44 Iron Deficiency and Overload

Question 1

The earliest stage of iron deficiency, in which storage iron is decreased or absent but serum iron concentration, transferrin saturation, and blood hemoglobin levels are normal

Answer 1

Iron depletion

Question 2

Characterized by absent storage iron, usually low serum iron concentration and transferrin saturation, but without frank anemia

Answer 2

Iron deficiency without anemia

Question 3

Most advanced stage of iron deficiency, is characterized by absent iron stores, low serum iron concentration, low transferrin saturation, and low blood hemoglobin concentration

Answer 3

Iron-deficiency anemia

Question 4

The most common anemia worldwide and is especially prevalent in women and children in regions where meat intake is low, food is not fortified with iron, and malaria, intestinal infections, and parasitic worms are common

Answer 4

Iron-deficiency anemia

Question 5

Most common cause of iron deficiency

Answer 5

Gastrointestinal or menstrual blood loss

Question 6

Most common cause of iron deficiency among men and in postmenopausal women

Answer 6

Gastrointestinal Blood Loss

Question 7

The average menstrual blood loss is approximately

Answer 7

40 mL per cycle

Question 8

Iatrogenic anemia is particularly prevalent in intensive care units, where repetitive blood sampling may result in removal of ______mL of blood daily

Answer 8

40–70 mL

Question 9

Each whole-blood donation removes approximately ______mg of iron from the body.

Answer 9

200 mg

Question 10

In pregnancy, the average iron loss resulting from diversion of iron to the fetus, blood loss at delivery (equivalent to an average of 150–200 mg of iron), and lactation is altogether approximately 900 mg; in terms of iron content, this is equivalent to the loss of more than _____ L of blood

Answer 10

2 L

Question 11

Approximately _____ mg of iron may be expended monthly in lactation.

Answer 11

30 mg of iron

Question 12

In infants, iron deficiency is most often a result of

Answer 12

Use of unsupplemented milk diets, which contain an inadequate amount of iron

Question 13

TRUE OR FALSE

Gastric secretion of hydrochloric acid is often reduced in iron deficiency.

Answer 13

TRUE

Gastric secretion of hydrochloric acid is often reduced in iron deficiency.

Question 14

TRUE OR FALSE

Intestinal malabsorption of iron is quite an uncommon cause of iron deficiency except after gastrointestinal surgery and in malabsorption syndromes.

Answer 14

TRUE

Intestinal malabsorption of iron is quite an uncommon cause of iron deficiency except after gastrointestinal surgery and in malabsorption syndromes.

Question 15

Identified in genome-wide association studies as genetic factors that cause or predispose to iron deficiency

Associated with the the genetic syndrome of iron-refractory iron-deficiency anemia mediated by inappropriately increased hepcidin

Answer 15

Tmprss667

Time-pers sa iron! Ayaw gumana

Question 16

TRUE OR FALSE

The concentration of many other iron-containing proteins is affected, often in an organ-specific manner.

Skeletal and cardiac muscle myoglobin is mildly depleted.

Answer 16

FALSE

The concentration of many other iron-containing proteins is affected, often in an organ-specific manner.

Skeletal muscle myoglobin is mildly depleted but cardiac myoglobin is not.

Question 17

A particularly iron-rich region of the brain and contains dopaminergic neurons that are suspected of involvement in restless leg syndrome

Answer 17

Substantia nigra

Question 18

TRUE OR FALSE

Iron deficiency decreases the risk and severity of malaria, and iron supplementation may have the opposite effect, especially when not targeted to patients with iron deficiency.

Answer 18

TRUE

Iron deficiency decreases the risk and severity of malaria, and iron supplementation may have the opposite effect, especially when not targeted to patients with iron deficiency.

Question 19

TRUE OR FALSE

The rapidly proliferating cells of the upper part of the alimentary tract seem particularly susceptible to the effect of iron deficiency.

Answer 19

TRUE

The rapidly proliferating cells of the upper part of the alimentary tract seem particularly susceptible to the effect of iron deficiency.

• There may be atrophy of the mucosa of the tongue and esophagus, stomach, and small intestine.
• The epithelium of the lateral margins of the tongue is reduced in thickness despite an increase in the progenitor compartment.

Question 20

Bone changes in IDA

Answer 20

Widening of diploic spaces of bones, particularly those of the skull and hands

In the skull, this is of the same character as in thalassemia, except that in β-thalassemia major there is maxillary hypertrophy, whereas in severe iron-deficiency anemia, maxillary growth and pneumatization are normal.

