annonces). Quarante cas ont été transmis par Tox Info Suisse, Zürich, qui concernaient principalement l’absorption en surdose de médicaments vétérinaires aromatisés ainsi que quelques cas de reconversions. Sur la base de l’ensemble des annonces, neuf signaux ont été identifiés qui ont conduit à l’adaptation des informations sur les produits dans les rubriques «effets secondaires indésirables» ou «contre-indications».Nel 2017 sono state inoltrate 306 notifiche di effetti indesiderati di medicamenti per uso veterinario. Questo rappresenta rispetto allo scorso anno un incremento del 21%. Più di frequente sono state inoltrate notifiche relative a reazioni nei piccoli animali (180 cani e 59 gatti), nei bovini e vitelli (38 notifiche) e nei cavalli (14 notifiche). I gruppi di medicinali maggiormente messi in causa sono gli antiparassitari (158 notifiche), i preparati ormonali (30) e gli antiinfiammatori (25). Dal Tox Info Suisse di Zurigo sono stati trasmessi 40 casi, riguardanti principalmente l’ingestione in sovradosaggio di medicinali ad uso veterinario contenenti aromi e alcuni con un cambiamento di destinazione. Tra tutte le notifiche sono stati identificati 9 punti che hanno portato a un adeguamento delle informazioni del preparato in questione nelle rubriche “effetti indesiderati” oppure “controindicazioni”.

Objectives: The role of alpha-lipoic acid in the amelioration of iron overload-induced hepatic damage remains largely under-explored. Therefore, this paper aimed at describing the structural effects of alpha lipoic acid on the liver following iron overload in mice. Methods: After ethical approval, a total of 24 male mice were used. Twenty mice were randomly divided into 2 groups: A and B. Group A rats received 50mg/kg of iron dextran intraperitoneally daily for 49 days while those in group B received a daily oral dose of 100mg/kg alpha lipoic acid by gavage in addition to the treatment in A. Four mice were used as normal controls. At the endpoint of the experiment, the livers were harvested and studied for iron deposition, parenchymal histoarchitecture and hepatocyte densities. Photomicrographs were taken using a digital photomicroscope for morphometric analysis. Results: Treatment of mice with iron led to a distortion of the histoarchitecture of the liver which was attenuated with co-administration of alpha lipoic acid. Additionally, co-treatment of iron with alpha lipoic acid resulted in significant lowering of hepatic iron deposition (p

PURPOSE To explore the feasibility of susceptibility-weighted imaging (SWI) for evaluating renal iron overload. METHODS Twenty-eight rabbits were randomly assigned into control (n = 14) and iron (n = 14) group. In the 0th week, the study group was injected with iron dextran. Both groups underwent SWI examination at the 0th, 8th, and 12th week. The signal intensity (SI) of cortex and medulla was assessed. Angle radian value (ARV) calculated with phase image was taken as the quantitative value for cortical and medullary iron deposition. After the 12th week, the left kidneys of rabbits were removed for pathology. The difference in the ARV among three groups was analyzed using Kruskal-Wallis test. The difference of the iron content between two groups was analyzed through independent sample t-test. RESULTS In the iron group: at the 12th week, eight rabbits were found to have decreased SI of only cortex, and the other six rabbits had decreased SI of cortex and medulla by the same degree; the ARV of cortex at the 8th and 12th week was significantly higher than that of the 0th week (P < 0.05); the ARV of the six rabbits' medulla at the 12th week was significantly higher than that of the 0th week, 8th week, and the other eight rabbits at the 12th week (P < 0.05); at the 12th week, eight rabbits (iron group) were found to have many irons only deposit in the cortex, and the others were found to have many irons deposit in both cortex and medulla; the iron content of cortex and six rabbits' medulla in the iron group was significantly higher than that of the control (P < 0.05). CONCLUSION The ARV of SWI can be used to quantitatively assess the excess iron deposition in the kidneys. Excessive iron deposition mainly occurs in the cortex or medulla and causes their SWI SI to decrease.

Objectives: It is hypothesized that the risk of hypersensitivity reactions (HSRs) may be lower with ferric carboxymaltose than iron dextran because of its non-dextran carbohydrate moiety. This study compares the risk of HSRs between iron dextran and ferric carboxymaltose.Methods: This was a retrospective pharmacoepidemiological study with a case-population design covering 2008-2017. Global exposure data were estimated using IQVIA™ sales data. Spontaneously reported HSR data were retrieved from the World Health Organization database (VigiBase™) using different search criteria including: the Standardized MedDRA® Query (SMQ) 'Anaphylactic reaction'; type I-IV HSR terms; narrow terms for anaphylactic/anaphylactoid reactions; and cases with a fatal outcome.Results: Total exposure in 100 mg doses was 117.3 million for iron dextran and 84.2 million for ferric carboxymaltose. The relative risk (with 95% confidence interval) for ferric carboxymaltose versus iron dextran was 4.18 (3.88-4.50) for SMQ Anaphylactic reaction; 12.9 (9.90-16.7) for type I-IV HSRs; 1.72 (1.45-2.04) for anaphylactic/anaphylactoid reactions; and 1.92 (1.24-2.99) for death.Conclusion: The risk of spontaneously reported HSRs was consistently higher with ferric carboxy-maltose than with iron dextran over the period 2008-2017. Thus, this study does not support that dextran-free intravenous irons are associated with fewer HSRs than iron dextran.

Chelators are commonly used to remove excess iron in iron-loading disorders. Deferoxamine (DFO) is an effective and safe iron chelator but an onerous parenteral administration regimen limits its routine use. To develop more effective methods for delivering iron chelators, we examined whether amphiphilic copolymer nanoparticles (NPs) could deliver DFO more efficiently. Physical characterization showed a uniform and stable preparation of DFO nanoparticles (DFO-NPs) with an average diameter of 105.3 nm. In macrophage (RAW264.7) and hepatoma (HepG2) cell lines, DFO-NPs proved more effective at depleting iron than free DFO. In wild-type mice previously loaded with iron dextran, as well as Hbbth3/+ and Hfe–/– mice, which are predisposed to iron loading, DFO-NPs (40 mg/kg DFO; alternate days; 4 weeks) reduced hepatic iron levels by 71, 46, and 37%, respectively, whereas the equivalent values for free DFO were 53, 7, and 15%. Staining for tissue iron and urinary iron excretion confirmed these findings. Pharmacoki...

