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遗传性铁过载疾病的诊断与治疗。

Diagnosis and Management of Genetic Iron Overload Disorders.

机构信息

Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA.

Department of Hematology/Oncology, Mayo Clinic, Jacksonville, FL, USA.

出版信息

J Gen Intern Med. 2018 Dec;33(12):2230-2236. doi: 10.1007/s11606-018-4669-2. Epub 2018 Sep 17.

Abstract

Iron overload disorders lead to excess iron deposition in the body, which can occur as a result of genetic or secondary causes. Genetic iron overload, referred to as hereditary hemochromatosis, may present as a common autosomal recessive mutation or as one of several uncommon mutations. Secondary iron overload may result from frequent blood transfusions, exogenous iron intake, or certain hematological diseases such as dyserythropoietic syndrome or chronic hemolytic anemia. Iron overload may be asymptomatic, or may present with significant diseases of the liver, heart, endocrine glands, joints, or other organs. If treated appropriately prior to end-organ damage, life expectancy has been shown to be similar compared to matched populations. Alongside clinical assessment, diagnostic studies involve blood tests, imaging, and in some cases liver biopsy. The mainstay of therapy is periodic phlebotomy, although oral chelation is an option for selected patients.

摘要

铁过载疾病导致体内铁过量沉积,其可能由遗传或继发原因引起。遗传性铁过载,即遗传性血色素沉着症,可能表现为常见的常染色体隐性突变,也可能表现为几种罕见突变之一。继发性铁过载可能由频繁输血、外源性铁摄入或某些血液疾病引起,如先天性红细胞生成异常性贫血或慢性溶血性贫血。铁过载可能无症状,也可能出现肝脏、心脏、内分泌腺体、关节或其他器官的严重疾病。如果在终末器官损伤之前进行适当治疗,与匹配人群相比,预期寿命已被证明相似。除了临床评估外,诊断研究还包括血液检查、影像学检查,在某些情况下还包括肝活检。治疗的主要方法是定期放血,尽管口服螯合疗法是某些患者的选择。

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