• Title/Summary/Keyword: Intravenous iron

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Intravenous Iron Supplementation in Korean Children on Chronic Dialysis (한국 만성 투석 소아 환자에서 정맥용 철분 제제 투여에 관한 연구)

  • Cho, Hee-Yeon;Hahn, Hye-Won;Ha, Il-Soo;Cheong, Hae-Il;Choi, Yong
    • Childhood Kidney Diseases
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    • v.13 no.2
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    • pp.197-206
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    • 2009
  • Purpose : Limited information is available on experiences of intravenous iron treatment in children. In this study, iron sucrose was administered intravenously to determine its effect, the factors predicting outcome, and safety in children on chronic dialysis. Methods : Twenty-one children whose serum ferritin levels were less than 100 ng/mL or transferrin saturations (TSAT) were less than 20% were enrolled. In 12 children on peritoneal dialysis (PD), the drug was infused intravenously as 200 mg/$m^2$ ($\leq$200 mg) at week 0, 2, 4, and 6. In 9 children on hemodialysis (HD), it was given intravenously as 8 weekly doses of 3 mg/kg ($\leq$100 mg) through week 0-7. Results : After treatment, serum ferritin levels increased significantly in both groups, and TSAT rose significantly in PD group. However, hemoglobin level did not rise significantly in both groups. Children with baseline hemoglobin less than 10 g/dL or baseline TSAT less than 20% showed significantly higher rise of hemoglobin after intravenous iron treatment. To the contrary, those with higher baseline hemoglobin and TSAT levels displayed higher rise in serum ferritin after the treatment. Although no serious adverse event occurred, TSAT levels exceeding 50% were noted in 6 patients in PD group. Conclusion : This suggests that 3 mg/kg/week of intravenous iron sucrose can be used safely in children on chronic HD, but 200 mg/$m^2$ every other week may incur excessive TSAT level in some patients on chronic PD.

Effect of intravenous deferoxamine in multiply transfused patients (대량 수혈을 받은 환아들에서 정맥 투여한 deferoxamine의 효과)

  • Oh, Sang Min;Kang, Joon Won;Kim, Sun Young
    • Clinical and Experimental Pediatrics
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    • v.50 no.12
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    • pp.1225-1230
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    • 2007
  • Purpose : Multiple transfusions in patients with chronic anemia can result in excessive iron deposition in tissues and organs. Effective iron chelation therapy in chronically transfused patients can only be achieved when iron chelators remove sufficient amounts of iron equivalent to those accumulated in the body from transfusions, thus leading to maintain body iron load at a non-toxic level. This study was retrospectively carried out to investigate the effect of intravenous iron chelation therapy with deferoxamine in patients who have received multiple transfusions. Methods : From March 2005 to January 2007, 15 patients who have received multiple transfusions were included in this study. Transfusion dependent patients were defined as those receiving >1 packed red blood cell (RBC) units/month for at least 6 months. They received intravenous deferoxamine for 7 days (10-30 mg/kg/day, 24 hour continuous infusions). Before and after deferoxamine infusions and 3 months later, we compared serum iron, TIBC, and ferritin in transfusion dependent patients and transfusion independent patients. Results : There were 6 males and 9 females and their age range was 5.6-21.3 (median 8.3) years. Transfusion dependent patients were 7 and 8 were transfusion independent states after stem cell transplantation or chemotherapy. There was no significant change in ferritin level after deferoxamine treatment for the transfusion dependent patients but significant falling of ferritin level was observed for the transfusion independent patients 3 months later compared with baseline ferritin level (P=0.046). Some adverse events were observed but symptoms were mild and tolerable. Conclusion : Seven days of intravenous deferoxamine was safe and effective in transfusion independent patients. In transfusion dependent patients, chelation therapy should be maintained, in order to minimize or prevent iron accumulation and storage in the tissues.

