Answer to: “Iron overload refractory to phlebotomies in a patient with hereditary hemochromatosis type 1”

Parra Salinas, Ingrid; Garcia-Erce, José Antonio

doi:10.1016/j.medcle.2023.03.016

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CT scans performed in March 2022 (A) and October 2022 (B)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Luis Carlos Saiz, María Villanueva Alcojol" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Luis Carlos" "apellidos" => "Saiz" ] 1 => array:2 [ "nombre" => "María" "apellidos" => "Villanueva Alcojol" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020623002656?idApp=UINPBA00004N" "url" => "/23870206/0000016100000002/v1_202307241700/S2387020623002656/v1_202307241700/en/main.assets" ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "Letter to the Editor" "titulo" => "Answer to: “Iron overload refractory to phlebotomies in a patient with hereditary hemochromatosis type 1”" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "86" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ingrid Parra Salinas, José Antonio Garcia-Erce" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Ingrid" "apellidos" => "Parra Salinas" "email" => array:1 [ 0 => "ingrid.mps@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "José Antonio" "apellidos" => "Garcia-Erce" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Hematología y Hemoterapia, Hospital de Barbastro, Barbastro, Huesca, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Banco de Sangre y Tejidos de Navarra, Pamplona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Respuesta a: «Sobrecarga férrica refractaria a flebotomías en un paciente con hemocromatosis hereditaria tipo 1»" ] ] "textoCompleto" => "We have read with interest in your journal the case “Iron overload refractory to phlebotomy in a patient with hereditary haemochromatosis type 1”, in the medical imaging section.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> We would like to congratulate the authors for the simultaneous diagnosis of two congenital pathologies that share the risk of iron overload. We agree with the authors on many of their comments regarding the role of MRI as a confirmatory test for tissue iron overload, to replace liver biopsy, as well as the importance of high diagnostic suspicion.<a class="elsevierStyleCrossRef" href="#bib0010">2</a>However, we do not consider the title to be ideal. It cannot be stated that the technique was refractory after only 19 phlebotomies, without further explanation of relevant data such as frequency, volume and duration of phlebotomies. As this is a young patient, we suggest the option of performing therapeutic erythropheresis for better treatment of these pathologies, accelerating iron depletion and thus avoiding clinical complications.<a class="elsevierStyleCrossRefs" href="#bib0015">3,4</a>On the other hand, due to the continuous need for blood in hospitals, the frequent shortage of blood during certain periods, the low probability that patients with iron overload will develop iron deficiency, and following the recommendations of the Ministry of Health (RD1088/2005)<a class="elsevierStyleCrossRef" href="#bib0025">5</a>:–In the case of donors with haemochromatosis, there would be no inconvenience (risk of iron deficiency) in authorising the donation, as long as the other selection criteria are met… It is worth considering the possibility, already established in some transfusion centres, of offering patients diagnosed with haemochromatosis, therapeutic bloodletting following a protocol previously established jointly by the patient's doctor and the transfusion centre–; we raise the possibility that any patient with iron overload could make donations." 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Part II: iron deficiency and iron overload" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Muñoz" 1 => "J.A. García-Erce" 2 => "Á.F. Remacha" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Clin Pathol" "fecha" => "2011" "volumen" => "64" "paginaInicial" => "287" "paginaFinal" => "296" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictive factors of response to erytrhocytapheresis in patients with biochemical iron overload with or without hereditary hemochromatosis type 1" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "I. Parra Salinas" 1 => "A. Montes Limon" 2 => "V. Recasens Flores" 3 => "N. Fernandez-Mosteirin" 4 => "J.A. Garcia-Erce" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.medcli.2013.05.043" "Revista" => array:6 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2014" "volumen" => "142" "paginaInicial" => "187" "paginaFinal" => "191" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24041941" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison between phlebotomy and erythrocytapheresis of iron overload in patients with HFE gene mutations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "N. Fernández-Mosteirín" 1 => "C. Salvador-Osuna" 2 => "J.A. García-Erce" 3 => "E. Orna" 4 => "G. Pérez-Lungmus" 5 => "M. Giralt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1157/13092766" "Revista" => array:6 [ "tituloSerie" => "Med Clin (Barc)" "fecha" => "2006" "volumen" => "127" "paginaInicial" => "409" "paginaFinal" => "412" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17020684" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Criterios sobre sobre donación de sangre y hemocromatosis [acuerdos 18-10-2006]. Comité científico seguridad transfusional. <a target="_blank" href="https://www.sanidad.gob.es/profesionales/saludPublica/medicinaTransfusional/acuerdos/docs/hemocromatosis.pdf">https://www.sanidad.gob.es/profesionales/saludPublica/medicinaTransfusional/acuerdos/docs/hemocromatosis.pdf</a>." ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000016100000002/v1_202307241700/S238702062300267X/v1_202307241700/en/main.assets" "Apartado" => array:4 [ "identificador" => "43309" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000016100000002/v1_202307241700/S238702062300267X/v1_202307241700/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S238702062300267X?idApp=UINPBA00004N"]

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Vol. 161. Issue 2.

Pages 86 (July 2023)

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