Report 2006 Iron Overload can mimic hepatic GVHD
 

Biol Blood Marrow Transplant. 2006 May;12(5):506-10.
Iron overload manifesting as apparent exacerbation of hepatic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation.

http://www.ncbi.nlm.nih.gov/pubmed/16635785

This report comes to the result that in the investigated cases of 6 patients after SZT the iron overload caused a decline of the liver-parameters of hepatic GVHD.

The patients had median 7231 mug/dl Ferritin with TF saturation of median 77 % and diagnosed liver gvhd after allogeneic SZT. They had received median 20 units of packed blood in lifetime.

They received a phlebotomy-cure with EPO which normalizied the liver function median after 7 months and the serum - ferritin after median 11 months.

4 Patients absolved the whole program, and their immunsuppression could be tapered.

These facts underpinned the impression that the iron overload and not the GVHD caused the problem.

All patients had to do maintainance phlebotomies months and years after the normalization of the Ferritinlevel.

Perhaps in many of the cases where SZT-Patients or others are chelated down from high ferritin-levels a sort of maintainance chelation is necessary to maintain/optimize the results. (This is only my thought).