Question 21

Condition wherein in the laryngopharynx, mucosal atrophy may lead to web formation in the postcricoid region, thereby giving rise to dysphagia + IDA

Answer 21

Paterson-Kelly or Plummer-Vinson syndrome

Question 22

The craving to eat unusual substances, for example, dirt, clay, ice, laundry starch, salt, cardboard, and hair, is a well-documented manifestation of iron deficiency

Answer 22

Pica

Question 23

INCREASE OR DECREASE (IDA)

Plasma iron concentration
Iron-binding capacity
Serum ferritin
Serum transferrin receptor (sTfR)
Erythrocyte zinc protoporphyrin
Marrow stainable iron

Answer 23

Plasma iron concentration: DECREASE
Iron-binding capacity: INCREASE
Serum ferritin: DECREASE
Serum transferrin receptor (sTfR): INCREASE
Erythrocyte zinc protoporphyrin: INCREASE
Marrow stainable iron: DECREASE

Question 24

The earliest recognizable morphologic change of erythrocytes in iron-deficiency anemia

Answer 24

Anisocytosis

• With further progression, hemoglobin concentration, erythrocyte count, mean corpuscular volume (MCV), and mean erythrocyte hemoglobin content all decline together
• The distribution of erythrocyte volume (eg, red cell distribution width [RDW]) is usually increased

Question 25

TRUE OR FALSE

Both thrombocytopenia and thrombocytosis have been associated with iron deficiency.

Answer 25

TRUE

Both thrombocytopenia and thrombocytosis have been associated with iron deficiency.

Question 26

TRUE OR FALSE

Evaluation of iron stores should be a sensitive and usually reliable means for the differentiation between iron-deficiency anemia and all other anemias.

Answer 26

TRUE

Evaluation of iron stores should be a sensitive and usually reliable means for the differentiation between iron-deficiency anemia and all other anemias.

Question 27

Decreased or absent hemosiderin in the marrow is characteristic of iron deficiency and is readily evaluated after staining by

Answer 27

Prussian blue

Question 28

Physiologically, the serum iron concentration has a diurnal rhythm; it decreases in late afternoon and evening, reaching a nadir near ______ and increases to its maximum between _______

Answer 28

9 pm

7 am and 10 am

Question 29

During chemotherapy of malignancy, the serum iron concentration may be quite elevated, because cytotoxic effects of the drugs on erythroblasts inhibit erythropoiesis and related iron consumption

This effect is observed from the ____________ day after inception of chemotherapy

Answer 29

Third to the seventh day

Question 30

Oral iron medication should be withheld for_____hours before blood samples are obtained for serum iron levels

Answer 30

24 hours

Question 31

A measure of the amount of transferrin in circulating blood

Answer 31

Iron-binding capacity

Question 32

The sum of the ______ and the _______represents total iron-binding capacity (TIBC).

Answer 32

UIBC and the plasma iron

Noermally, transferrin may be found to be approximately one-third saturated with iron.

Question 33

Serum ferritin, secreted mainly by

Answer 33

Macrophages and hepatocytes

Question 34

Conditions wherein the serum ferritin concentration is commonly in the range of thousands of micrograms per liter

Answer 34

Gaucher disease, juvenile rheumatoid arthritis and various macrophage activation syndromes, and in ferroportin disease

Question 35

Conditions wherein zinc protoporphyrin is increased

Answer 35

Iron deficiency, lead poisoning, and sideroblastic anemias

Question 36

Sensitive in the diagnosis of iron deficiency and practical for large-scale screening programs designed to identify children with either iron deficiency or lead poisoning

Answer 36

Erythrocyte Zinc Protoporphyrin

Question 37

TRUE OR FALSE

Erythrocyte Zinc Protoporphyrin can differentiate between iron deficiency and anemia that accompanies inflammatory or malignant processes.

Answer 37

FALSE

Erythrocyte Zinc Protoporphyrin does not differentiate between iron deficiency and anemia that accompanies inflammatory or malignant processes.