Efficacy of Intravenous Iron Sucrose for Treating Anemia after Gastrectomy (위절제술 후 빈혈에 있어서 Iron Sucrose의 효과)

  • Kwon, In-Gyu;Song, Jye-Won;Kang, Wook-Ho;Oh, Sung-Jin;Hyung, Woo-Jin;Choi, Seung-Ho;Noh, Sung-Hoon
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.262-266
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    • 2008
  • Purpose: Many patients suffer with anemia after gastrectomy. Iron deficiency due to a decreased oral intake and malabsoption is the most common cause of anemia in gastrectomized patients. This study evaluated the efficacy of administering intravenous iron sucrose for treating patients with anemia. Materials and Methods: From May 2007 to October 2007 at Yonsei University Severance Hospital, we reviewed 47 outpatients whose hemoglobin levels were below 11 g/dl after gastrectomy. Iron sucrose was used for iron supplementation. To determine the difference between before and after the treatment (at 1 week, 2 weeks, 3 weeks, 3 months and 6 months after treatment), we prospectively examined such anemia parameters as the hemoglobin level (Hgb), the hematocrit (Hct), serum iron, TIBC, ferritin and transferin. Results: Out of the 47 patients, only 36 completed their treatment. Eleven were male and 25 were female. The Hgb levels, which indicate anemia, were elevated 0.6, 0.8, 1.3, 2.1 and 2.2 g/dl after 1 week, 2 weeks, 3 weeks, 3 months and 6 months after administration, respectively (P<0.001). The changes from 1 week to 3 months were statistically significant, but those from 3 to 6 months were not. The Hgb levels of 26 patients, which accounted for 72% of all the patients, elevated up to 12 g/dl or more. No side effects or complications were found, but there was one case of temporary nausea. Conclusion: Anemia after gastrectomy is safely treated in a relatively short time with administering iron sucrose. The patients' Hgb levels are expected to increase in a week and keep increasing up to 3 months.

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Studies on Ancylostomiasis II. Clinical Symptomatology, Effects of Drugs, especially of Iron Compounds, with Relation to the Severity of Artificial Infection (구충증(鉤蟲症)에 관(關)한 연구(硏究) 제2편(第2編) 감염경중(感染輕重)에 따른 구충증(鉤蟲症)의 임상증상(臨床症狀), 빈혈상(貧血像) 및 약물(藥物) 특(特)히 철제제(鐵製劑)의 효과(效果))

  • Lee, Mun-Ho;Kim, Dong-Jip;Lee, Jang-Kyu;Seo, Byong-Sul
    • The Korean Journal of Nuclear Medicine
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    • v.1 no.2
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    • pp.41-59
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    • 1967
  • This study was aimed; firstly to observe various clinical symptomatology with reiation to the number of Ancylostoma duodenale larvae orally given to the human beings, secondly to evaluate the effects of some drugs like steroid hormones, antihistaminic3 and antitussives, and, thirdly to study the influences of some iron compounds in prevention and treatment of anemia of such origin. Ten healthy volunteers free from the previous history of hookworm infection were divided into 4 groups, to whom various numbers of actively moving filariform Ancylostoma duodenale larvae were orally given; 500 to 4 cases, 250 to 3 cases and 100 to 3 cases. Following were the results: 1. Clinical symptomatology 1. The most frequently encountered symptoms and signs were general malaise, cough and hoar seness. The tracheal itching and pain low back pain, arthralgia, sputum and salivation, acid belching, loss of appetite, abdominal pain and vomiting were also noted. 2. If the larger number of the larvae was given, the clinical symtomatology was more severe. 3. Prednisolone medication caused some improvement of such symptomatology, while the antihistaminics and antitussives like codeine or ephedrine were ineffective. 4. In volunteers whose nutritional conditions were rather poor appeared to show more severe symptomatology. 2. Effects of iron compounds 1. The oral administration of ferrous fumarate induced a slight increase of serum iron levels in the initial stage of the infection, then a decrease from $15{\sim}20$ days later and a recovery after 2 months. 2. The intravenous administration of saccharated ferric oxide induced a steady upkeep of the serum iron levels. 3. The hemoglobin contents also showed the upkeeps after either the oral or intravenous administration of the iron compounds. 4. The iron compounds, therefore, are considered to have the preventive as well as the therapeutic effects on hookworm anemia, which may strongly suggest that hookworm anemia is essentially the iron deficiency type. 3. Hematological changes 1. The severity of hookworm anemia generally correlated with the number of larvae given. 2. The moderate leucocytosis was observed in all cases regardless of the number of larvae given, which reached to a peak in $25{\sim}35$ days. 3. Eosinophilia was observed in all cases, but was more severe in cases given larger number of larvae, which was slightly less evident after the medication of prednisolone. 4. Red cell survival time The red cell survival time determined by $^{51}Cr$ was generally in the normal ranges except for the severe anemia patients.

