Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P02794 (ferritin)
17,525 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Norplant consists of 6 soft plastic capsules placed in the subcutaneous tissue on the inside of the upper arm which release levonorgestrel continuously over 5 years to prevent pregnancy. Health workers use an aseptic technique to insert the capsules within 0.5 cm of the incision. Scar tissue increases removal time to twice that of insertion time. The 1st year pregnancy rate is 0.2%. Body weight affects the cumulative 5-year pregnancy rate: 0.2% for 50 kg women, 3.4-5% for 50-69 kg women, and 8.5 for 70 kg women. It rises remarkably in the 3rd year. Women find the advantages to be, in order of importance, ease of use, effectiveness, long duration, reversibility, and arm placement. The most common misconception about Norplant is it causes cancer or sterility. Both before insertion and during the early months after insertion, family planning providers must thoroughly explain Norplant and stress how it is different from other contraceptive methods. 1 study reveals that the 1-year continuation rate for women who undergo careful preinsertion counseling is greater than it is for women who do not receive effective counseling (88% vs. 60%). The leading side effect is abnormal bleeding patterns. Even though bleeding patterns change, hemoglobin or ferritin levels do not decrease. In women who experience no bleeding, providers must conduct a urinary human chorionic gonadotropin test at 4-6 weeks. If the test reveal no pregnancy, they need to explain to the women that this is normal. Abnormal bleeding patterns improve with increased duration of Norplant use. Women who need to be carefully monitored or should not use Norplant are those with impaired glucose tolerance, hyperlipidemia, impaired liver function, premenstrual symptoms, and history of depression. The ideal candidate is a woman who has used oral contraceptives (OCs) with no side effects yet forgets to take them daily, has contraindications for estrogen, or has estrogenic side effects from OCs.
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PMID:Who is a candidate for Norplant? 161 60

During the period 1950-1985, a total of 179 cases of clinically overt hereditary haemochromatosis (HH) were registered in Denmark, 140 males and 39 females. Median age at diagnosis was 55 years (range 29-81). Diagnostic approaches, symptoms and physical signs at discovery are described. All patients had grade 3-4 liver haemosiderin iron, and cirrhosis was present in 84%. Serum (S-) transaminase was elevated in 92%, S-alkaline phosphatase in 47% and S-bilirubin in 23%, while plasma prothrombin time was below normal in 34%. Females had higher alkaline phosphatase than males (p less than 0.05). Bone marrow haemosiderin iron (n = 81) showed no relation to iron status indicators and was unsuitable as a diagnostic tool. Skin biopsy (n = 56) was positive for haemosiderin iron in 67% and for melanin in 57%, but was of limited value in the assessment of HH. Arthropathy was registered in 44%; arthralgias and clinical joint abnormalities occurred more frequently in females than in males (p less than 0.05). Latent diabetes mellitus was found in 34% and overt diabetes in 55%, being more frequent in males than in females (p less than 0.05). Other endocrine abnormalities were seen in 66%. Cardiac failure was observed in 9% and abnormal ECG in 35%. Males had higher haemoglobin (p less than 0.0001) and S-iron (p less than 0.01) than females, while S-transferrin, transferrin saturation, S-ferritin and mobilizable iron stores showed no significant sex differences. Median transferrin saturation was 87% (range 52-100); values greater than 62% were observed in 96% of the patients. Median S-ferritin was 3,400 micrograms/l (800-12,700) and median iron stores 14.8 g (4.5-36.4).
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PMID:Hereditary haemochromatosis in Denmark 1950-1985. Clinical, biochemical and histological features in 179 patients and 13 preclinical cases. 191 39

Oral glucose tolerance tests were conducted in 29 patients with aplastic anemia and 20 nondiabetic controls. Seventeen were men and 12 were women, ranging in age from 15 to 67 years. Based on the results of oral glucose tolerance test, the patients were divided into three groups: 14 previously treated cases with normal glucose tolerance; eight previously treated cases with abnormal glucose tolerance, of whom six had diabetes and two had impaired glucose tolerance; and seven newly diagnosed cases with normal glucose tolerance. Hyperinsulinemia and insulin resistance were observed in all patients. Multivariate analyses show that sex, age, body mass index, previous androgen and corticosteroid therapy, previous blood transfusion, initial hemoglobin and white blood cell and serum ferritin concentrations were not significantly related to hyperinsulinemia as expressed by the integrated insulin area under the curve of glucose tolerance test. Patients in the second group who had abnormal glucose tolerance had a delay in insulin secretion in response to glucose, indicating a deterioration of insulin reserve in the beta cells. Patients in this group were significantly older at the time of diagnosis than those in the first group. No other determinants of the development of abnormal glucose tolerance were demonstrated.
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PMID:Glucose intolerance, hyperinsulinemia and insulin resistance in aplastic anemia. 291 40

