Moslem Doctor
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can any one explain by simple way why there is iron over load :increase serum iron ,% saturation and ferritin; decrease TIBC in sadroblasitic anemia
i cant understand why there is increase serum iron?? there is a hemolysis here or what ?!
2- in anemia of chronic cause there is decrease serum iron why??
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| dariush
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1- first of all Fe is stuck in the mitochondria and can Not be incorporated into making heme, therefore giving the "Ring shape" and since Heme synth decreases,there is a microcytic hypochromatic anemia, like Fe-def.
Iron overload is common, however, even in patients without a significant blood product transfusion history. The exact cause of iron overload in sideroblastic anemia patients is unclear.
2- well Goljan explains this very well 
"...there is a system that God put in our body that whenever there is a chronic disease,our body thinks it is a bacterial infection and since Bacteria love Fe, our body stores it in the Hemosiderin (in machrophages) form which can not be released into the circulation.."
therefore neither Bacteria nor You can get the Fe!!
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| Moslem Doctor
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thank you my brother for answer but bear me bit more please
in second answer you based the fact of low serum iron on presence of macrophage trapping fe and deprive us from it ,But isnt true that serum iron level depend mostly on iron absorbed from intestine ? or it has relation with amount be stored either in bone marrow or RES?
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Say ye: "We believe in Allah, and the revelation given to us, and to Abraham, Isma'il, Isaac, Jacob, and the Tribes, and that given to Moses and Jesus, and that given to (all) prophets from their Lord: We make no difference between one and another of them: And we bow to Allah (in Islam)." Holy Quran
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| doc179
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serum iron level is the level of iron in the serum or blood which is always kept low by lactoferrin in chronic disease. so whether you are absorbing more iron from the intestine or not or you have a good amount stored in the marrow does not matter much
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| Moslem Doctor
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iam so thankfull to all of you and here is something near to what is be mentioned by doc 179
((During inflammatory process, cytokine liberation, as interleukin-1, seems to induce the increase of ferritin translation in macrophages, capturing iron and preventing liberation for transferrin. Interleukin-1 would also increase the macrophage avidity for iron, possibly by inducing lactoferrin liberation by neutrophil. This joint iron protein would capture free iron and transfer it rapidly to macrophage.))
http://www.medstudents.com.br/hemat/hemat5.htm
so this as what i was going to that serum iron level related in great portion of it to iron transfer from storage points to utilization points .Also read this :
(( The probable defect is a cytokine-mediated blockage in transfer of iron from the storage pool to the erythroid precursors in the bone marrow. The defect is either inability to free the iron from macrophages or to load it onto transferrin. The result is a normochromic, normocytic anemia in which total serum iron is decreased))
http://medstat.med.utah.edu/WebPath/TUTORIAL/IRON...
if we say that serum iron always correlates to amount stored so this can explain why there is hight serum iron in sedroblastic anemia ? or you see it cant explain it well
thanks
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Say ye: "We believe in Allah, and the revelation given to us, and to Abraham, Isma'il, Isaac, Jacob, and the Tribes, and that given to Moses and Jesus, and that given to (all) prophets from their Lord: We make no difference between one and another of them: And we bow to Allah (in Islam)." Holy Quran
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| Moslem Doctor
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any one discuss this and clearify it to me please?
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Say ye: "We believe in Allah, and the revelation given to us, and to Abraham, Isma'il, Isaac, Jacob, and the Tribes, and that given to Moses and Jesus, and that given to (all) prophets from their Lord: We make no difference between one and another of them: And we bow to Allah (in Islam)." Holy Quran
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