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药用铁剂所致肝硬化：放血疗法可逆转：发病机制研究

Medicinal iron-induced hepatic cirrhosis: reversal by phlebotomy: studies on pathogenesis.

作者信息

Wheby M S

出版信息

Trans Am Clin Climatol Assoc. 1978;89:100-8.

PMID:617015
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2279425/
Abstract

A patient with no underlying hematologic or iron metabolic disorder developed iron induced hepatic cirrhosis as a consequence of long term medicinal iron ingestion. Marked improvement in liver histology followed removal of 28 grams of iron by phlebotomy. Radioautographic studies in rats showed a periportal hepatocyte concentration of radioiron absorbed from the intestine while plasma transferrin was saturated. Based on these and other observations an hypothesis is proposed to explain liver damage in disorders of iron overload.

摘要

一名无潜在血液学或铁代谢紊乱的患者因长期摄入药用铁而发生铁诱导的肝硬化。通过放血去除28克铁后，肝脏组织学有明显改善。对大鼠的放射自显影研究显示，在血浆转铁蛋白饱和时，肠道吸收的放射性铁在门静脉周围肝细胞中聚集。基于这些及其他观察结果，提出了一个假说来解释铁过载疾病中的肝损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4cd/2279425/37e050c07110/tacca00100-0159-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4cd/2279425/854e76c54dad/tacca00100-0155-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4cd/2279425/393d045eb7f8/tacca00100-0157-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4cd/2279425/37e050c07110/tacca00100-0159-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4cd/2279425/854e76c54dad/tacca00100-0155-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4cd/2279425/393d045eb7f8/tacca00100-0157-a.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b4cd/2279425/37e050c07110/tacca00100-0159-a.jpg

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1
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引用本文的文献

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Rev Bras Hematol Hemoter. 2012;34(6):459-63. doi: 10.5581/1516-8484.20120113.
2
Drug effects on the liver. An updated tabular compilation of drugs and drug-related hepatic diseases.药物对肝脏的影响。药物及药物相关肝病的最新表格汇编。
Dig Dis Sci. 1983 Jul;28(7):651-66. doi: 10.1007/BF01299927.

本文引用的文献

1
EXCESSIVE ORAL IRON THERAPY CAUSING HAEMOCHROMATOSIS.过量口服铁剂治疗导致血色素沉着症。
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2
EFFECT OF TRANSFERRIN SATURATION ON IRON ABSORPTION IN MAN.转铁蛋白饱和度对人体铁吸收的影响。
N Engl J Med. 1964 Dec 31;271:1391-5. doi: 10.1056/NEJM196412312712704.
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THE RATE OF IRON ACCUMULATION IN IRON STORAGE DISEASE.
Blood. 1963 Oct;22:429-40.
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Role of transferrin in iron absorption.转铁蛋白在铁吸收中的作用。
J Clin Invest. 1963 Jul;42(7):1007-16. doi: 10.1172/JCI104785.
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Secondary hemochromatosis: its association with anemia.继发性血色素沉着症：其与贫血的关联。
Arch Pathol. 1960 Nov;70:623-39.
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Treatment of haemochromatosis by energetic phlebotomy; one patient's response to the letting of 55 litres of blood in 11 months.通过放血疗法治疗血色素沉着症；一名患者在11个月内放血55升后的反应。
Br J Haematol. 1958 Jan;4(1):82-8. doi: 10.1111/j.1365-2141.1958.tb03836.x.
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Hemochromatosis resulting from prolonged oral iron therapy.
N Engl J Med. 1968 May 16;278(20):1100-1. doi: 10.1056/NEJM196805162782006.
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Iron storage disorders of the liver.肝脏铁储存障碍
Gastroenterology. 1974 Dec;67(6):1257-83.