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Efficacy and Safety of Intraveous Iron Sucrose in the Perioperatively Anemic Patients of Gastrectomy (위 절제 수술 전후 빈혈 환자에 있어 철수크로오스의 유효성 및 안전성)

  • Yoo, Moon-Won;Cho, Jae-Jin;Lee, In-Kyu;Ahn, Hye-Seong;Jeong, Sang-Ho;Lee, Hyuk-Joon;Kim, Hyung-Ho;Lee, Kuhn-Uk;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.8 no.1
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    • pp.35-39
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    • 2008
  • Purpose: This study was aimed to evaluate the efficacy and safety of of intravenous iron sucrose ($Venoferrum^{(R)}$) for treating the perioperative anemic gastrectomy patients. Materials and Methods: From September 2006 to February 2007 at Seoul National University Hospital, the gastrectomy patients who displayed perioperative anemia (7.0 g/dl $\leq$ hemoglobin levels (Hb) < 11.0 g/dl) and who were admitted or visited the outpatient clinic of the Department of surgery, were divided into two groups. The preoperative (${\leq}\;2{\sim}3$ weeks before gastrectomy) or postoperative ($\geq$ 1 month after gastrectomy) patients without evidence of acute bleeding were included into Group 1. The immediate postoperative (< 1 month after gastrectomy) patients with stable vital signs were included into Group 2. The age, gender, diagnosis, Hb, hematocrit (Hct), mean corpuscular volume (MCV), serum ferritin (SF), total iron binding capacity (TIBC), serum iron and reticulocyte counts (RC) were evaluated before and after intravenous iron sucrose administration. The adverse effects of drugs were investigated. Results: The number of patients of group 1 and group 2 was 79 and 46, respectively. In group 1, there was a statistically significant difference in the Hb, Hct, MCV, SF, RC and TIBC with each mean change of 1.3 g/dl, 4.1%, 3.1ft, 195 ng/ml, 0.2% and -86.4 ug/dl, respectively. In group 2, there was a statistically significant difference in the Hb, Hct, MCV, SF and RC with each mean change of 1.8 g/dl, 6.1%, 3.4fl, 260 ng/ml and 0.3%, respectively. Two patients (1.6%) suffered local thrombophlebitis as an adverse effect. Conclusion: Intravenous iron sucrose for the perioperative anemia of gastrectomy patients was efficacious in the short period without significant adverse effects.

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Anemia Screening, Prevalence, and Treatment in Pediatric Inflammatory Bowel Disease in the United States, 2010-2014

  • Miller, Steven D.;Cuffari, Carmelo;Akhuemonkhan, Eboselume;Guerrerio, Anthony L.;Lehmann, Harold;Hutfless, Susan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.2
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    • pp.152-161
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    • 2019
  • Purpose: We examined the prevalence of anemia, annual screening for anemia, and treatment of anemia with iron among children with inflammatory bowel disease (IBD). Methods: A retrospective study of U.S. pediatric patients with IBD was performed in the MarketScan commercial claims database from 2010-2014. Children (ages 1-21) with at least two inpatient or outpatient encounters for IBD who had available lab and pharmacy data were included in the cohort. Anemia was defined using World Health Organization criteria. We used logistic regression to determine differences in screening, incident anemia, and treatment based on age at first IBD encounter and sex. Results: The cohort (n=2,446) included 1,560 Crohn's disease (CD) and 886 ulcerative colitis (UC). Approximately, 85% of CD and 81% of UC were screened for anemia. Among those screened, 51% with CD and 43% with UC had anemia. Only 24% of anemia patients with CD and 20% with UC were tested for iron deficiency; 85% were iron deficient. Intravenous (IV) iron was used to treat 4% of CD and 4% UC patients overall and 8% of those with anemia. Conclusion: At least 80% of children with IBD were screened for anemia, although most did not receive follow-up tests for iron deficiency. The 43%-50% prevalence of anemia was consistent with prior studies. Under-treatment with IV iron points to a potential target for quality improvement.

