scholarly journals Hemolytic Crisis in a Dog with Copper-Associated Chronic Hepatitis

2019 ◽  
Vol 47 ◽  
Author(s):  
Renata Dalcol Mazaro ◽  
Flávia Serena Da Luz ◽  
Alana Pivoto Herbichi ◽  
Milena Carolina Paz ◽  
Rafael Almeida Fighera
Keyword(s):  
Chronic Hepatitis ◽  
Prussian Blue ◽  
Macrocytic Anemia ◽  
Copper Toxicity ◽  
Occult Blood ◽  
Serum Biochemistry ◽  
The Body ◽  
Renal Tubules ◽  
Rubeanic Acid ◽  
Hemolytic Crisis

Background: Copper is an essential micronutrient for the body to function properly. However, although it is a vital element, an excess of copper in the body is extremely toxic. Copper toxicity has been reported mainly in sheep. In dogs, clinicopathological signs of toxicity are characterized by chronic liver failure. This means that the hemolytic crisis so common in sheep is a condition rarely associated with toxicity in dogs, so there are very few descriptions of this condition in the veterinary literature. The purpose of this report is to describe a case of hemolytic crisis in a dog with copper-associated chronic hepatitis.Case: A medium-sized 6-year-old bitch was brought to the Veterinary Hospital of the Federal University of Santa Maria, with clinical presentation of apathy, anorexia and red urine. A physical examination revealed mildly jaundiced mucosa and dark brown urine. A urinalysis indicated the presence of protein, bilirubin and occult blood. The blood count revealed hypochromic macrocytic anemia, leukocytosis due to left shift neutrophilia and thrombocytopenia. Serum biochemistry showed elevated levels of alanine aminotransferase and alkaline phosphatase. The animal was given a blood transfusion due to the severity of her anemia, but her clinical condition worsened and she died, whereupon her body was sent for necropsy. This necropsy revealed conspicuous signs of jaundice, splenomegaly and altered liver and kidney color. The liver was brownish, with its natural surface firm and slightly irregular. The kidneys were diffusely blackened. The urine was dark brown. Fragments of different organs were collected, fixed in 10% buffered formalin solution, routinely processed for histopathology and stained with hematoxylin and eosin. A histological dissection of the liver showed the hepatic lobes dissected by fibrosis, forming islands of hepatocytes and numerous lymphocytes and plasmocytes. Brown granular pigment was observed in periportal hepatocytes. Perls Prussian blue and rubeanic acid staining techniques were performed to characterize this pigment. Most of the pigment reacted strongly to rubeanic acid and but not to Perls’ Prussian blue, thus characterizing it as copper. Random hepatic necrosis was visible. The kidneys contained hemoglobin and necrotic epithelial cells obstructing the renal tubules. Based on the clinical and anatomopathological aspects, a diagnosis of hemolytic crisis due to copper-associated chronic hepatitis was established.Discussion: The most accepted mechanism to explain the occurrence of hemolysis is that copper long stored in hepatocytes is massively released into the bloodstream due to some stressful condition. When too much copper circulates in the bloodstream it inhibits enzymes that act on the energy metabolism of red blood cells, thereby lowering the synthesis of energy and nucleotides needed for glutathione activity, and causing hemoglobin to transform into methemoglobin. In the case reported here, copper toxicosis presumably originated from the animal’s diet since, according to the literature, the periportal distribution of copper revealed during histology suggests that the event resulted from excessive copper intake or was secondary to previous cholestatic liver injury. This paper describes a case of hemolytic crisis in a dog with copper-associated chronic hepatitis and, emphasizes the importance of including copper toxicity as a differential diagnosis for dogs presenting hemolytic crisis, in order to assist veterinarians in managing their patients. 

scholarly journals GLUCOSE HOMEOSTATIC AND PANCREAS PROTECTIVE POTENTIAL OF TECOMELLA UNDULATA ROOT EXTRACT IN STREPTOZOTOCIN INDUCED DIABETIC RATS .

