Iron accumulation diabetes

Another condition involving ceruloplasmin is aceru-loplasminemia. in this genetic disorder, levels of ceruloplasmin are very low and consequently its ferroxidase activity is markedly deficient. This leads to failure of release of iron from cells, and iron accumulates in certain brain cells, hepatocytes, and pancreatic islet cells. Affected individuals show severe neurologic signs and have diabetes mellitus. Use of a chelating agent or administration of plasma or ceruloplasmin concentrate may be beneficial. 

Exacerbation of hemochromatosis (an inherited disease in which excessive iron accumulates in the body) was reported in a 68-year-old woman with a history of type 2 diabetes, asthma, hypothyroidism, borderline hypertension, borderline diastolic dysfunction, and a fatty liver. The women had been taking 200 mg of milk thistle daily for over a year, along with two extra-strength acetaminophen pills every 2 to 3 days, and a can of cola (presumably a diet cola) every day (Whittington 2007). A letter regarding this case noted that elevated liver enzymes, reported as a sign of hemochromatosis exacerbation, may occur with regular acetaminophen use (Kidd 2008). 

Three symptoms dominate the clinicopathological picture of hemochromatosis cirrhosis, diabetes, and skin pigmentation. Cirrhosis is severe and is followed by its classical complications, portal hypertension and hepatic insufficiency. The portal hypertension leads to ascites, esophageal varices, and gastrointestinal hemorrhage. The destruction of the islet is responsible for diabetes, which is sometimes severe enough to lead to death in coma if insulin therapy is not instituted. The skin acquires a marked tan, sometimes reminiscent of the color of bister. The skin discoloration is due to melanin formation rather than iron accumulation. 

One of the most notable features of this inherited defect of iron homeostasis (Chapter 9) is the ability of individuals to accumulate large amounts of iron over many years and yet show no apparent adverse effects. This may in part be due to the ability of tissues, notably the liver, to increase their iron stores gradually over a long period of time, successfully sequestrating excess iron into ferritin and, predominantly, haemosiderin. However with time the excessive deposition of iron will cause a variety of toxic effects including diabetes and arthritis which are caused by deposition of iron in these tissues. Removal of this iron by venesection can often reduce these iron-induced symptoms. 

There are several inherited diseases which are associated with the gradual excess accumulation of iron via the gut. Hereditary haemochromatosis is a relatively rare condition in which iron absorption is increased through an unidentified mechanism. This condition usually presents in the fourth or fifth decade of life with the secondary effects of iron overload such as heart failure, liver cirrhosis or sugar diabetes. As the production of red cells is unaffected, the excess iron can be removed slowly by venesecting a unit of blood every week for up to two years. However, in the acute situation, iron chelation may be used to remove toxic low-molecular-weight iron until sufficient negative iron balance has been obtained by venesection. 

Hemochromatosis is a condition in which the body accumulates excess amounts, of iron it is one of the most common genetic diseases in humans. The symptoms of hemochromatosis include the classic triad of bronzing of the skin, cirrhosis, and diabetes. Other manifestations include cardiomyopathies and arrhythmias, endocrine deficiencies, and possibly arthropathies. 

The presence of too much iron in the body can also cause problems. People who suffer from hemochromatosis retain too much iron, causing it to accumulate in various organs, including the spleen, heart, and liver. Hemochromatosis can cause joint pain, heart failure, liver failure, or diabetes. 

Cadmium uptake is also dependent on gender, the nutritional status, in particular the status of other metal ions, and calcium and fiber in the diet. Under iron and zinc deficiency, cadmium uptake is higher (see Section 3.2.2 below). Vegetarian diets are of concern due to cadmium accumulation in crops and nutritionally induced mineral deficiencies. The damage to the kidney is dependent on these factors with contribution from co-morbidities, such as diabetic nephropathies. 

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