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Altered erythropoiesis and iron metabolism in carriers of thalassemia.
[alpha-thalassemia]
The
thalassemia
syndromes
(
α-
and
β-thalassemia
)
are
the
most
common
and
frequent
disorders
associated
with
ineffective
erythropoiesis
.
Imbalance
of
α-
or
β-globin
chain
production
results
in
impaired
red
blood
cell
synthesis
,
anemia
,
and
more
erythroid
progenitors
in
the
blood
stream
.
While
patients
affected
by
these
disorders
show
definitive
altered
parameters
related
to
erythropoiesis
,
the
relationship
between
the
degree
of
anemia
,
altered
erythropoiesis
,
and
dysfunctional
iron
metabolism
has
not
been
investigated
in
both
α-thalassemia
carriers
(
ATC
)
and
β-thalassemia
carriers
(
BTC
)
.
Here
,
we
demonstrate
that
ATC
have
a
significantly
reduced
hepcidin
and
increased
soluble
transferrin
receptor
levels
but
relatively
normal
hematological
findings
.
In
contrast
,
BTC
have
several
hematological
parameters
significantly
different
from
controls
,
including
increased
soluble
transferrin
receptor
and
erythropoietin
levels
.
These
changes
in
both
groups
suggest
an
altered
balance
between
erythropoiesis
and
iron
metabolism
.
The
index
sTfR
/
log
ferritin
and
(
hepcidin
/
ferritin
)
/
sTfR
are
,
respectively
,
increased
and
reduced
relative
to
controls
,
proportional
to
the
severity
of
each
thalassemia
group
.
In
conclusion
,
we
showed
in
this
study
,
for
the
first
time
in
the
literature
,
that
thalassemia
carriers
have
altered
iron
metabolism
and
erythropoiesis
.
Diseases
Validation
Diseases presenting
"blood cell synthesis"
symptom
alpha-thalassemia
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