Question 38

Transports transferrin iron into cells

Mirror the amount of cellular receptor, and therefore are proportional to the number of erythroblasts expressing the receptor and the number of receptors per erythroblast

Answer 38

Serum Transferrin Receptor

Increased in IDA

Question 39

Calculation for soluble transferrin index

Answer 39

Ratio of sTfR/log ferritin (TfR-F Index)

Question 40

An indicator of iron restriction of hemoglobin synthesis during 3–4 days before the test

Answer 40

Reticulocyte Hemoglobin Content

Question 41

Offers a longer-term assessment of iron restriction during the preceding few months

Answer 41

Percentage of hypochromic erythrocytes

Question 42

TRUE OR FALSE

Erythrocyte counts of 5 × 1012/L (5,000,000/μL) or higher are common among adults with iron-deficiency anemia than in thalassemia

Answer 42

FALSE

Erythrocyte counts of 5 × 1012/L (5,000,000/μL) or higher are relatively uncommon among adults with iron-deficiency anemia than in thalassemia

Question 43

Exceptions among hemolytic disorders that show pronounced erythrocytic hypochromia

Answer 43

Hemoglobin H disease or hemoglobin Köln disease

• In these disorders, there is moderate reticulocytosis, which helps to differentiate them from iron-deficiency anemia.
• The serum iron concentration is normal or increased.

Question 44

TRUE OR FALSE

In the patient with pernicious anemia or folic acid deficiency, early after starting treatment, the serum iron concentration decreases markedly as iron is utilized rapidly for hemoglobin synthesis.

Answer 44

TRUE

In the patient with pernicious anemia or folic acid deficiency, early after starting treatment, the serum iron concentration decreases markedly as iron is utilized rapidly for hemoglobin synthesis.

Question 45

Hyperthyroidism or Hypothyroidism

Causes normochromic and normocytic and may be accompanied by mild to moderate depression of serum iron concentration

Answer 45

Hypothyroidism

Iron deficiency often complicates myxedema because of menorrhagia, which is common in this disorder.

Question 46

If the cause of anemia is iron deficiency, adequate iron therapy should result in reticulocytosis, with a peak occurring after_______weeks of therapy

Answer 46

1–2 weeks

Question 47

A significant increase in the hemoglobin concentration of the blood should be evident ______ weeks later

Answer 47

3–4 weeks

Question 48

Hemoglobin concentration should attain a normal value within _____months

Answer 48

2–4 months

Question 49

TRUE OR FALSE

In general, the oral route is preferred but the IV route is increasingly used because of the improved safety and convenience of new parenteral iron preparations.

Answer 49

TRUE

In general, the oral route is preferred but the IV route is increasingly used because of the improved safety and convenience of new parenteral iron preparations.

Medicinal iron is superior to dietary iron in the therapy of iron deficiency.

Question 50

Each dose of an inorganic iron preparation for an adult should contain between __________ mg of ferrous iron

Answer 50

30 and 100 mg

Question 51

Form of iron that in the chronic renal disease setting has the potential benefit of acting as a phosphate binder

Answer 51

Ferric iron as citrate

Question 52

Substances that enhance iron absorption

Answer 52

Ascorbic acid, succinate, and fructose

Question 53

For therapy of iron deficiency in adults, the dosage should be sufficient to provide between _______ mg of elemental iron daily.

Answer 53

150 mg and 200 mg of elemental iron daily

Question 54

Traditionally, the iron is taken orally in __________ doses __________ before meals.

Answer 54

Three or four doses
One hour before meals

Question 55

Mild gastrointestinal side effects of oral iron

Answer 55

Nausea, heartburn, constipation, or changes in stool consistency and color

Question 56

Proposed as an alternative to iron salts, on the assertion that it can be given in large doses with minimal side effects

Answer 56

Carbonyl iron

Question 57

Formulated to enhance solubility and containing 210 mg of ferric iron in each tablet has been approved for the treatment of iron deficiency in the setting of chronic kidney disease, and it appears to be effective and well tolerated at doses of 3–12 tablets per day

Answer 57

Oral ferric citrate

Question 58

The earliest manifestation of iron poisoning is

Answer 58

Vomiting

Question 59

The initial treatment of iron poisoning is

Answer 59

Prompt evacuation of the stomach

• Gastric intubation and lavage
• Whole-bowel irrigation

Question 60

The agent of choice for specific therapy of hyperferremia/ acute iron poisoning

Answer 60

Intravenous desferrioxamine

Maximum rate of 15 mg/kg per hour for one hour, then lowered to 125 mg/h

Question 61

Established indications for the use of parenteral rather than oral iron

Answer 61

• Malabsorption, either because of systemic inflammation or gastrointestinal pathology
• Intolerance to iron taken orally
• Iron need in excess of an amount that can be absorbed in the intestine
• Noncompliance

Question 62

TRUE OR FALSE

Parenteral iron administration has an erythropoietin-sparing effect in anemic patients on long-term hemodialysis for chronic renal disease.