We studied 29 patients with thalassaemia major who had received intensive chelation for between 6.2 and 8.8 years. All patients had normal oral glucose tolerance tests before subcutaneous chelation therapy was introduced and 22 of 29 patients had normal liver function tests. At the end of the period of study 12 patients still had normal oral glucose tolerance (7 with normal liver function tests and 5 with chronic active hepatitis). On the other hand, 11 patients had developed impaired glucose tolerance tests (3 patients had normal liver function tests, 5 with chronic active hepatitis and 3 with cirrhosis), and 6 patients had developed frank diabetes mellitus (one with chronic active hepatitis and 5 with cirrhosis). Patients with chronic active hepatitis showed 91% positivity for one or more hepatitis B markers whilst all patients with cirrhosis were positive. Ferritin levels before subcutaneous chelation in patients with normal oral glucose tolerance tests were lower than in those patients with abnormal oral glucose tolerance or diabetes (P less than 0.05) but none had normal serum ferritin levels. In addition, a positive correlation was found between glucose area under the curve after chelation therapy and serum ferritin levels (r = 0.47, P less than 0.01). It is apparent that long term chelation therapy does not prevent the development of abnormal oral glucose tolerance in chronically transfused patients. More intensive chelation therapy is needed to prevent tissue damage. Chronic liver disease may have an important role to play in the deterioration of glucose tolerance.
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PMID:The development of diabetes mellitus and chronic liver disease in long term chelated beta thalassaemic patients. 354 13

In chronic renal failure both HbA1 and HbA1c levels have been reported to be elevated. In order to investigate the causes of such increase we measured HbA1 (cation-exchange chromatography), blood urea nitrogen, arterial blood pH, plasma bicarbonate, phosphatemia, serum iron and serum ferritin before dialysis in 60 uremic patients receiving long term hemodialysis. The increased levels of HbA1 do not correlate with glucose intolerance, phosphatemia, blood urea nitrogen, time averaged concentration of urea, serum iron and serum ferritin. On the contrary the presence of a highly significant correlation between HbA1 and arterial blood pH (p less than 0.001) and between HbA1 and plasma bicarbonate (p less than 0.001) seems to emphasize a major role for acidosis in increasing the HbA1 levels in uremic patients on long term hemodialysis.
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PMID:Origin of glycosylated hemoglobin A1 in chronic renal failure. 684 Aug 96

Insulin-dependent diabetes mellitus (IDDM) is a frequent complication in patients with beta-thalassaemia major. It is believed to be a consequence of the damage inflicted by iron overload to the pancreatic beta-cell. Liver disorders and genetic influences seem to be additional predisposing factors to diabetes mellitus in patients with beta-thalassaemia. Ethnic variations are frequently reported on prevalence and complications of diabetes mellitus in the beta-thalassaemia patients. We investigated 50 Saudi children (< 15 years) with beta-thalassaemia major and 50 beta-thalassaemia minor, and age- and sex-matched controls for the prevalence of diabetes mellitus, and its relation to hitherto claimed predisposing factors. Fasting blood glucose, plasma insulin level, liver function tests, plasma ferritin, iron, and transferrin were assessed in each patient and glucose tolerance was evaluated. Results in patients with beta-thalassaemia major were compared with those obtained for beta-thalassaemia minor and the controls. The results showed moderate elevation of ferritin level in the majority of the beta-thalassaemia major despite desferroxamine therapy. Either hyperinsulinaemia or hypoinsulinaemia was encountered in the majority of these patients. The prevalence of diabetes mellitus was 6 per cent compared to 2 per cent in the beta-thalassaemia minor and normal children. Impaired glucose tolerance (IGT) occurred at a significantly higher (24 per cent) frequency in the beta-thalassaemia major compared to 2 and 0 per cent in the beta-thalassaemia minor patients and normal controls, respectively. The prevalence of diabetes mellitus was significantly lower in the Saudi thalassaemic patients compared to the results obtained from patients of other ethnic groups reported in literature.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diabetes mellitus in children suffering from beta-thalassaemia. 780 19

Glucose intolerance is a common consequence of transfusion therapy in patients with thalassemia major (TM), but the relative contribution of pancreatic damage and insulin resistance to glucose intolerance is unclear. We have investigated oral (OGTT) and intravenous (IVGTT) glucose tolerance, insulin sensitivity, and fasting concentrations of insulin, proinsulin, and des 31,32 proinsulin in 12 patients with TM (seven hepatitis C virus [HCV] antibody-negative and five-positive), eight patients with hepatic cirrhosis, and nine healthy controls. Two-hour plasma glucose concentrations were marginally higher in anti-HCV-negative (median, 7.4 mmol/ L; range, 4.0 to 8.2) and significantly so in anti-HCV-positive thalassemics (median, 8.5 mmol/L; range, 6.4 to to 23.0) and cirrhotics (median, 8.0 mmol/L; range, 4.7 to 17.6) than in controls (median, 5.5 mmol/L; range, 3.0 to 6.3). Insulin sensitivity was also reduced in the three patient groups (P < .05). Insulin resistance was the main determinant of oral glucose intolerance in all patient groups (partial r2 = .49, P < .0001, n = 28). In turn, the main determinants of insulin insensitivity in TM patients were liver damage (albumin, r = .67, P = .02) and serum ferritin concentration (r = -.62, P = .03). There was no relationship of either 2-hour or incremental insulin concentrations with ferritin levels or with HCV status in TM subjects. Moreover, these patients showed no elevation of concentrations of proinsulin and des 31,32 proinsulin, markers of pancreatic beta-cell damage, in excess of those observed in cirrhotic patients. In conclusion, the glucose intolerance of TM, like that of cirrhosis, is associated with insulin resistance, not insulin deficiency, and may be a direct or indirect consequence of hepatic damage.
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PMID:Glucose intolerance in thalassemia major is related to insulin resistance and hepatic dysfunction. 862 11

