Paroxysmal nocturnal hemoglobinuria. A successful imposter

Renal hemosiderosis in patients with prosthetic aortic valves

Seven patients with prosthetic aortic valves and anemia are described. In six, the Teflon valves had become incompetent as a result of perforations or tears in the prosthetic cusps, and in the seventh the valve was severely stenotic as well as regurgitant. The anemia in each patient was secondary to intravascular hemolysis resulting from damage to the erythrocytes traversing the malfunctioning valve. Severe renal hemosiderosis, the anatomic indicator of severe intravascular hemolysis, was present in each patient. Although deposits of iron in the kidney in these circumstances may be extreme, no significant renal damage nor impairment of renal function appears to occur as a result of this deposition.