2017 ◽  
Vol 10 (6) ◽  
pp. 292
Author(s):  
Kanwar Lal ◽  
Ashok Purohit ◽  
Heera Ram
Keyword(s):  
Hematological Parameters ◽  
Ethanolic Extract ◽  
Serum Biochemistry ◽  
Diabetic Rats ◽  
The Body ◽  
Root Extract ◽  
Standard Drug ◽  
Protective Potential ◽  
Normal Ranges ◽  
Tecomella Undulata

Objective: The study was aimed to evaluate glucose homeostatic and pancreas protective potential of Tecomella undulata root extract in streptozotocin induced diabetic rats.Methods: The ethanolic root extract was prepared by following standard soxhlation methods. The experimental design was divided in to control and treated groups for 28 days of comparative experimental schedule. The body and organ weights, serum biochemistry, histo-pathology, hematology and toxicity profiles were assayed by following standard methods and protocols.Results: The treatment of ethanolic extract of root of T. undulata was significantly (p ≤ 0.001) reduced glucose levels at 7day, 14day, 21day and 28 days in comparison to standard drug of metformin. Correspondingly, lipid profile i.e. total cholesterol, HDL, VLDL, LDL and triglyceride were also altered significantly. Whereas, body and organs weight and hematological parameters were not shown significant changes. Subsequently, toxicity profile i.e. hepatic and renal parameters were remained under normal ranges. Corresponding, the treatment of ethanolic root extract caused normalcy of histoarchitecture of pancreas in comparison to standard drugs.Conclusion: The results of study illustrated that Tecomella undulata root extract possessing particular kind of phytocompounds which caused glucose homeostatic and pancreas protective potential in diabetic rats.

EFFECTS OF DEOXYCORTICOSTERONE ACETATE AND CORTISONE ON THE EXCRETION OF HYPOTONIC SALINE BY ADRENALECTOMIZED RATS

1954 ◽  
Vol 11 (3) ◽  
pp. 261-268 ◽  
Author(s):  
D. F. COLE
Keyword(s):  
Antidiuretic Hormone ◽  
Hormone Secretion ◽  
The Body ◽  
Renal Tubules ◽  
Water Diuresis ◽  
Deoxycorticosterone Acetate ◽  
Water Excretion ◽  
Normal Water ◽  
Hypotonic Saline ◽  
Adrenalectomized Rats

SUMMARY The response to loads of hypotonic saline has been investigated in intact and in adrenalectomized rats treated with deoxycorticosterone acetate, with cortisone acetate and with both steroids. The response of untreated adrenalectomized animals was also studied. Intact rats excreted more water than sodium during the 5 hr after loading with hypotonic saline. There was a reduction of the proportion of water reabsorbed in the renal tubules, but the proportion of sodium reabsorbed was unaltered. Adrenalectomized rats, either with or without deoxycorticosterone treatment, did not show this diuretic response, and there was evidence that sodium was lost from the body cells. Rats in these two groups reabsorbed a smaller proportion of sodium in their renal tubules than intactrats. Adrenalectomized rats treated with cortisone showed partial restoration of the ability to excrete water, but the renal loss of sodium was greater than in intact animals. Treatment of adrenalectomized rats with both cortisone and deoxycorticosterone restored water excretion to normal values, but excessive amounts of sodium were lost. In neither group which received cortisone was there any indication of loss of cell sodium. The response of rats in the group receiving both steroids was not a normal water diuresis because the animals were unable to excrete water without loss of sodium. It appeared unlikely that there was excessive antidiuretic hormone activity in the rats receiving cortisone and that some factor other than reduction of pituitary antidiuretic hormone secretion was essential for normal water diuresis.

scholarly journals Feline obesity: risk factors and clinical and metabolic findings

2021 ◽  
Vol 42 (6) ◽  
pp. 3305-3320
Author(s):  
Camila Moura de Lima ◽  
◽  
Gustavo Antônio Boff ◽  
Sergiane Baes Pereira ◽  
Alexsander Ferraz ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Environmental Management ◽  
Body Fat ◽  
Body Condition Score ◽  
Serum Biochemistry ◽  
The Body ◽  
Gamma Glutamyl Transferase ◽  
Glutamyl Transferase