Primary hemochromatosis is characterized by a specific pattern of clinical manifestations. It includes liver disease with hepatomegaly, glucose intolerance, e.g. diabetes, hyperpigmentation oft the skin, impotence/ amenorrhea, arthropathy, cardiomyopathy and fatigue. Laboratory investigation reveals significantly elevated serum ferritin and transferrin saturation with iron. The diagnosis is confirmed by liver biopsy and quantitative determination of elevated liver iron content. Wilson's disease represents a copper storage disease. Prominent clinical features are hepatomegaly and splenomegaly. Neurological alterations and detection of Kayser-Fleischer corneal rings are typical. In the acute initial phase the often young patients present with Coombs-negative hemolysis. Psychiatric alterations, cardiomyopathy, arthropathy, nephropathy, as well as thrombocytopenia and leucopenia are other clinical features. Laboratory parameters of Wilson's disease include low serum ceruloplasmin and serum copper. There is an elevated urinary copper excretion and elevated serum free copper concentration. The diagnosis is confirmed by liver biopsy with quantitative determination of an elevated liver copper content.
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PMID:[Current diagnosis: hereditary metabolic diseases of the liver (primary hemochromatosis, Wilson disease)]. 898 78

The incidence of endocrine dysfunction in relation to the detailed genotype of beta-thalassaemia is investigated in this study. In addition, the association of genotype to specific clinical features of beta-thalassaemia is examined, together with the relationship between serum ferritin levels and endocrine complications. Ninety-seven patients were included, all with transfusion dependent beta-thalassaemia. Patients were divided into 2 categories; group 1 consisted of patients with a beta0/beta0 genotype with or without a concomitant alpha-globin gene deletion as well as patients with beta0/beta+ or beta+/beta+ genotype and normal alpha-globin chain synthesis. Group 2 included patients with beta+/beta+ or beta+/beta0 genotype and one alpha-globin chain deletion and those with a moderate amount of beta-globin chain synthesis (beta++) and normal alpha-globin chain synthesis. The results showed that group 1 patients were more likely to have severe clinical disease (p=0.005). Sixty-four patients (66%) had at least 1 endocrine disorder and 39 (40%) had multiple endocrinopathies; the most common abnormality was hypogonadotrophic hypogonadism (HH). There was a significant association between patients with group 1 genotypes and the presence of HH and impaired glucose tolerance or diabetes. A positive correlation was demonstrated between serum ferritin concentrations and the presence of thyroid or parathyroid dysfunction.
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PMID:Incidence of endocrine complications and clinical disease severity related to genotype analysis and iron overload in patients with beta-thalassaemia. 929 54

Better awareness of the clinical presentation of idiopathic haemochromatosis is a key element for early diagnosis and treatment. We retrospectively analysed the medical records of 105 patients (80 males, 25 females) diagnosed with idiopathic haemochromatosis over the past two decades in the two academic hospitals of Louvain University. Age at diagnosis was 50 +/- 12 years (mean +/- SD). Median ferritin levels were 1,803 micrograms/L-1. Cirrhosis was found at histology in 51%. Ferritin levels were significantly higher in cirrhotic than non-cirrhotic subjects (P < 0.05). Impaired glucose tolerance and diabetes were found at admission in 7 and 40% of all patients. Diabetes was more frequent when cirrhosis was present (53 vs. 25% in cirrhosis-negative patients, P < 0.05). Accordingly, cirrhosis was also more frequent in diabetic than non-diabetic patients (70 vs. 40%, P < 0.05). Diabetic subjects with cirrhosis frequently presented with symptomatic hyperglycaemia at diagnosis, had higher HbA1c levels, and were more insulin-requiring than their non-cirrhotic diabetic counterparts (P < 0.05). There was also a trend towards more frequent chronic complications of diabetes in the former group. Diabetic patients with cirrhosis had slightly higher insulin levels but lower C-peptide values (P < 0.05) than diabetic subjects without cirrhosis. Chronic phlebotomy did not affect subsequent insulin requirements. Thus, diabetes is still a frequent complication of haemochromatosis in Belgium, and its presence and severity are markedly associated with that of cirrhosis at diagnosis of idiopathic haemochromatosis.
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PMID:Clinical aspects of diabetes secondary to idiopathic haemochromatosis in French-speaking Belgium. 934 44


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