Nombre: JEFERSON HORSTH SATHLER
Fecha de publicación: 03/04/2025
Junta de examinadores:
Nombre |
Papel |
|---|---|
| DIVANEI DOS ANJOS ZANIQUELI | Examinador Externo |
| MIRIAN FIORESI | Examinador Interno |
Sumario: Iron overload, although an essential element for life, can become toxic when in excess.
Chronic iron overload, whether due to genetic disorders such as hemochromatosis or
secondary conditions like sickle cell anemia, thalassemia, or other conditions requiring
frequent blood transfusions, causes damage to various organs, including the heart,
liver, and pancreas. However, there is a lack of data on the prevalence and
characterization of the population with iron overload in Brazil, especially in Espírito
Santo. This information is crucial not only to support future research but also to adjust
clinical practices and public health policies tailored to this population. Thus, this study
aimed to characterize the sociodemographic and clinical profile of patients with iron
overload treated at a reference center for hematology and hemotherapy in Espírito
Santo, Brazil. A total of 100 patients diagnosed with iron overload (both primary and
secondary) were included, following objective inclusion criteria according to the Clinical
Protocol and Therapeutic Guidelines of the Ministry of Health (2018).
Sociodemographic and health data, particularly cardiovascular information, were
collected through questionnaires and medical records. The results revealed that most
patients with secondary iron overload had a transfusional etiology, with sickle cell
anemia being the most prevalent underlying disease. This group consisted of younger
individuals (37.7±18.2 years), predominantly Black (Black/Brown: 82%), with lower
levels of education and income. The main comorbidities present were hypertension
and diabetes mellitus. A significantly high number of people had altered liver enzyme
levels in the past six months, as well as a higher prevalence of anemia compared to
the primary overload group. On the other hand, patients with primary iron overload
(hemochromatosis) had a higher mean age (53.2±14.6 years), were equally distributed
between Black (47.7%) and White (50%) individuals, and had higher education and
income levels compared to those with secondary overload. Although only a minority
had a confirmed genetic diagnosis, the most prevalent mutation for hemochromatosis
was C828Y homozygosity (found in 29% of confirmed cases). Additionally, in these
patients with primary overload, the prevalence of cardiovascular and metabolic
diseases was significantly higher than in the secondary group, as was the frequency
of patients who reported regular tobacco (25% vs. 10.7%) and alcohol use (40% vs.
9%). There were no differences in blood pressure levels and heart rate between the
groups, nor in body mass index and physical activity level. In conclusion, the
heterogeneity of the sociodemographic and clinical profile in this sample from a state
reference center for the care and follow-up of patients with iron overload highlights the
need for region-specific personalized care strategies. These strategies are essential
for better understanding and promoting equity in the treatment of these patients.
Furthermore, this pioneering study's data may assist in formulating more effective
public health policies for managing iron overload in Brazil.