Excess body fat can cause a series of metabolic and mechanical effects on the body. Therefore, this study aimed to verify the clinical, metabolic, and risk factors of overweight (OW) cats. For the acceptance of participation in the research, the tutors were asked to answer a questionnaire containing 34 questions and to point out the body condition score (BCS) on a sheet containing nine images of different scores (1 to 9 on a 9-point scale). Thereafter, the body evaluations were performed as a classification of the BCS on a scale from 1 to 9, with an ideal score (IS) of BCS 5 and OW for BCS > 5. Further, the lean mass index and morphometric measurements (thoracic and abdominal circumferences and height and length of the patella to calcaneal tuberosity) were performed to estimate the percentage of body fat. Systolic blood pressure was measured using the non-invasive Doppler method and blood was collected for hemogram and serum biochemistry (creatinine, urea, alanine aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, glucose, triglycerides, and cholesterol). After these analyses, we sought to guide and raise the awareness of the tutors to promote the correct nutritional and environmental management of the animals. Thirty adult cats were divided into two groups, based on the classification of the BCS, with eight having an IS and 22 being OW. The OW group was found to have a low level of physical activity, hypercholesterolemia, and higher values of body characteristics. Additionally, there was a median agreement between the perceptions of the clinician and the tutors. Therefore, it was concluded that the main laboratory alteration found in the obese cats was hypercholesterolemia, which was a critical parameter. It was observed that a low degree of physical activity could cause excess weight gain. It was found that the guardians of the cats with ideal weight underestimated the BCS, which could contribute to the supply of excess food and consequently, obesity. Thus, this study was sought to guide and raise the awareness of tutors, to promote the correct nutritional and environmental management thereby providing welfare and quality of life to the animals.

scholarly journals Streptococcus Salivarius Subsp Salivarius BIO5 - Toxicity Evaluation of a Possible Probiotic Strain

2020 ◽  
pp. 51-56
Author(s):  
Fantinato V ◽  
Camargo HR ◽  
Sousa ALOPilleggi
Keyword(s):  
Oral Cavity ◽  
Urine Analysis ◽  
Probiotic Strain ◽  
Serum Biochemistry ◽  
The Body ◽  
Streptococcus Salivarius ◽  
Toxicity Evaluation ◽  
Pcr Assay ◽  
Traditional Treatment ◽  
Intestinal Functions

Probiotic bacteria, which are traditionally studied to aid intestinal functions, are also currently being researched for benefits in other parts of the body such as the oral cavity. In the case of throat infections caused by bacteria, which traditional treatment involves antibiotics, some researchers are studying the possibility of introducing special strains of commensal bacteria into the mouth that can specifically inhibit the tonsillitis agent Streptococcus pyogenes for both prevention and treatment of such disease. A PCR assay was used to identify Streptococcus salivarius subsp salivarius. Therefore, tests for the complete absence of toxicity of these strains are required to ensure their safe use in human trials. In this research, we evaluated the new Streptococcus salivarius subsp salivarius BIO5 strain for toxicity factors, as follows: clinical, ophthalmic lesions, behavioral observations, mortality, anatomopathological examination, biopsy, hematology, serum biochemistry, and urine analysis. This strain, isolated from the oral cavity and with bacteriocinogenic activity against S. pyogenes, showed a complete absence of toxicity and thus it may be used in replacement therapy as a probiotic.

scholarly journals Putative Aspergillus niger-induced oxalate nephrosis in sheep : clinical communication

2009 ◽  
Vol 80 (1) ◽  
Author(s):  
C.J. Botha ◽  
M. Truter ◽  
T. Bredell ◽  
L. Lange ◽  
M.S.G. Mulders
Keyword(s):  
Aspergillus Niger ◽  
Oxalic Acid ◽  
High Performance ◽  
Clinical Signs ◽  
The Body ◽  
Renal Tubules ◽  
Fungal Culture ◽  
Clinical Communication ◽  
Hind Limbs ◽  
Polarised Light

A sheep farmer provided a maize-based brewer's grain (mieliemaroek) and bales of Eragrostis curvula hay to ewes and their lambs, kept on zero-grazing in pens. The 'mieliemaroek' was visibly mouldy. After 14 days in the feedlot, clinical signs, including generalised weakness, ataxia of the hind limbs, tremors and recumbency, were noticed. Six ewes died within a period of 7 days. A post mortem examination was performed on 1 ewe. The carcass appeared to be cachectic with mild effusions into the body cavities; mild lung congestion and pallor of the kidneys were observed. Microscopical evaluation revealed nephrosis and birefringent oxalate crystals in the renal tubules when viewed under polarised light. A provisional diagnosis of oxalate nephrosis with subsequent kidney failure was made. Amongst other fungi, Aspergillus niger was isolated from 'mieliemaroek' samples submitted for fungal culture and identification. As A. niger is known to synthesise oxalates, a qualitative screen to detect oxalic acid in the mieliemaroek and purified A. niger isolates was performed using high-performance liquid chromatography (HPLC). Oxalic acid was detected, which supported a diagnosis of soluble oxalate-induced nephropathy.

