Details
Zusammenfassung: <jats:title>Abstract</jats:title><jats:p>Pyruvate kinase deficiency is a chronic illness with age specific consequences. Newborns suffer life‐threatening hemolytic crisis and hyperbilirubinemia. Adults are at risk for infections because of asplenia, pregnancy‐related morbidity, and may suffer organ damage because of systemic iron overload. We describe 27 Old Order Amish patients (ages 8 months–52 years) homozygous for c.1436G&gt;A mutations in <jats:italic>PKLR</jats:italic>. Each subject had a predictable neonatal course requiring packed red blood cell transfusions (30 ± 5 mL/kg) to control hemolytic disease and intensive phototherapy to prevent kernicterus. Hemochromatosis affected 29% (<jats:italic>n</jats:italic> = 4) of adult patients, who had inappropriately normal serum hepcidin (34.5 ± 12.7 ng/mL) and GDF‐15 (595 ± 335pg/mL) relative to hyperferritinemia (769 ± 595 mg/dL). A high prevalence of <jats:italic>HFE</jats:italic> gene mutations exists in this population and may contribute to iron‐related morbidity. Based on our observations, we present a strategy for long‐term management of pyruvate kinase deficiency. Am. J. Hematol. 2011. © 2011 Wiley‐Liss, Inc.</jats:p>
Umfang: 827-834
ISSN: 0361-8609
1096-8652
DOI: 10.1002/ajh.22118