Infection is a major cause of morbidity and mortality in patients with thalassaemia major.18
Control of iron overload may have a therapeutic benefit against infections.16
Physicians should talk with their patients about these risks: the control of systemic iron from invading microbes are important strategies of host defence.16
Some of the pathogens that increase their virulence and pathogenicity in the presence of excess iron16
| Yersinia enterocolitica |
|---|
| Klebsiella species |
| Escherichia coli |
| Streptococcus pneumoniae |
| Pseudomonas aeruginosa |
| Listeria monocytogenes |
| Legionella pneumophila |
Iron has subtle effects on cell-mediated immune effector pathways and systemic iron overload is associated with unfavorable outcomes in many types of infection.16
Although viruses do not require iron to survive, as other bacteria, studies have reported that iron increases the risk of viral infections.16
Infection is a significant contributor to morbidity and mortality also in sickle cell disease. Worldwide, it remains the leading cause of death, particularly in less developed nations.19
| Common phatogens associated with infection in sickle cell anaemia with underlying mechanism for predisposition19 | |||||||||
|---|---|---|---|---|---|---|---|---|---|
| Phatogen | Predisposing factors | ||||||||
| Encapsulated bacteria (e.g., Streptococcus pneumoniae, Haemophilus influenzae, Neisseria meningitidis, Salmonella spp) | Impaired splenic function Impaired opsonization |
||||||||
| Salmonellae | Recurrent vaso-occlusion with intestinal infarct, necrosis and increased gut permeability. Decreased neutrophil killing | ||||||||
| Malaria | Decreased deoxyhemoglobin solubility | ||||||||
| Parvovirus | Increased red cell turnover | ||||||||
| Hepatittis B, C | Multiple blod transfusion | ||||||||
| Chlamydophia | Unknow | ||||||||
| Yersinia enterocolitica | Iron overload | ||||||||
| Mycoplasma | Unknow | ||||||||
| Edwardsiella tarda | Increased intestinal permeability and biliary sludging | ||||||||
Booth C. et al. Int J Infect Dis. 2010. Table 1. Common pathogens associated with infection in sickle cell anaemia with underlying mechanism for predisposition p.e6. Copyright Clearence Center license no 5265950150835.
Iron has subtle effects on cell-mediated immune effector pathways and systemic iron overload is associated with unfavorable outcomes in many types of infection.16
For HCP: In case you want to report an adverse drug reaction you become aware of, please report it to your Health Authority according to the requirements set by the pharmacovigilance legislation.