Answer 62

TRUE

Parenteral iron administration has an erythropoietin-sparing effect in anemic patients on long-term hemodialysis for chronic renal disease.

Question 63

Formula for calculating dosage of iron

Answer 63

The dose of iron (mg) = whole-blood hemoglobin deficit (g/dL) × body weight (lbs) + iron stores*

• 1000 mg for men
• 600 mg for women

Question 64

Form of parenteral iron that was associated with anaphylactoid adverse events

Answer 64

High-molecular-weight dextran

Question 65

Form of parenteral iron that may cause clinically important phosphate wasting and hypophosphatemia which can result in osteomalacia after chronic repeated use

Answer 65

Ferric carboxymaltose
Iron polymaltose
Saccharated ferric oxide

.

It is important to check serum phosphate levels before repeat administration of ferric carboxymaltose, iron polymaltose, or saccharated ferric oxide

Question 66

The mechanism involved in hypophosphatemia with Ferric carboxymaltose is increased plasma concentrations of the active form of this phosphaturic hormone

Answer 66

Fibroblast growth factor 23

Question 67

IV iron preparation that doesn’t require processing by reticuloendothelial macrophages

It transfers iron directly to transferrin and has been approved for iron supplementation during hemodialysis.

Answer 67

Ferric pyrophosphate citrate

Question 68

The reticulocyte count begins to increase after a few days, usually reaches a maximum at about _______ days

Answer 68

7–12 days

Question 69

Used to designate an increase of tissue iron resulting in a disease state

Answer 69

Iron storage disease and hemochromatosis

The hemoglobin concentration in the blood may be halfway back to normal after 4–5 weeks of therapy.

Question 70

Denotes an increase of tissue iron stores with or without tissue damage

Answer 70

Hemosiderosis

Question 71

Occurs in patients who receive multiple blood transfusions, particularly when they have ineffective erythropoiesis and hence hyperabsorb dietary iron

Answer 71

Secondary hemochromatosis

Question 72

Characterized by increased quantities of brain iron

Found in Alzheimer disease, parkinsonism, Friedreich ataxia, Hallervorden-Spatz disease, and multiple-system atrophy.

Answer 72

Aceruloplasminemia

Question 73

Characterized by hepatic and extrahepatic iron deposition and fulminant hepatitis caused by the maternal immune response to fetal antigens.

Answer 73

Neonatal hemochromatosis

Question 74

Types of Hereditary Hemochromatosis

Answer 74

• Classical hemochromatosis (HFE hemochromatosis) (type 1)- most common
• Juvenile hemochromatosis (type 2)
  Abnormality in hemojuvelin (HFE2, HJV)
  Abnormality of hepcidin (Hamp)
• Transferrin receptor-2 deficiency (type 3)
• Ferroportin abnormalities (type 4)- (SLC40A1)
  Gain of function (systemic iron overload)
  Loss of function (macrophage iron overload)
• Ferritin H-chain iron-responsive element mutation
• African iron overload

Classic Young TransFeree

Question 75

Hereditary hemochromatosis usually is applied to the common genetic form of the disorder, found principally in those of northern European ancestry, and as a result of mutation of this gene

Answer 75

HFE gene

The patient’s gender is clearly a modifying factor, with more severe manifestations observed in males, because pregnancy and menstrual iron losses tend to ameliorate the disease in women.

Question 76

The most important HFE gene mutation

Answer 76

c.845 A→G (C282Y) mutation

Gene frequency of approximately 0.07 in the northern European population, approximately 5 in 1000 northern Europeans are homozygous for the mutation.

Question 77

Haber-Weiss reaction

Answer 77

Fe++ + H2O2 → Fe+++ + OH– + HO∙
O2− + Fe+++ → O2 + Fe++

Question 78

Fenton reaction:

Answer 78

O2− + H2O2 → O2 + OH− + HO∙

Question 79

Subunit of ferritin that exerts most of its ferroxidase activity in the cytosol

Answer 79

H-ferritin (heavy)

Question 80

The common pathway that causes hyperabsorption of iron is

Answer 80

Deficiency of hepcidin

Question 81

The erythroid suppressors of hepcidin

Answer 81

GDF-15 and erythroferrone

Question 82

In the liver of patients with classical hemochromatosis, TfR2 mutations and in juvenile hemochromatosis, hemosiderin is found primarily in____________. Kupffer cells are relatively spared.

