Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion.
<h4>Background</h4>Vitamins and minerals are routinely administered by total parenteral nutrition (TPN). However, in Japan, adjustments in iron dosage are difficult because blended mineral preparations are often used. It is therefore unclear whether the iron content is appropriate in cas...
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2020-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0237104 |
| _version_ | 1819140157707649024 |
|---|---|
| author | Hiroyasu Akatsu Toshie Manabe Yoshihiro Kawade Hajime Tanaka Takayoshi Kanematsu Kazuyuki Arakawa Yoshiyuki Masaki Chie Hishida Takeshi Kanesaka Norihiro Ogawa Yoshio Hashizume Koichi Tsuneyama Hirotaka Ohara Mitsuo Maruyama Takayuki Yamamoto |
| author_facet | Hiroyasu Akatsu Toshie Manabe Yoshihiro Kawade Hajime Tanaka Takayoshi Kanematsu Kazuyuki Arakawa Yoshiyuki Masaki Chie Hishida Takeshi Kanesaka Norihiro Ogawa Yoshio Hashizume Koichi Tsuneyama Hirotaka Ohara Mitsuo Maruyama Takayuki Yamamoto |
| author_sort | Hiroyasu Akatsu |
| collection | DOAJ |
| description | <h4>Background</h4>Vitamins and minerals are routinely administered by total parenteral nutrition (TPN). However, in Japan, adjustments in iron dosage are difficult because blended mineral preparations are often used. It is therefore unclear whether the iron content is appropriate in cases of long-term TPN. The aim of the study was to assess the influence of iron administration by long-term TPN on iron deposition in post-mortem liver samples isolated from older deceased patients.<h4>Methods</h4>Liver tissues were collected from post-mortem autopsies of 187 patients over a period of 15 years. Samples were stained with Prussian blue and histologically evaluated from Grade 0-V by at least three different observers. Specimens with positive and negative iron staining were compared, and positive samples were grouped according to the level and distribution of the staining. Post-mortem blood obtained from the subclavian vein during autopsy was also analysed. Samples were collected for the measurement of unsaturated serum iron, serum iron, albumin, prealbumin, hepcidin, and IL-6 concentrations.<h4>Results</h4>Iron accumulation in the liver was significantly higher in male patients (p = 0.005) with a history of surgery (p = 0.044) or central vein administration of iron (p<0.001). Additionally, the duration of TPN in the iron-positive group was significantly longer than in the iron-negative group (p = 0.038). Serum analysis revealed that unsaturated serum iron was significantly higher in the iron-negative group and that ferritin and serum iron were significantly higher in the iron-positive group. No other statistically significant differences were observed between the two groups.<h4>Conclusions</h4>Chronic intravenous administration of iron was associated with iron deposition in the liver, even when given the minimum recommended dosage. In long-term TPN patients, the iron dose should therefore be carefully considered. |
| first_indexed | 2024-12-22T11:34:06Z |
| format | Article |
| id | doaj.art-af67705082d54d71b0d02c99b687b94d |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-22T11:34:06Z |
| publishDate | 2020-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-af67705082d54d71b0d02c99b687b94d2022-12-21T18:27:29ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01158e023710410.1371/journal.pone.0237104Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion.Hiroyasu AkatsuToshie ManabeYoshihiro KawadeHajime TanakaTakayoshi KanematsuKazuyuki ArakawaYoshiyuki MasakiChie HishidaTakeshi KanesakaNorihiro OgawaYoshio HashizumeKoichi TsuneyamaHirotaka OharaMitsuo MaruyamaTakayuki Yamamoto<h4>Background</h4>Vitamins and minerals are routinely administered by total parenteral nutrition (TPN). However, in Japan, adjustments in iron dosage are difficult because blended mineral preparations are often used. It is therefore unclear whether the iron content is appropriate in cases of long-term TPN. The aim of the study was to assess the influence of iron administration by long-term TPN on iron deposition in post-mortem liver samples isolated from older deceased patients.<h4>Methods</h4>Liver tissues were collected from post-mortem autopsies of 187 patients over a period of 15 years. Samples were stained with Prussian blue and histologically evaluated from Grade 0-V by at least three different observers. Specimens with positive and negative iron staining were compared, and positive samples were grouped according to the level and distribution of the staining. Post-mortem blood obtained from the subclavian vein during autopsy was also analysed. Samples were collected for the measurement of unsaturated serum iron, serum iron, albumin, prealbumin, hepcidin, and IL-6 concentrations.<h4>Results</h4>Iron accumulation in the liver was significantly higher in male patients (p = 0.005) with a history of surgery (p = 0.044) or central vein administration of iron (p<0.001). Additionally, the duration of TPN in the iron-positive group was significantly longer than in the iron-negative group (p = 0.038). Serum analysis revealed that unsaturated serum iron was significantly higher in the iron-negative group and that ferritin and serum iron were significantly higher in the iron-positive group. No other statistically significant differences were observed between the two groups.<h4>Conclusions</h4>Chronic intravenous administration of iron was associated with iron deposition in the liver, even when given the minimum recommended dosage. In long-term TPN patients, the iron dose should therefore be carefully considered.https://doi.org/10.1371/journal.pone.0237104 |
| spellingShingle | Hiroyasu Akatsu Toshie Manabe Yoshihiro Kawade Hajime Tanaka Takayoshi Kanematsu Kazuyuki Arakawa Yoshiyuki Masaki Chie Hishida Takeshi Kanesaka Norihiro Ogawa Yoshio Hashizume Koichi Tsuneyama Hirotaka Ohara Mitsuo Maruyama Takayuki Yamamoto Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion. PLoS ONE |
| title | Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion. |
| title_full | Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion. |
| title_fullStr | Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion. |
| title_full_unstemmed | Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion. |
| title_short | Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion. |
| title_sort | iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion |
| url | https://doi.org/10.1371/journal.pone.0237104 |
| work_keys_str_mv | AT hiroyasuakatsu irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT toshiemanabe irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT yoshihirokawade irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT hajimetanaka irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT takayoshikanematsu irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT kazuyukiarakawa irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT yoshiyukimasaki irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT chiehishida irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT takeshikanesaka irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT norihiroogawa irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT yoshiohashizume irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT koichitsuneyama irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT hirotakaohara irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT mitsuomaruyama irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion AT takayukiyamamoto irondepositioninautopsiedliverspecimensfromolderpatientsreceivingintravenousironinfusion |