scholarly journals Perfil hematobioquímico e produção de leite de vacas mestiças Girolando suplementadas com resíduo de caju desidratado

2015 ◽  
Vol 36 (5) ◽  
pp. 3329 ◽  
Author(s):  
Leison Rocha Bezerra ◽  
Ricardo Loiola Edvan ◽  
Ronaldo Lopes Oliveira ◽  
Aderbal Marcos de Azevedo Silva ◽  
Geraldo Fábio Viana Bayão ◽  
...  
Keyword(s):  
Milk Production ◽  
Control Diet ◽  
Latin Square ◽  
Experimental Period ◽  
Serum Biochemistry ◽  
The Body ◽  
Control Group ◽  
Total Plasma Protein ◽  
The Mean ◽  
Different Levels

<p>This paper aims to evaluate the influence of different levels of supplemental product-dehydrated cashew in the feed for crossbred Girolando cows on milk production and hemato-biochemical profile. The experiments were conducted using eight cows that were randomly distributed in a Latin square design (4×4), in which treatments consisted of four supplementation levels with product-dehydrated cashew (PDC) in animal diets, namely: 0% PDC (control diet), 1.0 kg of DCP, 1.5 kg of PDC and 2.0 kg of PDC in total dry matter . The milk and animals were weighed and the body condition of the animals were evaluated within seven days of milk collection during each experimental period. To determine the serum biochemistry and blood count of cows, three blood samples were taken in each period, at 7, 14 and 21 days before the daily supply of supplementation with samples collected from 5 ml of blood by puncturing the jugular vein. Supplementation with 2 kg of PDC reduced milk production and the levels of glucose and total plasma protein compared to the control group, due to the higher level of tannin in this group. Supplementation with PDC raised the total count of the erythrocytes, reduced the mean corpuscular volume (MCV) and non-changed number of leukocytes. Increased levels of phenolic compounds in the diet inhibited the absorption of dietary proteins, which decreased milk production.</p>

Bioavailability of Iron and Cyanide from 59Fe-and 14C-Labelled Hexacyanoferrates(II) in Rats

1990 ◽  
Vol 45 (6) ◽  
pp. 681-690 ◽  
Author(s):  
Peter Nielsen ◽  
Bernd Dresow ◽  
Roland Fischer ◽  
Hellmuth C. Heinrich
Keyword(s):  
Oral Administration ◽  
Prussian Blue ◽  
Ferrous Iron ◽  
Intestinal Tract ◽  
Ferric Iron ◽  
The Body ◽  
Female Rats ◽  
Exhaled Air ◽  
Severe Nuclear Accident

Abstract “Soluble” (KFeIII[FeII(CN )6]) and “insoluble Prussian blue” (FeIII4[FeII(CN)6]3 labelled with 59Fe either in the ferric (FeIII) or ferro (FeII) position and 14C in the cyanide group were synthesized and administered intraperitoneally or orally to adult female rats with normal body iron stores. Following i.p. injection of KFe[Fe(CN)6], the colloidal complex is disintegrated into ferric iron and hexacyanoferrate(II) anion almost completely. About 96% of the ferric iron was retained in the body. Nearly 90% of both ferrous iron and cyanide were excreted with the urine within 7 days after i.p. injection, indicating that most of the undissociated hexacyanoferrate(II) anion ([Fe(CN)6]4-) was excreted through the kidney. Only 9% of the ferrous iron from [Fe(CN)6]4- was found mainly in carcass, liver and gut. As the 59Fe/14C-ratios in organs were found close to 1.0, the dissociation of the hexacyanoferrate(II) anion can only be small in vivo. No detectable 14CO2-activity (< 0.01 %) was monitored in the breath of rats after i.p. injection of the 14C-labelled KFe[Fe(CN)6], also indicating that no significant amounts of cyanide were released after parenteral administration. After oral administration of the soluble and insoluble Prussian blue, 0 .3 -0 .7% of the ferric iron was absorbed and retained mainly in carcass, liver and blood. Only 0.06-0.18% of the ferrous iron was absorbed and mostly excreted with the urine (0.05-0.15%), so that only 0.01-0.03% of the oral ferrous 59Fe was retained in the body after 7- 10 days. Very small fractions of 14C-label from the 14CN-group of the soluble and insoluble hexacyanoferrate(II) were observed in the exhaled air (0.04-0.08% of the oral dose). From the 14CO2-exhalation, the 14Curine excretion and the distribution of iron in blood and organs it can be concluded that the hexacyanoferrate(II) moiety disintegrated only to a small extent in the intestinal tract after oral administration. From a dose of 36 mg hexacyanoferrate(II)/kg, an amount of free (non complex bound) cyanide can be calculated which is in maximum two orders of magnitude below the LD100-level. Thus, the very low bioavailability of iron and cyanide from hexacyanoferrate(II) compounds after oral application is demonstrated in rats. In the case of a severe nuclear accident, appropriate doses of “soluble” and “insoluble” Prussian blue can be used as safe and effective antidote against radiocaesium contamination.

