Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion
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...
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| creator | Akatsu, Hiroyasu Manabe, Toshie Kawade, Yoshihiro Tanaka, Hajime Kanematsu, Takayoshi Arakawa, Kazuyuki Masaki, Yoshiyuki Hishida, Chie Kanesaka, Takeshi Ogawa, Norihiro Hashizume, Yoshio Tsuneyama, Koichi Ohara, Hirotaka Maruyama, Mitsuo Yamamoto, Takayuki |
| description | 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. 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. 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 |
| doi_str_mv | 10.1371/journal.pone.0237104 |
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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. 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. 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. 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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0237104</identifier><identifier>PMID: 32750083</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Albumins ; Analysis ; Autopsies ; Autopsy ; Biology and Life Sciences ; Blood ; Care and treatment ; Composition ; Deposition ; Diagnostic specimens ; Dietary minerals ; Dosage ; Drug dosages ; Elderly patients ; Ferritin ; Food and nutrition ; Geriatrics ; Gerontology ; Health aspects ; Hepatitis ; Hepcidin ; Hospitals ; Infusion ; Interleukin 6 ; Intravenous administration ; Iron ; Iron (Nutrient) ; Iron content ; Laboratories ; Liver ; Medical education ; Medical examination ; Medicine and Health Sciences ; Minerals ; Nutrition ; Older people ; Parenteral nutrition ; Patient outcomes ; Patients ; Physical Sciences ; Pigments ; Quality ; Research and Analysis Methods ; Staining ; Stains & staining ; Statistical analysis ; Statistical methods ; Studies ; Supervision ; Surgery ; University graduates ; Variables ; Veins ; Vitamins</subject><ispartof>PloS one, 2020-08, Vol.15 (8), p.e0237104-e0237104</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Akatsu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Akatsu et al 2020 Akatsu et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c713t-165516ad5a290ca341314b48c693fbd509987964afee540f2341b8e0540f12eb3</citedby><cites>FETCH-LOGICAL-c713t-165516ad5a290ca341314b48c693fbd509987964afee540f2341b8e0540f12eb3</cites><orcidid>0000-0002-0089-6033 ; 0000-0003-0318-0441</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7402501/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7402501/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2095,2914,23846,27903,27904,53769,53771,79346,79347</link.rule.ids></links><search><contributor>Kanda, Tatsuo</contributor><creatorcontrib>Akatsu, Hiroyasu</creatorcontrib><creatorcontrib>Manabe, Toshie</creatorcontrib><creatorcontrib>Kawade, Yoshihiro</creatorcontrib><creatorcontrib>Tanaka, Hajime</creatorcontrib><creatorcontrib>Kanematsu, Takayoshi</creatorcontrib><creatorcontrib>Arakawa, Kazuyuki</creatorcontrib><creatorcontrib>Masaki, Yoshiyuki</creatorcontrib><creatorcontrib>Hishida, Chie</creatorcontrib><creatorcontrib>Kanesaka, Takeshi</creatorcontrib><creatorcontrib>Ogawa, Norihiro</creatorcontrib><creatorcontrib>Hashizume, Yoshio</creatorcontrib><creatorcontrib>Tsuneyama, Koichi</creatorcontrib><creatorcontrib>Ohara, Hirotaka</creatorcontrib><creatorcontrib>Maruyama, Mitsuo</creatorcontrib><creatorcontrib>Yamamoto, Takayuki</creatorcontrib><title>Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion</title><title>PloS one</title><description>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. 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. 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. 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.</description><subject>Albumins</subject><subject>Analysis</subject><subject>Autopsies</subject><subject>Autopsy</subject><subject>Biology and Life Sciences</subject><subject>Blood</subject><subject>Care and treatment</subject><subject>Composition</subject><subject>Deposition</subject><subject>Diagnostic specimens</subject><subject>Dietary minerals</subject><subject>Dosage</subject><subject>Drug dosages</subject><subject>Elderly patients</subject><subject>Ferritin</subject><subject>Food and nutrition</subject><subject>Geriatrics</subject><subject>Gerontology</subject><subject>Health aspects</subject><subject>Hepatitis</subject><subject>Hepcidin</subject><subject>Hospitals</subject><subject>Infusion</subject><subject>Interleukin 