Iron

Question 1

What are the three ways in which iron are present in the body and how are these measured?

Answer 1

Functional iron (Hb concentration)
Transport iron  (% saturation of transferrin with iron)
Storage iron (Serum ferritin or  tissue biopsy)

Question 2

How much iron should you absorb per day?

Answer 2

1mg

Question 3

What does hepcidin do?

Answer 3

Stops iron from being exported into the body by downregulation of ferroportin. Major negative regulator of iron uptake; produced in the liver in response to iron load and inflammation

Question 4

Where is the gut is iron absorbed?

Answer 4

Duodenum

Question 5

Increased release of which protein leads to anaemia of chronic disease?

Answer 5

Hepcidin

Question 6

Describe how anaemia of chronic disease occurs

Answer 6

In response to inflammatory cytokines, increasingly IL-6,[1] the liver produces increased amounts of hepcidin. Hepcidin in turn causes increased internalisation of ferroportin molecules on cell membranes which prevents release from iron stores. Inflammatory cytokines also appear to affect other important elements of iron metabolism, including decreasing ferroportin expression, and probably directly blunting erythropoiesis by decreasing the ability of the bone marrow to respond to erythropoietin.

Question 7

What would the ferritin levels like in iron overload?

Answer 7

Above 300 in men and above 200 in women (pre menopausal)

Question 8

What gene is mutated in iron overload?

Answer 8

HFE

Question 9

What is the treatment of hereditaty haemochromatosis?

Answer 9

Weekly venesection until serum ferritin is at normal levels

After there monthly venesection to keep ferritin below 50