Evaluation of thermally cross-linked superparamagnetic iron oxide nanoparticles for the changes of concentration and toxicity on tissues of Sprague-Dawley rats

  • Hue, Jin Joo;Lee, Hu-Jang;Jon, Sangyong;Nam, Sang Yoon;Yun, Young Won;Kim, Jong-Soo;Lee, Beom Jun
    • Korean Journal of Veterinary Research
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    • v.54 no.4
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    • pp.245-252
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    • 2014
  • This study was investigated the change of concentration and toxicity of thermally cross-linked superparamagnetic iron oxide nanoparticles (TCL-SPION) on tissues of Sprague-Dawley rats. TCL-SPION at the dose of 15 mg/kg body weight was intravenously injected into the tail vein of the male Sprague-Dawley rats. The fate of TCL-SPION in serum, urine and tissues was observed during 28 days. Serum iron level was maximal at 0.25 h post-injection and gradually declined thereafter. In addition, the sinusoids of liver and the red pulp area of spleen were mainly accumulated iron from 0.5 h to 28-day post-injection. In kidney, iron deposition was detected in the tubular area until 0.5 h after injection. Malondialdehyde concentration in the liver slightly increased with time and was not different with that at zero time. In the liver and spleen, TNF-${\alpha}$ and IL-6 levels of TS treated with TCL-SPION were not different with those of the control during the experimental period. From the results, TCL-SPION could stay fairly long-time in certain tissues after intravenous injection without toxicity. The results indicated that TCL-SPION might be useful and safe as a contrast for the diagnosis of cancer or a carrier of therapeutic reagents to treat diseases.

Detection of Magnetic Nanoparticles in Tissue Using Magneto-Motive DP-OCT

  • Oh, Jung-Hwan;Lee, Ho;Kim, Jee-Hyun
    • Journal of the Optical Society of Korea
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    • v.11 no.1
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    • pp.26-33
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    • 2007
  • We demonstrate the capability of differential-phase optical coherence tomography (DP-OCT) to detect superparamagnetic iron oxide (SPIO) nanoparticles taken up by liver parenchymeal macrophages (Kupffer cells). We apply an external time-varying high-intensity focused magnetic field. Our experiments demonstrate a novel diagnostic modality to detect macrophages that have taken up SPIO nanoparticles. Magnetic force acting on the nanoparticles was varied by applying a sinusoidal current to a solenoid containing a conical iron core that substantially increased and focused the magnetic field strength ($B_{max}$ = 2 Tesla). $ApoE^{-/-}$ mice were sacrificed 2 days post intravenous injections of different SPIO doses (1.0, and 0.1 mmol Fe/kg body weight). Livers of $ApoE^{-/-}$ mice with and without injection of SPIO nanoparticles were investigated using DP-OCT, which detects tissue movement with nanometer resolution. Frequency response of iron-laden liver movement was twice the stimulus frequency. Movement was not observed in livers of control mice. Results of our experiments indicate DP-OCT is a candidate methodology to detect tissue based macrophages containing SPIO nanoparticles excited by an external focused magnetic field.

Analysis of Serum Proteom after Intravenous Injection of cultivated wild ginseng pharmacopuncture (산양산삼 증류약침의 혈맥주입 후 나타나는 혈장의 Proteom 분석)