6</subject><subject>Intravenous administration</subject><subject>Iron</subject><subject>Iron (Nutrient)</subject><subject>Iron content</subject><subject>Laboratories</subject><subject>Liver</subject><subject>Medical education</subject><subject>Medical examination</subject><subject>Medicine and Health Sciences</subject><subject>Minerals</subject><subject>Nutrition</subject><subject>Older people</subject><subject>Parenteral nutrition</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Pigments</subject><subject>Quality</subject><subject>Research and Analysis Methods</subject><subject>Staining</subject><subject>Stains & staining</subject><subject>Statistical analysis</subject><subject>Statistical methods</subject><subject>Studies</subject><subject>Supervision</subject><subject>Surgery</subject><subject>University 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deposition in autopsied liver specimens from older patients receiving intravenous iron infusion</title><author>Akatsu, Hiroyasu ; Manabe, Toshie ; Kawade, Yoshihiro ; Tanaka, Hajime ; Kanematsu, Takayoshi ; Arakawa, Kazuyuki ; Masaki, Yoshiyuki ; Hishida, Chie ; Kanesaka, Takeshi ; Ogawa, Norihiro ; Hashizume, Yoshio ; Tsuneyama, Koichi ; Ohara, Hirotaka ; Maruyama, Mitsuo ; Yamamoto, Takayuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c713t-165516ad5a290ca341314b48c693fbd509987964afee540f2341b8e0540f12eb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Albumins</topic><topic>Analysis</topic><topic>Autopsies</topic><topic>Autopsy</topic><topic>Biology and Life Sciences</topic><topic>Blood</topic><topic>Care and treatment</topic><topic>Composition</topic><topic>Deposition</topic><topic>Diagnostic specimens</topic><topic>Dietary 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Koichi</au><au>Ohara, Hirotaka</au><au>Maruyama, Mitsuo</au><au>Yamamoto, Takayuki</au><au>Kanda, Tatsuo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion</atitle><jtitle>PloS one</jtitle><date>2020-08-04</date><risdate>2020</risdate><volume>15</volume><issue>8</issue><spage>e0237104</spage><epage>e0237104</epage><pages>e0237104-e0237104</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>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. 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. 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. 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.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>32750083</pmid><doi>10.1371/journal.pone.0237104</doi><tpages>e0237104</tpages><orcidid>https://orcid.org/0000-0002-0089-6033</orcidid><orcidid>https://orcid.org/0000-0003-0318-0441</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2020-08, Vol.15 (8), p.e0237104-e0237104 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2430360504 |
| source | DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Albumins Analysis Autopsies Autopsy Biology and Life Sciences Blood Care and treatment Composition Deposition Diagnostic specimens Dietary minerals Dosage Drug dosages Elderly patients Ferritin Food and nutrition Geriatrics Gerontology Health aspects Hepatitis Hepcidin Hospitals Infusion Interleukin 6 Intravenous administration Iron Iron (Nutrient) Iron content Laboratories Liver Medical education Medical examination Medicine and Health Sciences Minerals Nutrition Older people Parenteral nutrition Patient outcomes Patients Physical Sciences Pigments Quality Research and Analysis Methods Staining Stains & staining Statistical analysis Statistical methods Studies Supervision Surgery University graduates Variables Veins Vitamins |
| title | Iron deposition in autopsied liver specimens from older patients receiving intravenous iron infusion |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T00%3A18%3A39IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Iron%20deposition%20in%20autopsied%20liver%20specimens%20from%20older%20patients%20receiving%20intravenous%20iron%20infusion&rft.jtitle=PloS%20one&rft.au=Akatsu,%20Hiroyasu&rft.date=2020-08-04&rft.volume=15&rft.issue=8&rft.spage=e0237104&rft.epage=e0237104&rft.pages=e0237104-e0237104&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0237104&rft_dat=%3Cgale_plos_%3EA631557020%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2430360504&rft_id=info:pmid/32750083&rft_galeid=A631557020&rft_doaj_id=oai_doaj_org_article_af67705082d54d71b0d02c99b687b94d&rfr_iscdi=true |