Iron deficiency anemia (IDA) is one of the most common medical disorder disturbing pregnancies particularly in low resources countries, and contributes significantly to morbidities and mortalities. Thus, early diagnosis and prompt management of IDA is highly recommended.To Test the efficacy and safety of oral lactoferrin plus health education provided by a nurse versus total dose infusion (TDI) of low-molecular weight (LMW) iron dextran for treating IDA in the second and third trimester of pregnancy.A prospective interventional, randomized, parallel-group, single-center longitudinal study.Woman's Health Assiut University Hospital, Assiut, Egypt, at the outpatient clinic and inpatient unit. It comprised 120 cases divided into two groups as pineapple flavored lactoferrin oral sachets 100 mg twice daily with health education (group A) and TDI of LMW iron dextran (group B).The primary efficacy parameter was clinical improvement and the amount of increase in hemoglobin concentration by 4 weeks after therapy, secondary outcome measures included measurement of the rest of RBC, and iron indices, the adverse effects related to iron therapy and the patient compliance to the treatment.There was insignificant difference between both groups regarding sociodemographic data, parity and mean gestational age. Both groups showed a significant clinical improvement of anemia 4 weeks post-therapy. There was no statistically significant difference in mean Hb level improvement in both groups after 1 month of therapy. However, mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) improved significantly more in group B than A while iron indices (serum iron and serum ferritin) were significantly more in group A than group B.Pineapple flavored lactoferrin oral sachets plus health education can be widely used as an alternative to TDI iron dextran supplementation due to clinical as well as laboratory improvement of IDA during pregnancy after 1 month of treatment. Proper health education of the pregnant women with nurse recommendations of balanced diet containing good sources of iron would increase awareness of pregnant women and help eradicate IDA with its serious sequel during pregnancy.

Iron deficiency is presently a serious problem in suckling piglets on pig farms. The most often used method of anaemia prevention in piglets is parenteral administration of iron dextran. Oral iron represents an alternative to this method. The goal of this article is to review current knowledge on oral iron administration in suckling piglets. The substances that can be used for this purpose include iron dextran, iron salts, iron chelates, carbonyl iron, an iron polymaltose complex and iron microparticles. The different methods of oral iron administration in piglets are discussed.

Study objective: To test safety, efficacy, and cost-effectiveness of total dose infusion (TDI) of low molecular weight (LMW) iron dextran for treatment of iron deficiency anemia (IDA) during pregna...

Aim Practitioners often avoid administering iron dextran in parenteral nutrition (PN) for hospitalised children because of the concern for anaphylaxis. The primary aim of the present study was to determine the risk of anaphylaxis associated with exposure to PN containing iron dextran in the inpatient setting. Methods Charts were reviewed for all children admitted to The Children's Hospital of Philadelphia from January 1, 2011 to December 30, 2013 who received PN containing low molecular weight (LMW) iron dextran. Subject characteristics, primary diagnoses and PN orders were evaluated. The pharmacy adverse events database was queried for adverse drug reactions. Results Over three years, 89 subjects received PN containing a maintenance dose of LMW iron dextran with a total of 2774 days of exposure. Subjects ranged from two months to 21 years of age and received between 1 and 196 days of PN containing iron dextran. The mean dose of iron dextran in children decreased as the weight category increased from

Intravenous bevacizumab decreased mucosal bleeding in some patients with hereditary hemorrhagic telangiectasia (HHT). We treated a 47-year-old male who had HHT, severe epistaxis, and gastrointestinal bleeding, alcoholic cirrhosis, and portal hypertension with intravenous bevacizumab 2.5 mg/kg every 2 weeks. We tabulated these measures weekly during weeks 1–33 (no bevacizumab); 34–57 (bevacizumab); and 58–97 (no bevacizumab): hemoglobin (Hb) levels; platelet counts; units of transfused packed erythrocytes (PRBC units); and quantities of iron infused as iron dextran to support erythropoiesis. We performed univariate and multivariable analyses. We sequenced his ENG and ACVRL1 genes. Epistaxis and melena decreased markedly during bevacizumab treatment. He reported no adverse effects due to bevacizumab. Mean weekly Hb levels were significantly higher and mean weekly PRBC units and quantities of intravenous iron were significantly lower during bevacizumab treatment. We performed a multiple regression on weekly Hb levels using these independent variables: bevacizumab treatment (dichotomous); weekly platelet counts; weekly PRBC units; and weekly quantities of intravenous iron. There was 1 positive association: (bevacizumab treatment; p = 0.0046) and 1 negative association (PRBC units; p = 0.0004). This patient had the novel ENG mutation E137K (exon 4; c.409G→A). Intravenous bevacizumab treatment 2.5 mg/kg every 2 weeks for 24 weeks was well-tolerated by a patient with HHT due to ENG E137K and was associated with higher weekly Hb levels and fewer weekly PRBC units.

Parenteral iron administration has been a common practice for the prevention of iron deficiency in newborn piglets. The efficacy and safety of this method require reexamination due to the introduction of new genetic lines and management changes in swine production. The aim of this article was to review current knowledge on this method of anaemia prevention in piglets. Iron requirements, iron sources, and the mode of action, dosage, and negative effects of iron dextran injection are discussed. The paper also reviews methods for evaluating the efficacy of iron administration in piglets.