  • Lee, Dong-Hee;Kwon, Ki-Rok
    • Journal of Pharmacopuncture
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    • v.9 no.2
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    • pp.17-37
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    • 2006
  • Objectives : To observe the changes in the serum proteins after intravenous injection of cultivated wild ginseng pharmacopuncture. Methods : Blood was collected before and after the administration of cultivated wild ginseng pharmacopuncture and only the serum was taken. Then differences in the spots on the scanned image after carrying out 2-Dimensional electrophoresis were located and conducted mass analysis and protein identification. Results : Following results were obtained from the comparative analysis of serum proteins before and after the administration of cultivated wild ginseng pharmacopuncture. 1. 28 spots were identified before and after the administration. 2. In confirming manifestation degree, spots with more than two-times increase were 204, 1302, 2205, 3105, 7104, 8006, spots with more than one-time increase were 1101, 1505, 2013, 2403, 3009, 3010, 4002, 4009, 6704, 8101, and spots with decrease were 205, 801, 803, 3205, 5202, 6105, 6106, 7103, 9001, 9003. 3. After conducting protein identification, proteins 205, 804, 1302, 4009, 6105, 6106 are unidentified yet, and 1l01 is unnamed protein. Protein 204 is identified as complement receptor CR2-C3d, 801 as YAPl protein, 803 as antitrypsin polymer, 1505 as PRO0684, 2013 and 3010 as proapolipoprotein, 2205 as USP48, 2403 as vitamin D binding protein, 3009 as complement component 4A preprotein, 3105 as immunoglobulin lambda chain, 3205 as transthyretin, 4002 as Ras-related protein Ral-A, 4204 as beta actin, 5202 and 7104 as apolipoprotein Ll, 6704 as alpha 2 macroglobulin precursor, 7103 as complement component 3 precursor, 8006 as testis-specific protein Y, 8101 as transferrin, 9001 as (Alpha-Oxy, Beta-(Cl12g)deoxy) T-State Human Hemoglobin, and 9003 as human hemoglobin. 4. Immune protein CR2-C3d(204), which acts against microbes and pathogenic organisms, was increased by more than two-times after the administration of pharmacopuncture. 5. Antitrypsin(803), which is secreted with inflammatory response in the lungs, was reduced after the administration of pharmacopuncture. 6. Proapolipoprotein(2013, 3010) and apolipoprotein(7104), key components of the HDL-cholesterol which plays an important role in preventing arteriosclerosis, were increased after the administration of pharmacopuncture. 7. Vitamin D binding protein(DBP, 2403), protecting the lung at the time of inflammatory response, was increased after the administration of pharmacopuncture. 8. Transthyretin(TTR, 3205), which is the main protein causing familial amyloid polyneuropathy(FAP), was decreased after the administration of pharmacopuncture. 9. Ras-related protein Ral-A(4002) that controls phospholipid metabolism, cytoskeletal formation, and membrane traffic, was increased after the administration of pharmacopuncture. 10. Testis-specific protein Y(8006), which takes part in determination of the gender, was increased by more than two-times after the administration of pharmacopuncture. 11. Transferrin(8101), which balances the iron level in the body, was increased after the administration of pharmacopuncture. Conclusion : Above results support the notion that intravenous injection of cultivated wild ginseng pharmacopuncture induce changes in serum proteins and this research can be a pioneer work in finding biomarkers.

Chromium concentration and half-life in rats biological samples after intravenous administration of soluble trivalent and hexavalent chromium compounds (흰쥐에 정맥 주사한 수용성 크롬의 분포 및 배설)

  • Kim, Yong-Lae;Kim, Chy-Nyon;Roh, Jaehoon
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.11 no.1
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    • pp.9-16
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    • 2001
  • Chromium exposure can be in the forms of environmental pollution and occupational exposure. The harmful effects of chromium on the body greatly differ depending on its valence or solubility. Accordingly, the recommended permissible exposure limit for each chromium compound is different. This study investigated the increase or decrease of distribution and excretion of total chromium exposed simultaneously the soluble Cr+6 and Cr+3 compounds. There were no difference of total chromium concentration in plasma, red bloods cells, urine, organs between simultaneously injected and individually injected soluble Cr+6 and Cr+3 compound. The chromium clearances in urine also showed that there were two phases in the two groups. In the first phase, biological half lives of the total chromium of the two groups have been similar within 24 hr., but in the second phase, biological half life of the group injected simultaneously was 62.7 hr. and was less than that of the other group's 188.3 hr. The average concentration of total chromium in plasma was same with the control, and that of RBCs was $0.218nmol/m{\ell}$ and was slightly increased in comparison with $0.121nmol/m{\ell}$ of the control, which was not statistically significant. As a result, there were no differences of distribution and excretion of chromium between the group exposed simultaneously and the other group exposed separately the soluble Cr+6 and Cr+3 compounds. The biological half life of chromium of the former group in urine was less than that of the other group.

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