scholarly journals Characterization of Novel Nonobese Type 2 Diabetes Rat Model with Enlarged Kidneys

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Ayaka Domon ◽  
Kentaro Katayama ◽  
Yuki Tochigi ◽  
Hiroetsu Suzuki
Keyword(s):  
Type 2 Diabetes ◽  
Rat Model ◽  
Inflammatory Cells ◽  
The Body ◽  
Female Rats ◽  
Male Rats ◽  
Oral Glucose ◽  
Renal Tubules ◽  
Age Related

A variety of animal models of diabetes mellitus (DM) are required to study the genetics and pathophysiology of DM. We established a novel rat strain showing nonobese type 2 diabetes with enlarged kidneys from the LEA.PET-pet congenic strain and named it Diabetes with Enlarged Kidney (DEK). The body growth of DEK affected rats was similar to that of normal rats before the development of DM but was attenuated with the deterioration of DM. There was a marked difference in the etiology of DEK by gender: DM phenotypes including polyuria, polydipsia, and hyperglycemia (nonfasting blood glucose over 300 mg/dl) were found in male rats aged over 10 weeks but not in female rats. The cumulative incidence of DM in DEK males at the age of 30 weeks was 44.8%. Oral glucose tolerance tests showed glucose intolerance and decreased insulin secretion in response to glucose loading in affected males, features which were exacerbated with age. Affected males exhibited disorganized architecture of pancreatic islets, decreased numbers of β cells, and markedly decreased expression of insulin, despite no pathological findings of hemorrhage or infiltration of inflammatory cells in the pancreatic islet. Age-related islet fibrosis appeared similar in normal and affected males. Affected males also showed enlarged kidneys with dilation of renal tubules in both the cortex and medulla, but no obvious glomerular lesions typical of diabetic nephropathy (DN) at the age of 30 weeks. Plasma levels of urea nitrogen and creatinine were normal, but hypoalbuminemia was detected. These pathophysiological features in affected males indicated that their renal function was almost maintained despite severe DM. Taken together, these findings indicate that the affected males of the DEK strain are a novel nonobese type 2 diabetes rat model useful for studying the mechanisms underlying β cell loss and identifying genetic factors protective against DN.

Radiographic and Biochemical Evaluations of Postnatal Development of Bones of the Forelimb in Nigerian Indigenous Dogs.

2021 ◽  
Vol 3 (1) ◽  
pp. 19-28
Author(s):  
M. N. Bappah
Keyword(s):  
Calcium Phosphate ◽  
Bone Development ◽  
Serum Biochemistry ◽  
The Body ◽  
Radiographic Evaluation ◽  
Serum Samples ◽  
Ossification Centre ◽  
Mean Values ◽  
Distal Epiphysis ◽  
Sodium And Potassium

Bone is a hard and resilient tissue structure that provides mechanical support for the body of an organism. This study was aimed to evaluate the radiographical and biochemical changes during postnatal bone development of forelimbs in Nigerian indigenous puppies from 2-week-old to 24-week-old. Six (6) Nigerian indigenous puppies were chemically restrained using chlorpromazine at 2 mg/kg I.M. and positioned using ropes and sandbags for mediolateral and craniocaudal views of bones of the forelimbs. At 2-week-old, radiographic evaluation of bones of the forelimbs were undertaken and continued bi-weekly up to 24-week-old. Serum samples were analysed from 4-week-old to 24-week-old at four weeks’ interval for mineral (electrolytes) using colometric method for calcium and phosphorus and flame photometry method for sodium and potassium. At 2-week-old, there was an ill-defined radiopaque secondary ossification centre at the proximal epiphysis and a small ovoid radiopaque structure at the distal epiphysis of the humerus. There was not any sign of secondary ossification centre at proximal and distal epiphyses of both radius and ulna. There was the presence of a small radiopaque (ill-defined) accessory carpal. 1st to 5th metacarpals were present together with the proximal, middle and distal phalanges of all digits except the 1st digit that has proximal and distal phalanges. From 20-week-old, fully developed carpals and bony structures were observed through 24-week-old where the commencement of fusion of apophyses of olecranon (proximal epiphysis of ulna) at the centre and acrophyses of metacarpals and phalanges. The mean values (mean ± SEM) from serum biochemistry of calcium, phosphate, sodium and potassium in mmol/L from this study were within the normal limits throughout the study. Conclusively, the complementary information from calcium, phosphate, sodium and potassium in this study showed that these elements are within the normal limit that suggests normal bone development during the study period, which stressed the importance of the knowledge on serial changes of bone development which could be useful in clinical practice.

