This morning’s topic was clotting disorders, such as Hemophilia. Nearing the end of the lecture, ushered into the room were two visitors who nobody was expecting. They were dogs from the Queen’s University Hemophilia-A colony. This colony has been raised at Queen’s for over 20 years, and so we were meeting at least the 16th generation of Hemophiliac dogs. They provide a model for research into better therapies for Hemophilia, including the much-anticipated gene therapy.  Because they are prone to spontaneous bleeding, exceedingly good care is devoted to these dogs. They were so cute!

We have an awesome faculty !

On Wednesday the topic of the morning was hemolytic anemias. Hemolysis is the disease process whereby red blood cells are destroyed either mechanically, or by the immune system. The result is anemia, or not enough oxygen reaching all of your tissues.

Anyway, our professor had challenged his kids over the weekend to build this incredible model of a paper mache red blood cell. Best of all – it was a pinata ! In large bold letters on the front: “Meds 2012: Hemolyze This!”. So right there, at the end of lecture, we played pinata and hemolyzed that giant red blood cell spilling lovely hemoglobin candies (zoo animals!).

Seriously. Awesome faculty.

UPDATE: Watch the video posted by a classmate on Facebook!

Bloodletting was a common medical procedure of antiquity that involved draining sometimes large quantities of blood from ill patients. It was believed to be helpful for a plethora of diseases, including everyday ailments like fever and headaches. There were detailed medical protocols for how much blood to take, how often, and from which anatomical locations. In infants,  the entry-point of choice for bloodletting was from the anterior fontenelle, or the “soft spot” on the top of the baby’s still-forming skull.

Modern medicine has demonstrated that bloodletting has little therapeutic benefit for most of the diseases that it was standardly used for. Additionally, bloodletting introduced all sorts of horrific complications like infections, hypovolemic shock, and even brain damage when the needle went too far into the infant’s head.

That being said, I was surprised to discover that there is at least one disease for which bloodletting is effective, and still used today! The disease has to do with iron in the blood. Most people think about blood-iron in the context of iron-deficient anaemia, or not having enough iron to make adequate red blood cells. But, it is also possible to have too much iron in the blood.

Iron overloading in North America is most often due to a genetic disease called hereditary hemachromatosis. It involves a mutation for a protein that normally regulates iron absorption in the gut. As a consequence, the gut absorbs too much iron and the blood becomes “overloaded”. Iron overload can have serious consequences causing damage to the liver, pancreas, pituitary gland, and skin.

Since the body has limited capacity for excreting iron, the best treatment for hereditary hemachromatosis is regular bloodletting to remove the excess iron. Of course, nowadays we use the fancy term “plebotomy”, but the principle is still the same! Neat, eh?