Jaundice

[Sally C]

Good morning all,
I have a question that I hope someone can shed some light on as our doctors don't seem to have an answer and don't seemed to be concerned enough to find out.
My husband Don has MDS (RAMD) - and is currently in the Eltrombopag (Promacta) clinical trial for platelets at NIH. He is tolerating the med very well and his platelets are holding in the 20,000 for the first time since 2009. He is still red cell transfusion dependent. But that's an aside.
He also has some type of colitis/ulcerative colitis but they don't seem to be able to come up with a firm diagnosis as to what exactly he has - even after a colonoscopy. That's an aside as well.
The subject I'm writing about is that he is jaundiced. His face is yellow and parts of the whites of his eyes are yellow. Not terribly but noticeable enough that some of our health care providers have commented about it. The weird thing is that all his liver enzyme tests are normal - bilirubin - everything. He also recently had an abdominal ultrasound which showed a little sludge in his gallbladder and some athersclerosis (small buildup of cholesterol) in his abdominal aorta.
I would appreciate any input if someone has any experience with something like this.
Thanks so much and God Bless,
Sally

[Hopeful]

Hi Sally,

Here is something to bring up with your doctors, as I am not an expert and this is pure speculation...When I was red cell transfusion dependent, I also started turning yellow. I just did a quick search on the web for a possible link and found that it could have been caused by a delayed hemolytic reaction to the transfusion itself or by autoimmune hemolytic anemia.

[Marlene]

How's his iron?

[Sally C]

Hi Hopeful and Marlene,
Thank you both for responding to my post.
Hopeful, I will look into autoimmune hemolytic anemia and delayed hemolytic reaction. I know nothing about either of them.
Marlene, I don't know if you're referring to his ferritin (not sure the difference in iron and ferritin). His ferritin is slightly over 1,000. It's been higher so I'm not sure that could be the cause. But I will look into it.
Again thank you both for taking the time to respond. Will let you know if I find out anything.
Take care and God Bless,
Sally

[Marlene]

With a FE at 1000, I doubt that it's a factor. Unless he had an iron problem prior to MDS and transfusions which would mean long term exposure to excess iron. But if the elevated iron/FE is a result of recent transfusions , then it's most likely not the culprit. Hopefully he had a baseline FE done before starting any treatments so you can better assess it. High iron usually takes 10 years to effect organs but it seems to effect the very young and old sooner.