The objective of this experiment was to evaluate the blood profile, growth performance, and tissue mineral concentration during the nursery period in weanling pigs that received various dosages of iron at birth. A total of 70 crossbred pigs (weaning BW 6.36 ± 0.92) from 5 different injectable iron dosage treatments administered at birth (0, 50, 100, 200, and 300 mg iron from iron dextran) were used. Pigs were weighed at d 22 (weaning), 23, 24, 25, 29, 38, 44, and 52. Blood was collected from 10 pigs per treatment at the same times as above except for d 44 and analyzed for a complete blood count (CBC). A total of 3 pigs per treatment were euthanized on d 22, 38, and 52 to determine tissue mineral concentration. All pigs were fed a common nursery diet supplemented with 100 mg/kg Fe from ferrous sulfate. All data were subjected to ANOVA with the pig as the experimental unit. As injectable iron dosage at birth increased, hemoglobin concentration (Hb) increased at weaning (linear and quadratic: P < 0.05), to d 29 and then quadratically through (P < 0.05) d 38. Along with the other CBC measurements, Hb was similar between treatments at d 52. There was a quadratic response (P < 0.05) for ADG from d 22 to 52. Although by d 52, final BW peaked (quadratic: P < 0.05) for pigs receiving 100 mg iron. Iron concentration of the liver and spleen were greater (linear: P < 0.05) at weaning as iron injection dosage increased but was greater only in the liver at d 38 (P < 0.05) and the spleen at d 52 (P < 0.05). Results indicate that an iron injection administered shortly after birth is vital for proper growth and hematological functions during the nursery period.

FN, a 29-year-old gravida 3 Para 2+2 female (with no live child), member of Jehovah’s Witness sect had emergency Caesarean section under general anaesthesia with endotrachael intubation for abruptio placentae at 35 weeks of gestation. Preoperative and postoperative packed cell volume (PCV) was 28% and 9% respectively. She received erythropoietin and iron dextran infusions. Patient developed anaemic heart failure on 3rd post-operative day which was managed successfully. She recovered completely and was discharged home on the 28th post-operative day. Management dilemmas specific to the Jehovah’s Witness parturient with abruptio placentae are discussed.

El objetivo de esta investigación fue evaluar el efecto de diferentes protocolos de administración de hierro en la prevención de anemia en lechones, a través de variables hematológicas como cantidad de hematíes (RBC), hemoglobina (HB), hematocrito (HT0), índices eritrocitarios (VCM, HCM, CHCM), ferritina (FT) y transferrina (TF). El estudio se realizó en el Centro Experimental Uyumbicho, Pichincha (Ecuador). Se utilizó un total de 27 lechones (Landrace x Yorkshire x Pietrain) distribuidos en un diseño completamente aleatorizado en tres tratamientos (T). En T1 se aplicó hierro-dextrano (100 mg/ml), a una única dosis de 2 ml al tercer día de edad; T2 hierrodextrano (100 mg/ml), 1 ml a los días 3 y 7 de edad; y T3 hierro dextrano (200 mg/ml), 1 ml al día 3 de edad. Adicionalmente se evaluó el peso vivo a los 28 días de edad (destete). Las muestras de sangre fueron tomadas 4 días después de la aplicación. Se encontraron diferencias (p0,05). Respecto al peso vivo no hubo diferencias entre los grupos evaluados (p>0,05). Se concluye que la aplicación de dos dosis de hierro-dextrano (100 mg/dl a los 3 y 7 días de edad), fue más efectiva para prevenir la anemia, como lo reflejan los valores de hematíes, hemoglobina y hematocrito. El peso vivo del lechón no se vio favorecido por ninguno de los tratamientos aplicados.

Background: Intravenous (IV) iron preparations are widely used in the treatment of anemia in patients undergoing hemodialysis (HD). All IV iron preparations carry a risk of causing hypersensitivity reactions. However, the pathophysiological mechanism is poorly understood. We hypothesize that a relevant number of these reactions are mediated by complement activation, resulting in a pseudo-anaphylactic clinical picture known as complement activation-related pseudo allergy (CARPA). Methods: First, the in-vitro complement-activating capacity was determined for 5 commonly used IV iron preparations using functional complement assays for the 3 pathways. Additionally, the preparations were tested in an ex-vivo model using the whole blood of healthy volunteers and HD patients. Lastly, in-vivo complement activation was tested for one preparation in HD patients. Results: In the in-vitro assays, iron dextran, and ferric carboxymaltose caused complement activation, which was only possible under alternative pathway conditions. Iron sucrose may interact with complement proteins, but did not activate complement in-vitro. In the ex-vivo assay, iron dextran significantly induced complement activation in the blood of healthy volunteers and HD patients. Furthermore, in the ex-vivo assay, ferric carboxymaltose and iron sucrose only caused significant complement activation in the blood of HD patients. No in-vitro or ex-vivo complement activation was found for ferumoxytol and iron isomaltoside. IV iron therapy with ferric carboxymaltose in HD patients did not lead to significant in-vivo complement activation. Conclusion: This study provides evidence that iron dextran and ferric carboxymaltose have complement-activating capacities in-vitro, and hypersensitivity reactions to these drugs could be CARPA-mediated.

RESUMO Com o objetivo de avaliar o uso de diferentes fontes de ferro na prevenção da anemia ferropriva e no desempenho em leitões lactentes, dividiram-se 202 leitões em cinco tratamentos: FD - aplicação intramuscular de 200mg de ferro dextrano no terceiro dia de idade; T24 - terra à vontade fornecida aos leitões a cada 24 horas do terceiro ao 19º dia; T48 - terra à vontade fornecida aos leitões a cada 24 horas do terceiro ao 10º dia e do 11º ao 19º dia, com intervalo de 48 horas; T72 - terra à vontade fornecida aos leitões a cada 24 horas do terceiro ao 10º dia e do 11º ao 19º dia, com intervalo de 72 horas; SA - suplemento alimentar ultraprecoce rico em ferro quelatado em pó (SAUP) fornecido do terceiro ao 11º dia, com intervalo de 48 horas. O ferro dextrano aplicado no terceiro dia de vida e a suplementação com terra e SAUP foram eficientes para garantir o desempenho de leitões no período de aleitamento e não influenciaram no consumo de ração nem na taxa de viabilidade. As diferentes fontes de ferro estudadas não influenciaram o leucograma e foram eficientes na prevenção da anemia ferropriva e no desempenho dos leitões lactentes. Com relação às concentrações de hemoglobina e hematócrito, os animais suplementados com ferro dextrano apresentaram valores superiores quando comparados aos que recebem terra e SAUP.