Answer 82

Hepatocytes

Question 83

In the case of patients with ferroportin mutations that prevent transport of iron, storage of iron takes place mostly in the _________ and fibrosis seems to be absent

Answer 83

Kupffer cells

Ferroportin mutations that prevent interaction with hepcidin, on the other hand, are associated with hepatocyte iron overload, as is seen in classical hemochromatosis.

Question 84

An iron concentration of more than________ μmol/g dry weight (or about _______μmol/g wet weight) is considered strong evidence for hemochromatosis when factors such as transfusions are eliminated as the cause.

Answer 84

300 μmol/g dry weight (or about 50 μmol/g wet weight)

Question 85

TRUE OR FALSE

Iron accumulates more slowly in the myocardium than in the liver but the heart is less sensitive to its toxic effects.

Answer 85

FALSE

Iron accumulates more slowly in the myocardium than in the liver but the heart is more sensitive to its toxic effects.

Question 86

The leading cause of death in transfused patients with β-thalassemia major.

Answer 86

Accumulation of cardiac iron

Question 87

Direct cardiac iron measurement using _______________ predicts cardiac complications and can stratify the risk of subsequent cardiac dysfunction.

Answer 87

Magnetic resonance imaging

Measures the half-life, T2*, of cardiac muscle darkening (with respect to echo time) produced by magnetically active stored cardiac iron

Question 88

Iron overload in the marrow is characteristically distributed into small, equal-size granules located in ___________ rather than in macrophages.

The quantity of iron in the marrow of patients with classical hereditary hemochromatosis is only modestly increased, if at all.

Answer 88

Endothelial lining cells

Question 89

The most common cause of hereditary hemochromatosis

Answer 89

Mutation of the HFE gene

Question 90

The HFE gene, an HLA-like gene, resides on chromosome ______.

Answer 90

Chromosome 6

Question 91

Three polymorphic HFE mutations have been identified

Answer 91

• 187- H63D
• 193 - S65C
• 845- C282Y

Question 92

The phenotypic severity of HFE mutations on iron homeostasis is manifested in the following order:

Answer 92

C282Y > H63D > S65C

Question 93

Mode of inheritance of Hereditary hemochromatosis

Answer 93

Autosomal recessive

Question 94

Rare mutation of hepcidin associated with severe juvenile hemochromatosis

Answer 94

Hamp (Hepcidin)

Question 95

Mode of inheritance of SLC40A1 (Ferroportin) Mutations

Answer 95

Autosomal dominant

Question 96

Two types of SLC40A1 (Ferroportin) Mutations

Answer 96

Gain of function mutations: C326S mutation, interfere with hepcidin binding to ferroportin or with the resulting ferroportin endocytosis

Loss-of-function mutations: (more common); ferroportin mutations that do not localize to the cell surface, or prevent transport of iron

Question 97

Mode of inheritance of TfR2 Mutations

Answer 97

Autosomal recessive

Question 98

Known to be a key regulator of hepcidin transcription

Answer 98

Bone morphogenetic protein receptor

BMP

Question 99

Mutation associated with hepatic hemosiderosis and most with abnormal liver function tests in addition to microcytic hypochromic anemia

Answer 99

DMT-1 Human Mutations

Question 100

The clinical features of the most common form of hereditary hemochromatosis

Answer 100

Cirrhosis of the liver, darkening of the skin, cardiomyopathies, and diabetes

“Bronze diabetes”

Question 101

Onset of Juvenile Hemochromatosis

Answer 101

Second or third decade of life

Question 102

Onset of classical hereditary hemochromatosis

Answer 102

Fifth or sixth decade of life

Question 103

Characteristic features of the arthropathy of patients with hemochromatosis

Answer 103

Begin at the small joints of the hands, especially the second and third metacarpal joints, and in some cases, episodes of acute synovitis

Question 104

Features considered distinctive to arthropathy of patients with hemochromatosis

Answer 104

• Joint distribution
• The presence of shape osteophytes emerging from the radial sides of the metacarpal distal epiphysis
• Presence of radiolucent zones in the subchondral area of the femoral head

