Rao K V, Anderson W R
Am J Nephrol. 1985;5(6):419-30. doi: 10.1159/000166976.
We analyzed the clinical data and liver histology for iron overload in 74 renal allograft recipients. Twenty of the 74 patients had histological evidence of hemosiderosis. Four patients had hemochromatosis. Of the 2 noninvasive diagnostic tests the serum ferritin level was more reliable than percent saturation of transferrin in predicting the histological diagnosis of hemosiderosis. Of the 20 patients with hemosiderosis 14 died either from liver failure or concomitant sepsis. Female patients and those who received long-term dialysis had higher susceptibility for developing hemosiderosis. Of the 6 patients treated with phlebotomies, the response was good in 4 and incomplete in 2. Hemosiderosis and hemochromatosis should be considered in the differential diagnosis of posttransplant liver disease. Intermittent phlebotomies if carried out early may prevent the progression of hemosiderosis to micronodular cirrhosis.
我们分析了74例肾移植受者铁过载的临床资料和肝脏组织学情况。74例患者中有20例有血色素沉着症的组织学证据。4例患者患有血色素沉着病。在两种非侵入性诊断测试中，血清铁蛋白水平在预测血色素沉着症的组织学诊断方面比转铁蛋白饱和度更可靠。在20例血色素沉着症患者中，14例死于肝功能衰竭或并发败血症。女性患者和接受长期透析的患者发生血色素沉着症的易感性更高。在6例接受放血治疗的患者中，4例反应良好，2例不完全。在移植后肝病的鉴别诊断中应考虑血色素沉着症和血色素沉着病。如果早期进行间歇性放血，可能会防止血色素沉着症发展为小结节性肝硬化。