Parental iron supplementation in neonatal piglets is a routine management to solve anemia but may cause welfare problems. The aim of this study was to assess behavior responses generated after oral or parenteral iron supplementation. Parenteral supplementation consisted of 200 mg of iron dextran intramuscular. The novel oral iron supplement was a combination of encapsulated nonheme/heme iron (252 mg of total iron) delivered orally. Two litters formed by 11, 2-day-old piglets were assigned to each treatment. The litters were video recorded for 6 hours, 3 before and 3 after iron supplementation. Scan sampling every 3 minutes was used to register the occurrence of 7 behaviors. The highest overall percentage of time was allocated to resting, 46.5% (167.4 minutes) for the parenteral group and 42.4% (152.6 minutes) for the oral group; and suckling 24.6% (88.6 minutes) for the parenteral group and 27.8% (100.1 minutes) for the oral group. Resting time was higher after 1 hour of iron supplementation in the parenteral group 51.9% (31.1 minutes) vs. 33.8% (19.7 minutes). In conclusion, the oral iron supplementation resulted in a higher behavioral disruption in neonatal pigs, probably associated to increased handling time and aversive flavor of the supplement.

Patients with blood transfusion-dependent anemias develop transfusional iron overload (TIO), which may cause cardiosiderosis. In patients with an ineffective erythropoiesis, such as thalassemia major, common transfusion regimes aim at suppression of erythropoiesis and of enteral iron loading. Recent data suggest that maintaining residual, ineffective erythropoiesis may protect from cardiosiderosis. We investigated the common consequences of TIO, including cardiosiderosis, in a minipig model of iron overload with normal erythropoiesis. TIO was mimicked by long-term, weekly iron-dextran injections. Iron-dextran loading for around one year induced very high liver iron concentrations, but extrahepatic iron loading, and iron-induced toxicities were mild and did not include fibrosis. Iron deposits were primarily in reticuloendothelial cells, and parenchymal cardiac iron loading was mild. Compared to non-thalassemic patients with TIO, comparable cardiosiderosis in minipigs required about 4-fold greater body iron loads. It is suggested that this resistance against extrahepatic iron loading and toxicity in minipigs may at least in part be explained by a protective effect of the normal erythropoiesis, and additionally by a larger total iron storage capacity of RES than in patients with TIO. Parenteral iron-dextran loading of minipigs is a promising and feasible large-animal model of iron overload, that may mimic TIO in non-thalassemic patients.

In pigs, iron deficiency anemia (IDA) is the most prevalent deficiency disorder during the early postnatal period, frequently developing into a serious illness. On the other hand, in humans, only low-birth-weight infants, including premature infants, are especially susceptible to developing IDA. In both human and pig neonates, the initial cause of IDA is low birth iron stores. In piglets this shortage of stored iron results mainly from genetic selection over the past few decades for large litter sizes and high birth weights. As a consequence, pregnant sows cannot provide a sufficient amount of iron to the increasing number of developing fetuses. Supplementation with iron is a common practice for the treatment of IDA in piglets. For decades, the preferred procedure for delivering iron supplements during early life stages has been through the intramuscular injection of a large amount of iron dextran. However, this relatively simple therapy, which in general, efficiently corrects IDA, may generate toxic effects, and by inducing hepcidin expression, may decrease bioavailability of supplemental iron. New iron supplements are considered herein with the aim to combine the improvement of hematological status, blunting of hepcidin expression, and minimizing the toxicity of the administered iron. We propose that iron-deficient piglets constitute a convenient animal model for performing pre-clinical studies with iron supplements.

There exists a need for accurate, non-invasive point-of-care tests to detect body iron burden. This study investigated the use of x-ray fluorescence (XRF) measurements of skin iron as a marker for organ iron content in rats. This study also evaluated a novel application of a commercial XRF device, commonly used in mining and construction, as a rapid, portable, and non-invasive measurement tool. Rats (n = 32) were loaded with iron dextran and the iron signal of each animal’s skin, liver, and kidney was measured using a conventional XRF system. A quadratic correlation was observed between liver and skin iron signal (R2 = 0.92) and a linear correlation was observed between kidney and skin iron signal (R2 = 0.65). As such, it is concluded that skin iron content can act as a marker for both liver and kidney iron content. The same skin samples were measured using the portable XRF device and compared to the liver and kidney samples measured in the conventional XRF system. Again, a quadratic correlation was observed between liver and skin iron signal (R2 = 0.91) and a linear correlation was observed between kidney and skin iron signal (R2 = 0.83). Thus, the portable XRF device can provide rapid non-invasive, skin XRF measurements. Dosimetry was performed using the portable XRF device to assess the radiological hazard associated with its use. The average skin equivalent dose from this device is 30 ± 10 mSv/min, when the device is collimated and operated at 40 kV. In conclusion, skin iron XRF measurements can act as a surrogate marker for liver iron content, and can be measured using a commercial XRF device for a portable, fast, and non-invasive measurement.

There is increasing clinical evidence to suggest a suppressive effect on hematopoiesis in myelodysplastic syndrome patients with iron overload. However, how iron overload influences hematopoiesis in myelodysplastic syndrome (MDS) remains unknown. Here, the RUNX1S291fs-transduced bone marrow mononuclear cells were yielded and transplanted into lethally irradiated recipient mice together with radioprotective bone marrow cells to generate MDS mice. Eight weeks post transplantation, the recipient mice received an intraperitoneal injection of 0.2 mL iron dextran at a concentration of 25 mg/mL once every other day for a total of 8 times to establish an iron overload model. In the present study, we show that iron overload impairs the frequency and colony-forming capacity of normal hematopoietic stem and progenitor cells, especially in erythroid, in MDS mice, which is due, at least in part, to growth differentiation factor 11-induced reactive oxygen species, shortening survival of MDS mice. Given that we are the first to construct an iron overload model in MDS mice, we hope this model will be helpful for further exploring the influence and mechanism of iron overload on MDS.

