Rare cause of weight loss in a kidney transplant recipient: iron overload.

Various reasons such as malignancies and chronic infections may cause weight loss in kidney transplant patients. In this report, iron overload as a rare cause of weight loss in a kidney transplant patient is presented. Forty-seven-year-old male patient who transplanted from a deceased donor 5 years ago was hospitalized because of 20 kg of weight loss. In medical history, he had history of hemodialysis for 89 months and received 100-300 mg of intravenous iron therapy per week before transplantation and transfused eight units of blood. In physical examination, weight and height were 45 kg and 185 cm, respectively. Respiratory and cardiac auscultation was normal. Laboratory results revealed as follow: glucose 76 mg/dL, urea 60 mg/dL, creatinine 1.35 mg/dL, aspartate aminotransferase 74 U/L, alanine aminotransferase 77 U/L, C-reactive protein 2.59 mg/dL, albumin 3.3 g/dL, globulin 3.4 g/dL, white blood cells 3200/mm(3), hemoglobin 13.1 g/dL and platelets 190,000/mm(3). Chest and abdominal tomography didn't reveal any pathology. Portal Doppler ultrasound showed signs of early cirrhosis. Viral and autoimmune hepatitis markers were negative. Ferritin was 5300 ng/mL and transferrin saturation was 82%. In liver biopsy, hemosiderosis was diagnosed and heterozygous H63D gene mutation was detected. Totally, 19 units of phlebotomy were performed. Liver function tests and serum ferritin decreased gradually. At outpatient follow-up in 6 months, he returned to former weight. In conclusion, there can be several causes of weight loss in kidney transplant patients. Iron overload can come across as a rare cause of weight loss. In these patients, ferritin levels should be checked and diagnosis should be clarified by liver biopsy and gene mutation analysis.

Evaluation of sleeping energy expenditure using the SenseWear Armband in patients with overt and subclinical hypothyroidism.

PURPOSE: The aim of the present study was to evaluate the average sleeping energy expenditure (EE) levels using the SenseWear Armband (SWA) in patients with overt and subclinical hypothyroidism. METHODS: Sixty patients with hypothyroidism and 30 healthy individuals were recruited for the study. Hypothyroid patients were divided into two groups: group 1 (n = 30) consisted of patients with overt hypothyroidism and group 2 (n = 30) consisted of patients with subclinical hypothyroidism. Lastly, group 3 (n = 30) consisted of healthy subjects. The average EE and metabolic equivalent of task (MET) values during sleep of all the hypothyroid participants were analyzed at baseline and at the end of the study. Data were also obtained from the healthy subjects at baseline. RESULTS: The average sleeping EE and METs values were not significantly different at baseline. Similarly, these values did not change significantly after achieving a euthyroid state via thyroid hormone replacement (both p > 0.05). CONCLUSIONS: Contrary to what has been previously reported , the average sleeping EE and METs values in all hypothyroid patients and healthy individuals were similar at baseline and did not change in the patients with overt and subclinical hypothyroidism after achievement of a euthyroid state.