RT Journal Article
SR Electronic
T1 Unexplained iron deficiency in idiopathic and heritable pulmonary arterial hypertension
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 326
OP 332
DO 10.1136/thx.2010.147272
VO 66
IS 4
A1 Elaine Soon
A1 Carmen M Treacy
A1 Mark R Toshner
A1 Robert MacKenzie-Ross
A1 Vijay Manglam
A1 Mark Busbridge
A1 Mark Sinclair-McGarvie
A1 Jayantha Arnold
A1 Karen K Sheares
A1 Nicholas W Morrell
A1 Joanna Pepke-Zaba
YR 2011
UL http://thorax.bmj.com/content/66/4/326.abstract
AB Background Anaemia is common in left heart failure and is associated with a poorer outcome. Many patients with pulmonary arterial hypertension (PAH) are anaemic or iron-deficient. This study was performed to investigate the prevalence of iron deficiency in PAH and to identify possible causes.Methods All patients with idiopathic or heritable PAH diagnosed in 1995–2008 were identified. Controls were selected from patients with chronic thromboembolic pulmonary hypertension (CTEPH). Full blood counts were examined and any abnormality was investigated. Patients were excluded if they had a cause for iron deficiency. The prevalence study was based on 85 patients with idiopathic PAH and 120 with CTEPH. A separate group of 20 patients with idiopathic PAH and 24 with CTEPH with matching haemodynamics were prospectively investigated for serum factors affecting iron metabolism.Results The prevalence study identified a point prevalence of unexplained iron deficiency of 50% in premenopausal women with idiopathic PAH compared with 8% in premenopausal women with CTEPH (p=0.002); 14% in postmenopausal women with idiopathic PAH compared with 6% in postmenopausal women with CTEPH (p=0.16); 28% in men with idiopathic PAH men compared with 2% in men with CTEPH (p=0.002); and 60% in patients with heritable PAH. The serum study showed that patients with idiopathic PAH had lower serum iron and transferrin saturations than those with CTEPH. Interleukin-6 levels correlated with iron levels(r=−0.6, p=0.006) and transferrin saturations (r=−0.68, p=0.001) in idiopathic PAH but not in CTEPH.Conclusions The prevalence of unexplained iron deficiency is significantly higher in idiopathic PAH than in CTEPH. This may be linked to interleukin-6.