Arthritis does not respond to phlebotomy therapy

Question 105

Major clinical features of Juvenile Hemochromatosis

Answer 105

Cardiomyopathies and endocrine deficiencies

Question 106

The main laboratory features of hereditary hemochromatosis

Answer 106

High transferrin saturation, and increased serum ferritin level

Question 107

An uncommon autosomal dominant defect in which a mutation in the 5′ iron-responsive element of the ferritin light chain prevents binding of the iron-regulatory proteins, resulting in unrestrained constitutive production of the ferritin chains

Answer 107

Hyperferritinemia-cataract syndrome

Question 108

“Gold standard” for the diagnosis of iron overload

No longer required for the diagnosis of hemochromatosis

Answer 108

Liver biopsy

Question 109

Formula for iron index

Answer 109

Dividing the iron content by the patient’s age

*liver biopsy

Question 110

An iron index of greater than_______ implies the presence of hemochromatosis.

Answer 110

2

Question 111

Can detect and reliably quantify increased amounts of iron in the liver

Answer 111

Magnetic resonance imaging

Question 112

Treatment of choice for iron overload in patients who are able to mount an erythropoietin response

Answer 112

Phlebotomy

Question 113

Treatment for patient that has marked impairment of erythropoiesis, as in thalassemia and dyserythropoietic anemia

Answer 113

Chelating agents

Occasionally serial phlebotomy will stimulate sufficient erythropoiesis to make it a viable therapy

Question 114

End point of the initial part of the phlebotomy program

Answer 114

Signs of iron deficiency

Question 115

The frequency of phlebotomies tailored to maintain the serum ferritin level, the best indicator of body stores, below _______ ng/m

Answer 115

100 ng/m

Question 116

TRUE OR FALSE

The hematocrit or hemoglobin and the MCV of the red cells should be measured before each phlebotomy is undertaken. If there has been a substantial decrease in the hematocrit or hemoglobin, the phlebotomy should be deferred.

Answer 116

TRUE

The hematocrit or hemoglobin and the MCV of the red cells should be measured before each phlebotomy is undertaken. If there has been a substantial decrease in the hematocrit or hemoglobin, the phlebotomy should be deferred.

Question 117

During phlebotomy, the transferrin saturation and serum ferritin level should be measured every _______months

Answer 117

Two or three months

When the transferrin saturation is less than 10% and the serum ferritin less than 10 ng/mL, phlebotomy should be discontinued and the patient monitored every 3–6 months so that the rate of ferritin rise can be estimated.

When the serum ferritin is in the 50–100 ng/mL range, the maintenance phase should be initiated.

Question 118

A naturally occurring iron-chelating compound synthesized by the microorganism Streptomyces pilosus, having evolved to enable the microbe to obtain iron from its environment

Answer 118

Desferrioxamine

Question 119

Rapid IV or intramuscular injection results in relatively little iron mobilization; instead, it is necessary to administer desferrioxamine by

Answer 119

Slow IV or subcutaneous infusion over a period of 8–10 hours

Poorly absorbed from the gastrointestinal tract

Question 120

Usual recommended dose of desferrioxamine

Answer 120

30–50 mL/kg

Vitamin C (up to 200 mg daily) may be given to enhance iron excretion.

Question 121

Large doses of desferrioxamine are associated with

Answer 121

Hearing loss, night blindness and other visual abnormalities, growth retardation, and skeletal changes

Question 122

Usual recommended dose of deferiprone

Answer 122

75 mg/kg per day divided into three doses

Question 123

Toxic effects of deferiprone

Answer 123

Gastrointestinal disturbances, arthropathy, transient increases in the serum levels of liver enzymes, and zinc deficiency

Question 124

Oral chelating agent excreted almost entirely in the urine

Answer 124

Deferiprone

Question 125

Oral chelating agent that has propensity to produce neutropenia and agranulocytosis

Answer 125

Deferiprone

Question 126

More effective in removing iron from the heart

Answer 126

Deferiprone

Question 127

More effective with respect to liver iron accumulations

Answer 127

Desferrioxamine

Question 128

Usual recommended dose of Deferasirox

Answer 128

30 mg/kg per day

Question 129

Toxic effects of Deferasirox

Answer 129

Renal and hepatic, but it may also cause gastrointestinal hemorrhage