Assessment of Renal Function in Transfused b-Thalassemia Patients Based on Cystatin C Measurements and Equations.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2769-2769 ◽  
Author(s):  
Antonios Kattamis ◽  
Alexandra Margeli ◽  
Eugenia Hantzi ◽  
George Paleologos ◽  
Athanasia Sergounioti ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Insufficiency ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Stable Process ◽  
Significant Proportion ◽  
Dietary Factors ◽  
The Body ◽  
Tubular Dysfunction ◽  
Renal Tubules

Abstract Cystatin C is a non-glycosylated protein that belongs to the cystatin superfamily of cysteine protease inhibitors. Its low molecular weight (13.3kDa) and positive charge at physiological pH levels facilitates its glomerular filtration and subsequently it is reabsorbed and almost completely catabolized in the proximal renal tubules. Therefore and due to its constant rate of production, its serum concentration is determined by the rate of glomerular filtration (GFR). Cystatin C production in the body is a stable process that is not influenced by renal conditions, increased protein catabolism or dietary factors. Moreover, in contrary to creatinine, it does not change with age or muscle mass. For these reasons, serum cystatin C has been suggested to be an ideal endogenous marker of GFR. Studies on the renal function of patients with transfusion-dependent β-thalassemia are sparse. These studies suggested that the renal abnormalities observed in β-thalassemia are due to proximal tubular dysfunction and postulated that their severity is related with the degree of anemia. They were less severe in patients on hypertransfusion and appropriate desferrioxamine therapy suggesting that the damage might be caused by both anemia and increased oxidation induced by excess iron deposition. None of these studies have demonstrated renal insufficiency as reflected by decreased GFR. This was probably due to the fact that all estimations were based on creatinine measurements. In this study we estimated GFR in 195 transfused patients with β-thalassemia major by measuring cystatin C and calculating GFR according to the recently proposed cystatin C-based prediction equation using only concentration in mg/L and a prepubertal factor:1GFR [mL/min/1.73m2] = 84.7 × cystatin C (mg/L)−1.68 × 1.38* (*if a child <14 years). We found that 136 patients had normal cystatin C levels (0.66–1.03mg/L) and GFR values (80–170mL/min/1.73m2), 36 patients had mild renal insufficiency (cystatin C levels: 1.04–1.22mg/L and GFR values: 60–79mL/min/1.73m2), 21 patients had moderate renal insufficiency (cystatin C levels: 1.23–1.72mg/L and GFR values: 34–59mL/min/1.73m2), while 2 patients had severe renal insufficiency with cystatin C levels >2.5mg/L and GFR values <20mL/min/1.73m2. We further determined plasma levels of Neutrophil gelatinase-associated lipocalin (NGAL) in 30 randomly selected patients. NGAL is a protein expressed on tubular cells of which the production is markedly increased in response to harmful stimuli, such as ischemia or toxicity. We found increased NGAL levels in 19 β-thalassemia patients (mean: 95.0±45.0mg/L compared to normal values of 51.2±11.8mg/L, p<0.0003). NGAL levels correlated significantly with cystatin C levels (r=0.740, p<0.0001), indicating that the renal impairment in these patients seems to be originated from tubular injury. The findings of this study indicate that renal insufficiency is present in a significant proportion of transfusion-dependent β-thalassemia patients. Further studies are warranted in order to identify predisposing factors that contribute to the renal damage in thalassemia and to establish appropriate guidelines for the evaluation and follow up of renal function in these patients. 1. Clin Chem2005;51:1420–143.

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