Iron-deficiency anaemia (IDA) is a serious health problem in neonatal piglets and is controlled by routine application of iron in various formulations. The efficacy and safety of two iron-containing products for the prevention of IDA in suckling piglets were compared in a randomised, parallel study. Newborn piglets were treated with 200 mg iron supplied by intramuscular injection in the neck as either Forceris (gleptoferron; n=13) or Uniferon 200 (iron dextran; n=12) 24–48 hours after birth. Blood samples were collected before and after treatment (2nd, 18th and 31st day of life) for complete haematology. The treatments were well tolerated with only mild transient swelling observed in two piglets (Forceris group). Piglets treated with Forceris had significantly higher haemoglobin, haematocrit, mean corpuscular volume and haemoglobin concentration values, as well as significantly higher plasma iron and transferritin saturation and a lower total iron binding capacity than those treated with Uniferon. No animals in the Forceris group but 17 per cent of piglets in the Uniferon group had haemoglobin levels

This study was conducted to compare effects of dietary administration of iron dextran and bacterial-iron on growth performance, fecal microbial flora, and blood profiles in sows and their litters. A total of 20 multiparous sows (Landrace × Yorkshire) were randomly allotted into two treatments: (i) ID (basal diet, piglets were injected with iron dextran); (ii) BR (basal diet + bacterial-iron; bacterial-iron was given to sows, piglets were not injected with iron dextran). There were five replicates per treatment with two sows per replicate. No differences were observed on sow and piglet growth performance, fecal microbial flora as well as sow blood profiles between ID and BR treatments. In piglets, blood iron, red blood cell and hemoglobin concentrations in ID treatment were higher (P

Iron deficiency anemia is one of the major nutritional deficiency disorders. Iron deficiency anemia occurs due to decreased absorption of iron from diet, chronic blood loss and other associated diseases. The importance of iron and deleterious effects of iron deficiency anemia are discussed briefly in this review followed by the transdermal approaches to deliver iron. Transdermal delivery of iron would be able to overcome the side effects associated with conventional oral and parenteral iron therapy and improves the patient compliance. During preliminary investigations, ferric pyrophosphate and iron dextran were selected as iron sources for transdermal delivery. Different biophysical techniques were explored to assess their efficiency in delivering iron across the skin, and in vivo studies were carried out using anemic rat model. Transdermal iron delivery is a promising approach that could make a huge positive impact on patients suffering with iron deficiency.

The possibility of preventing the negative metabolic effects of megestrol acetate in the body of cats using it as a means to suppress the manifestations of the estrous cycle was investigated. It was found that in cats, which are used megestrol acetate for 7 days after dosing hemoglobin level decreased to 1.17 times, and on the fourteenth day was 1.33 times. It was determined that increasing the number of eosinophils in animals which megestrol acetate is used 2.7 times at 14 hours after dosing, animals receiving the drug protective iron eosinophils increased by 2.2 times on the fourteenth day after administration. In cats, the group which used megestrol acetate ALT activity increased by 16.9 % on the fourth day after the beginning of the experiment, 33.6 % on the 7th, and by 55.6 % on the fourteenth day after the administration of the drug as compared to the initial activity, whereas the animals which were used tread means the phenomenon was not observed. We found that increased levels of glucose in the animals of the first group by 14 % on the 4th day, 22 % on the 7th day and 22.4 % on the 14th day after the drug compared with the baseline values. It is found that the use of iron dextran solution in a dose of 7.5 mg / kg concurrently with megestrol acetate significantly reduces blood biochemical shift in profile in cats. It is shown that iron with simultaneous application of megestrol acetate formulation prevents a sharp decrease in the number of erythrocytes and increase of eosinophils in the blood of cats.

Background Medial vascular calcification is a specific complication in chronic kidney disease (CKD) patients although its pathogenesis is poorly understood. The administration of iron (Fe), generally used for the treatment of anemia in CKD patients, induces oxidative stress. Fe loading possibly affects the progress of vascular calcification in uremia. We investigated the effect of Fe on vascular calcification and its mechanism in uremic rats. Method Thirty-two rats were divided into four groups: untreated rats (controls), rats fed a standard diet with Fe administration (Fe group), rats fed an adenine-enriched diet (uremic group), and rats fed an adenine-enriched diet with Fe administration (uremic + Fe group). Iron dextran was administered once a week for 5 weeks intraperitoneally. Morphological alterations and vascular calcification-associated factors in the aortic wall were evaluated. Results No aortic calcification was observed in the control group although uremic rats developed severe vascular calcification. Fe loading suppressed vascular calcification in the uremic groups. Expressions of runt-related transcription factor 2 (Runx2), single-strand (ss)DNA and phosphate transporter (Pit)-1 were increased in the uremic rats compared to the control rats. In the uremic group, Fe administration did not show any effect on ssDNA expression, but reduced Runx2 and Pit-1 expressions. Conclusion Fe suppressed the development of vascular calcification through the prevention of Pit-1 and vascular smooth muscle cell osteoblastic transdifferentiation.

Suckling piglets cannot satisfy their demand for the essential trace element iron from sows&rsquo, milk alone, which is poor in iron. Therefore, iron is usually supplemented by injecting 200 mg iron (as iron dextran) on day 3 post natum. However, the longer suckling period in organic pig herds leads to iron intake from feed starting later. We hypothesized that one iron injection is not enough for organically reared piglets, and that a second and third injection would improve their iron status and growth. On an organically certified experimental farm, 288 piglets from 32 litters were allocated to three treatments with one iron injection on day 3, two injections on day 3 and 14 and three injections on day 3, 14 and 21 post natum, respectively. One injection resulted in the lowest hematocrit and serum iron levels until day 28 post natum and the lowest daily weight gains until weaning, while piglets receiving two or three iron injections did not differ from each other. Based on these observations, we conclude that one iron injection is not enough to ensure adequate iron supply and unimpaired growth of organically reared piglets, and additional iron supply is necessary.

