Chittamsetty Harika, Sekhar M S Muni, Ahmed Syed Afroz, Suri Charu, Palla Sridevi, Venkatesh S Muni, Tanveer Shahela
Senior Lecturer, Department of Oral Pathology, Sri Sai College of Dental Sugery , Vikarabad, Andhra Pradesh, India .
J Clin Diagn Res. 2013 Jun;7(6):1219-22. doi: 10.7860/JCDR/2013/5551.3084. Epub 2013 Apr 27.
Iron is vital for all the living organisms. However, excess iron is hazardous because it produces free radical formation. Therefore, the iron absorption is carefully regulated to maintain an equilibrium between the absorption and the body loss of iron. Considering the lack of specific excretory pathways for iron in humans, an iron overload in the tissues is frequently encountered. It can be precipitated by a variety of conditions such as increased iron absorption, as is seen in haemochromatosis or a frequent parenteral iron administration, as is seen in thalassaemia and sickle cell anaemia patients (a transfusional overload).
To demonstrate the iron overload at an early stage by oral exfoliative cytology in the oral mucosal cells of thalassaemia and sickle cell anaemia patients and to compare the presence of iron in the exfoliated oral epithelial cells with that of the serum ferritin levels in those patients.
The present study comprised of 40 β- thalassaemia major and 20 sickle cell anaemia patients who were undergoing repeated blood transfusions of a minimum of 15/more, along with 60 clinically healthy individuals. Scrapings were obtained from the buccal mucosa and they were smeared onto glass slides. Then the slides were stained with a Perl's Prussian staining kit and they were examined under a light microscope.
72.5% of the thalassaemia patients and 35% of the sickle cell anaemia patients revealed a positivity for the Perl's Prussian blue reaction and none of the controls showed this positivity. It was also observed that as the serum ferritin levels increased, the iron overload in the oral mucosal cells of the thalassaemia patients also increased, which was not statistically significant, whereas it was statistically significant in case of the sickle cell anemia patients.
Since the exfoliative cytology is a simple, painless, non-invasive and a quick procedure to perform, a lot of research should be carried out on the correlation of the Perl's Prussian blue reaction to the serum ferritin levels.
铁对所有生物都至关重要。然而，过量的铁是有害的，因为它会产生自由基。因此，铁的吸收受到严格调节，以维持铁吸收与身体铁流失之间的平衡。考虑到人类缺乏特定的铁排泄途径，组织中的铁过载经常出现。它可能由多种情况引发，如铁吸收增加，如在血色素沉着症中所见；或频繁静脉注射铁，如在地中海贫血和镰状细胞贫血患者中所见（输血性过载）。
通过口腔脱落细胞学检查在β地中海贫血和镰状细胞贫血患者的口腔黏膜细胞中早期显示铁过载，并比较这些患者脱落的口腔上皮细胞中铁的存在情况与血清铁蛋白水平。
本研究包括40例重型β地中海贫血患者和20例镰状细胞贫血患者，他们正在接受至少15次或更多次的反复输血，以及60名临床健康个体。从颊黏膜获取刮片并涂抹在载玻片上。然后用Perl氏普鲁士蓝染色试剂盒对载玻片进行染色，并在光学显微镜下检查。
72.5%的地中海贫血患者和35%的镰状细胞贫血患者Perl氏普鲁士蓝反应呈阳性，而对照组均未显示这种阳性。还观察到，随着血清铁蛋白水平的升高，地中海贫血患者口腔黏膜细胞中的铁过载也增加，但无统计学意义，而在镰状细胞贫血患者中具有统计学意义。
由于脱落细胞学检查是一种简单、无痛、非侵入性且快速的操作程序，因此应就Perl氏普鲁士蓝反应与血清铁蛋白水平的相关性开展大量研究。
