TY - JOUR
T1 - Non-transferrin-bound serum iron (NTBI) in megaloblastic anemia
T2 - Effect of vitamin B12 treatment
AU - Gafter-Gvili, Anath
AU - Prokocimer, Miron
AU - Breuer, William
AU - Cabantchik, Ioav Zeev
AU - Hershko, Chaim
PY - 2004
Y1 - 2004
N2 - Introduction: The abnormalities in iron metabolism associated with megaloblastic anemia are rapidly reversed by B12 therapy in pernicious anemia (PA). Although non-tranferrin-bound plasma iron (NTBI) was previously shown to be associated with severe iron overload, its origin is unknown. Methods and results: Four patients with PA were studied before and after B12 treatment. NTBI was measured by a fluorescence-based one-step assay. All patients had very high transferrin saturation, NTBI values ranging from 1.1 to 2.6,μmol/l and normal serum ferritins. B12 treatment resulted in the disappearance of NTBI and normalization of transferrin saturation within 22-42 h. Conclusions: The prompt disappearance of NTBI following B12 therapy implicates catabolic iron derived from ineffective erythropoiesis as the major source of NTBI in untreated PA and possibly in thalassemia major and sideroblastic anemia. Our findings offer further insight into the pathogenesis of NTBI in diseases associated with abnormal erythropoiesis.
AB - Introduction: The abnormalities in iron metabolism associated with megaloblastic anemia are rapidly reversed by B12 therapy in pernicious anemia (PA). Although non-tranferrin-bound plasma iron (NTBI) was previously shown to be associated with severe iron overload, its origin is unknown. Methods and results: Four patients with PA were studied before and after B12 treatment. NTBI was measured by a fluorescence-based one-step assay. All patients had very high transferrin saturation, NTBI values ranging from 1.1 to 2.6,μmol/l and normal serum ferritins. B12 treatment resulted in the disappearance of NTBI and normalization of transferrin saturation within 22-42 h. Conclusions: The prompt disappearance of NTBI following B12 therapy implicates catabolic iron derived from ineffective erythropoiesis as the major source of NTBI in untreated PA and possibly in thalassemia major and sideroblastic anemia. Our findings offer further insight into the pathogenesis of NTBI in diseases associated with abnormal erythropoiesis.
KW - B deficiency
KW - Iron overload
KW - Megaloblastic anemia
KW - Non-transferrin-bound plasma iron (NTBI)
UR - http://www.scopus.com/inward/record.url?scp=1342330480&partnerID=8YFLogxK
U2 - 10.1038/sj.thj.6200332
DO - 10.1038/sj.thj.6200332
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C2 - 14745427
AN - SCOPUS:1342330480
SN - 1466-4860
VL - 5
SP - 32
EP - 34
JO - Hematology Journal
JF - Hematology Journal
IS - 1
ER -