Purpose To determine the feasibility of liver iron quantification by 3 Tesla (T) MRI using a novel iron overload rabbit model. Materials and Methods Forty-two rabbits underwent iron dextran loading from 1 to 15 weeks. MRI signal intensity ratio (SIR) was measured using a gradient-echo sequence, and R2(1/T2) measured using an eight-echo spin-echo sequence at 3T. Ex vivo hepatic pathology was obtained for all rabbits studied. Postmortem assessments of liver iron concentration (LIC) were conducted in an atomic absorption spectrophotometer. MRI measures were fitted against LIC using linear regression for 30 of the iron-loaded rabbits. The remaining 12 iron-loaded rabbits were used to test the prediction accuracy of the derived models. Results LIC was linearly correlated to both liver-to-muscle SIR (r = −0.845) and R2 (r = 0.965) in a range achieved in this study (LIC < 10 mg/g dry tissue) at 3T. By regression, the linear equations were determined as: (1) Y1 = 10.581−5.924X1 (Y1: LIC, X1:SIR); (2) Y2 = −1.273+0.103X2 (Y2:LIC, X2:R2). In the 12 test rabbits, the predicted LICs using the derived equations agreed well with the results obtained using the spectrophotometer. Conclusion Both SIR and R2 are highly correlated with LIC in a novel rabbit model. MRI quantification of liver iron overload is feasible at 3T. J. Magn. Reson. Imaging 2013;38:1585–1590. © 2013 Wiley Periodicals, Inc.

Iron deficiency is one of the most prevalent and serious health issues among people all over the world. Iron-dextran (ID) colloidal solution is one among the very few US Food and Drug Administration (FDA)-approved iron sources for parenteral administration of iron. Parenteral route does not allow frequent administration because of its invasiveness and other associated complications. The main aim of this project was to investigate the plausibility of transdermal delivery of ID facilitated by microneedles, as an alternative to parenteral iron therapy. In vitro permeation studies were carried out using freshly excised hairless rat abdominal skin in a Franz diffusion apparatus. Iron repletion studies were carried out in hairless anemic rat model. The anemic rats were divided into intact skin (control), microneedle pretreated, and intraperitoneal (i.p.) groups depending on the mode of delivery of iron. The hematological parameters were measured intermittently during treatment. There was no improvement in the hematological parameters in case of control group, whereas, in case of microneedle pretreated and i.p. group, there was significant improvement within 2-3 weeks. The results suggest that microneedle-mediated delivery of ID could be developed as a potential treatment method for iron-deficiency anemia.

Background Various techniques used to assess brain iron concentrations have demonstrated the presence of low iron stores in patients with restless legs syndrome (RLS). Previous open-label and randomized studies generally support the value of iron treatment for RLS symptoms. Only one of these studies assessed iron therapy response to changes in brain iron status. The current study was designed to assess the effect of iron therapy on RLS symptoms and on CSF measures of brain iron status. Methods Idiopathic RLS patients drawn from the Korean population received four weekly intravenous (IV) doses of 250 mg low-molecular weight iron dextran for a total dose of 1 g. One week after the last dose, any subject on RLS medication tapered off the RLS medications. Blood and CSF samples were taken to measure iron parameters at baseline and again, three weeks after the last dose. We have been following their response to the drug for two years after treatment. Results Twenty-five patients (age 55.2 ± 9.3, 18 female) enrolled in this study without serious adverse reactions. Seventeen of the 25 patients (68%) showed moderate or complete improvement of all RLS symptoms after treatment based on the Korean-translated versions of the International RLS Severity scale (K-IRLS). Changes in the K-IRLS did not correlate significantly with changes in CSF ferritin. The response to IV iron could not be predicted by patients’ demographics, or by blood or CSF iron baseline characteristics. RLS symptom improvement started between one and six weeks after treatment and the treatment benefits lasted from one month to 22 months. Fourteen patients, (56%) completely stopped all medications, for a mean duration of 31.3 ± 33.1 weeks. These results are comparable to those from a prior study with high molecular weight dextran. Conclusions Intravenous low-molecular weight iron dextran produced significant improvement of RLS symptoms in a majority of patients without any significant adverse effects. Serious anaphylaxis occurs with high molecular weight, but rarely, if ever, with this low molecular weight dextran. Given apparent comparable efficacy the low molecular weight and not the high molecular weight iron dextran, should be considered for RLS treatment. Although changes in CSF ferritin were seen following therapy, these changes were not related to clinical improvements.

Several intravenous iron complexes are available for the treatment of iron deficiency anemia (IDA). Iron dextran (DEX) is associated with an elevated risk of potentially serious anaphylactic reactions, whereas others must be administered in several small infusions to avoid labile iron reactions. Ferric carboxymaltose (FCM) is a nondextran intravenous iron which can be administered in high single doses. A randomized, open label, and multicenter comparison of FCM to DEX in adults with IDA and baseline hemoglobin of ≤11.0 g/dL was conducted. A total of 160 patients were in the safety population (FCMn=82; DEXn=78). Adverse events, including immune system disorders (0% in FCM versus 10.3% in DEX,P=0.003) and skin disorders (7.3% in FCM versus 24.4% in DEX,P=0.004), were less frequently observed in the FCM group. A greater portion of patients in the FCM group experienced a transient, asymptomatic decrease in phosphate compared to patients in the DEX group (8.5% in FCM versus 0% in DEX,P=0.014). In the FCM arm, the change in hemoglobin from baseline to the highest observed level was 2.8 g/dL, whereas the DEX arm displayed a change of 2.4 g/dL (P=0.20). Treatment of IDA with FCM resulted in fewer hypersensitivity-related reactions than DEX.

A total of 25 clinically anaemic pups aged 3-5 months were randomly divided into 5 equal groups. Pups in Group T5 were treated with single i/m injection of iron dextran and served as control group. Pups in Group T1 were transfused with fresh blood and those of Group T2, T3, and T4 received 7, 14 and 21 days preserved (4-6oC) blood, respectively, @ 20 ml/kg body weight as a single therapy. The clinico-biochemical parameters before blood transfusion showed significant increase in pulse and respiration rates, and significant decrease in total protein, albumin and blood glucose concentration. After 24, 72 and 120 hrs of blood transfusion, a significant improvement in the clinicobiochemical parameters approaching to normal values was observed, whereas no significant change was noticed in anemic control group treated with single i/m injection of iron dextran. It was concluded that blood transfusion, irrespective of fresh or stored blood, can improve clinicobiochemical status and thus is considered as an important life saving measure in severely anemic dogs.

Purpose An analysis of reported adverse events (AEs) among patients using i.v. iron products, including the newer agent ferumoxytol, is presented. Methods All AE reports to the Food and Drug Administration (FDA) citing iron sucrose, ferric gluconate, high- and low-molecular-weight iron dextran products, or ferumoxytol from October 2009 through June 2010 were evaluated. The rates of various classifications of reported AEs were calculated on a per-unit-sold basis and, for comparison of products supplied in different unit sizes, also in terms of 100-mg dose equivalents (DEq) of iron. Results A total of 197 reported AEs were identified (a cumulative rate of 14.1 AEs per million units sold). The rates of all AE classifications combined ranged from 5.25 to 746 per million units sold for iron sucrose and ferumoxytol, respectively; using the other method of calculation, the rates ranged from 5.24 per million DEq (iron sucrose) to 147 per million DEq (ferumoxytol). Relative to iron sucrose and sodium ferric gluconate, ferumoxytol was associated with significantly elevated risks of death (odds ratio [OR], 475 and 156, respectively; p < 0.0001), serious nonfatal AEs (OR, 263 and 121, respectively; p < 0.0001), and all evaluated AE classifications combined (OR, 142 and 109, respectively; p < 0.05). Conclusion Analysis of reports submitted to FDA revealed large differences among i.v. iron products in reported deaths, serious AEs, other major AEs, and other AEs. Iron sucrose and sodium ferric gluconate were associated with much lower rates of AEs per million units sold than iron dextran or ferumoxytol, which were associated with the highest rates of all reported AE classifications.

Resume Introduction Le fer dextran de bas poids moleculaire peut etre administre en une perfusion unique d’une dose totale correspondante a la carence en fer. L’objectif de cette etude observationnelle etait de determiner si l’administration unique d’une dose totale de fer dextran permettait de corriger la carence martiale du patient en dialyse peritoneale pendant une duree de quatre mois. Patients et methodes Les patients traites par dialyse peritoneale depuis plus de trois mois et ayant une anemie (hemoglobine Resultats Douze des dix-sept patients inclus terminaient l’etude. La dose totale moyenne administree etait de 742 ± 150 mg sans effet indesirable rapporte. Quatre mois apres l’injection on observait une augmentation significative de la moyenne de l’hemoglobinemie (10,1 ± 0,7 g/dL vs 11,4 ± 1,2 g/dL, p Conclusion Chez le patient traite par dialyse peritoneale, le fer dextran de faible poids moleculaire en injection unique d’une dose totale permet de corriger l’anemie ferriprive pendant une duree de quatre mois.

Excessive accumulation of iron in the body can lead to organ injury. Some flavonoids which possess high affinity to iron can be used as iron chelators for curing iron overload diseases such as haemochromatosis. In this article, the effects of baicalin and quercetin on different mouse tissues (liver, kidney and heart) afflicted with iron overload-induced injury were studied. It was found that after administration of 500 mg kg⁻¹ iron dextran for 45 days, the degree of oxidative injury in the three organs was different. When iron dextran-induced iron-overloaded mice were fed a diet containing baicalin or quercetin (1% w/w), both flavonoids showed significant effects in suppressing iron overload-induced injury. The efficiencies of both flavonoids on different tissues varied. Both flavonoids caused a significant decrease of iron content in liver and kidney tissues but not in the heart, whereas the flavonoids were more efficient in inhibiting the increase of carbonyl content and the thiobarbituric acid reactive substance levels in heart tissues. The results indicate that the protective effects of baicalin and quercetin on different tissues of iron-overloaded mice are different.

For more than 50 years, iron dextran has been the mainstay of parenteral iron therapy in the United States. In October 2009, the Food and Drug Administration expanded its existing black box warning that cautioned practitioners to administer a test dose first because of the risk of anaphylactic, often fatal adverse reactions. It further modified the warning, stating that fatal reactions can still occur even in patients who tolerated the test dose. As a result, health care providers have sought safer alternatives to parenteral iron dextran when oral iron repletion is not an option. The purpose of this review is to discuss the currently available formulations, with a focus on the needs of the pediatric patient, in whom there is limited experience in using products other than iron dextran.

Iron-induced cardiovascular disease is the leading cause of death in iron-overloaded patients. Deferasirox is a novel tridentate oral chelator that exhibits a half-life suitable for once-daily dosing; however, little is known regarding the effectiveness of this agent in preventing iron-induced cardiovascular disease. Adult male Mongolian gerbils were randomly divided into 3 groups: control, iron overload, and iron overload followed by deferasirox treatment. Iron-overloaded animals received iron dextran 100 mg/kg intraperitoneally (ip)/5 days for 10 weeks, while deferasirox was given 100 mg/kg per d orally (po) for 9 months post iron loading. Cardiac and aortic iron levels were determined by inductively coupled plasma atomic emission spectrometry. Gerbil electro- and echocardiograms were obtained in anesthetized animals at regular intervals. Compared to control animals, iron concentration was 3.3- and 2.4-fold higher in iron-overloaded heart and aorta, respectively (P.05). Deferasirox treatment reduced cardiac and aortic iron levels by 32% and 35%, respectively (P.05). These results were consistent with the decrease in cellular iron deposition observed with Prussian Blue iron staining. Iron-overloaded gerbils were found to exhibit frequent arrhythmias including premature ventricular contractions, supraventricular tachycardia, and recurrent ventricular tachycardia. In addition, echocardiographic assessment demonstrated iron overload-associated increase in left ventricular dimensions including left ventricular posterior wall dimension (LVPWd: 49%), left ventricular internal dimension (LVIDd: 26%), and left ventricular septum thickness (LVSd: 42%). These parameters were significantly reduced with deferasirox treatment (LVPWd: 23%, LVIDd: 24%, and LVSd: 27%). Iron overload was also associated with reduced ejection fraction (EF: by 30%) and fractional shortening (FS: by 23%) in comparison with controls (P.05). With deferasirox treatment, these values were higher (EF: by 30%, FS: by 28%) compared to iron-overloaded group. These findings suggest that deferasirox may be useful for attenuating iron-induced changes in cardiac structure and function.

Sir,Thanks to Dr Abbas for his interest in our recently published paper entitled “Lactoferrin plus health education versus total dose infusion (TDI) of low-molecular weight (LMW) iron dextran for t...

Summary Iron resorption from intramuscular injection of an iron dextran complex (Fedex) is almost complete in piglets one week after injection. The excess of resorbed iron is stored in liver and spleen. The stored iron is made available for the growing pig since half of the iron recorded on the 14th day after injection is used during the third week. The remaining iron stores might well be enough to cover the needs for the fourth week also, although it is not absolutely necessary for the pigs at this age. Zusammenfassung Eisenresorption und Eisenreserven bei Ferkeln nach intramuskularer Injektion von 59Fe-Dextran Eine Woche nach intramuskularer Injektion des Eisen-Dextran-Komplexes Fedex ist die Eisenresorption bei Ferkeln fast vollstandig. Der uberschus des resorbierten Eisens wird in der Leber und der Milz gespeichert. Dieses Depoteisen ist wahrend der Wachstumsphase der Schweine verfugbar, denn die Halfte des Eisens, das nach 14 Tagen noch gemessen werden konnte, wurde wahrend der dritten Woche verbraucht. Wir glauben, das das verbleibende Eisendepot ausreichen wurde, um auch den Bedarf der vierten Woche zu decken. Das ist bei Schweinen dieses Alters allerdings nicht mehr unbedingt notig. Resume Resorption et depot du fer chez des porcelets apres l'injection intramusculaire du 59Fe-Dextran La resorption du fer chez des pourceaux apres l'injection intramusculaire du Fedex, complexe du fer-dextran, etait presque totale une semaine apres l'application. L'exces du fer resorbe fut depose dans le foie et la rate. Le depot du fer etait accessible pour les pourceaux en developpement puisque la moitie des reserves constatees le 14ieme jour etait utilisee au cours de la troisieme semaine. Nous croyon que le reste du fer mis en depot est suffisant pour couvrir les besoins en fer au cours de la quatrieme semaine, quoique cela ne soit pas absolument indispensable pour les pourceaux de cet âge. Resumen Reabsorcion de hierro y almacenamiento de hierro en lechones despues de inyeccion intramuscular de 59Fe-Dextrano En lechones inyectados con Fedex, complejo de hierrodextrano, la reabsorcion de este compuesto fue casi completa despues de una semana de haber sido inyectados. El exceso del hierro reabsorbido fue almacenado en el higado y el bazo. El hierro almacenado fue accesible para el desarrollo de los lechones, puesto que la mitad de las reservas constatadas en el catorceavo dia fue utilizada durante la tercera semana. Creemos que el resto de la cantidad de hierro es suficiente para cubrir tambien las necesidades de hierro durante la cuarta semana, aunque esto no es absolutamente necesario para los lechones de esta edad.

This research was carried out to detect the effect of Sappan Wood Extract (Caesalpinia sappan), Wheat grass and Vitamin E Treatment on the liver structure of iron overload rat (Rattus norvegicus).The method of experimental used Completely Random Design (CRD in triple repetition. The treatment had been carried out orally. Iron dextran with total dose of 1.5 g kg -1 of body were given to rat on the first, fourth, seventh, ten and thirteenth day. Sappan Wood Extract (Caesalpinia sappan)200 mg kg -1 bw, 400 mg kg -1 bw, Wheat grass extract 100 mg kg -1 bw and Vitamin E 60 mg kg -1 bw were given to rat everyday for 15 days. At the seventeenth, rat were killed and their liver were taken. The observed parameters are morphological abnormality including the colour, the contour, ratio between liver weight and body weight as well as histological destruction. The result showed iron dextran treatment was proved the abnormality on morphological and histological desruction. Futhermore, Sappan Wood Extract (Caesalpinia sappan), Wheat grass and Vitamin E Treatment can decrease the morphological abnormality and the liver histological destructionon of iron overload rat. Keywords: Sappan Wood Extract, Wheat grass, Vitamin E, Iron, Morphological abnormality, Histological destruction

Biosusceptometry is a non-invasive procedure for determination of iron overload in a human body; it is essentially an assessment of the diamagnetic (water) and paramagnetic (iron) properties of tissues. We measured in vivo iron overload in the liver region of 12 rats by a room temperature susceptometer. The rats had been injected with sub-toxic doses of iron dextran. A quantitative relationship has been observed between the measurements and the number of treatments. The assessment of iron overload requires evaluating the magnetic signal corresponding to the same rat ideally without the overload. This background value was extrapolated on the basis of the signal measured in control rats versus body weight (R(2) = 0.73). The mean iron overload values for the treated rats, obtained after each iron injection, were significantly different from the means of the corresponding control rats (p0.01). The in vivo measurements have been complemented by chemical analysis on excised livers and other organs (R(2) = 0.89). The magnetic moment of iron atoms in liver tissues was measured to be 3.6 Bohr magneton. Evaluation of the background signal is the limit to the measure; the error corresponds to about 30 mg (1 SD) of iron while the instrument sensitivity is more than a factor of 10 better.

Iron replacement for iron-deficiency anemia has historically been accomplished with the use of oral iron therapy. Although oral iron is appropriate for most iron-deficiency anemia patients, many patients do not respond to or may be intolerant of oral iron, or may experience bleeding of sufficient magnitude to require higher iron doses than that achievable with oral iron. Intravenous iron therapy is a useful option for these latter patients. Three intravenous iron products are recommended: low-molecular weight iron dextran (INFeD), ferric gluconate (Ferrlecit), and iron sucrose (Venofer). These intravenous iron products have superior safety profiles compared to high-molecular weight iron dextran. The Food and Drug Administration's approval of erythropoietic-stimulating agents to treat certain types of anemia has increased usage of intravenous iron for functional iron deficiency. This review summarizes the current status of intravenous iron products and discusses their advantages and disadvantages in treating both absolute and functional iron deficiency.