Iron-Deficiency Anaemia: Its Effect on Transfer Factor for the Lung (Diffusing Capacity) and Ventilation and Cardiac Frequency during Sub-Maximal Exercise

1972 ◽  
Vol 42 (3) ◽  
pp. 325-335 ◽  
Author(s):  
J. E. Cotes ◽  
J. M. Dabbs ◽  
P. C. Elwood ◽  
A. M. Hall ◽  
A. McDonald ◽  
...  

1. Measurements of transfer factor and sub-maximal exercise ventilation and cardiac frequency have been made on twenty women with iron-deficiency anaemia (Hb 8–9 g/100 ml) before and after ‘treatment’ with iron or placebo tablets and on control subjects. 2. The exercise ventilation, cardiac frequency and oxygen uptake were independent of haemoglobin concentration but the transfer factor was lower in the test than in control subjects and was increased by iron but not by placebo treatment. The results support the validity of the reaction-rate data for carbon monoxide with oxyhaemoglobin of Roughton & Forster (1957) despite evidence to the contrary from other studies. 3. In interpretation of sub-maximal exercise ventilation and cardiac frequency in iron-deficiency anaemia no allowance need be made for variation in haemoglobin concentration in the range 8–15 g/100 ml. For transfer factor a correction should be made by using a variant of the relationship of Roughton & Forster (1957).

Author(s):  
K. P. Poojitha ◽  
B. S. B. Mallika ◽  
K. V. Siva Prasad

Background: Prevalence of iron deficiency anaemia is high in developing countries like India. Treatment of iron deficiency anaemia in pregnancy is very important to bring down maternal mortality rate as blood loss during delivery can lead to death of the patient. The aim and objective of our study is to evaluate the efficacy and safety of intravenous iron sucrose infusions in antenatal women admitted in hospital suffering from moderate iron deficiency anaemia. Special emphasis was given to observe adverse drug effects.Methods: This was a prospective observational study conducted in Obstetrics and Gynaecology department, Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh. Study period was two months and study population included antenatal women with gestational age less than 37 weeks with moderate iron deficiency anaemia. Peripheral smear was examined for microcytic hypochromic anaemia and they were treated with intravenous infusion of iron sucrose. Haemoglobin levels were checked before and 5 weeks after iron infusions. Monitoring was done for adverse reactions.Results: Out of 322 admissions, 95% were found to be anaemic. 72 patients were suffering from moderate anaemia from which 25 have been included and treated with intravenous iron sucrose infusions. They were observed for efficacy and safety parameters. Two minor adverse events were reported (fever with chills and angioedema of lips) and they were excluded from study. Mean haemoglobin concentration was found to be raised from 7.08±0.73 (SD) to 11.33±0.48 (SD) within 5 weeks for 23 patients.Conclusions: Iron sucrose infusion is safe and effective for anaemia in pregnancy.


2020 ◽  
Vol 7 (1) ◽  
pp. e000403 ◽  
Author(s):  
Orouba Almilaji ◽  
Carla Smith ◽  
Sue Surgenor ◽  
Andrew Clegg ◽  
Elizabeth Williams ◽  
...  

ObjectiveTo refine and validate a model for predicting the risk of gastrointestinal (GI) cancer in iron deficiency anaemia (IDA) and to develop an app to facilitate use in clinical practice.DesignThree elements: (1) analysis of a dataset of 2390 cases of IDA to validate the predictive value of age, sex, blood haemoglobin concentration (Hb), mean cell volume (MCV) and iron studies on the probability of underlying GI cancer; (2) a pilot study of the benefit of adding faecal immunochemical testing (FIT) into the model; and (3) development of an app based on the model.ResultsAge, sex and Hb were all strong, independent predictors of the risk of GI cancer, with ORs (95% CI) of 1.05 per year (1.03 to 1.07, p<0.00001), 2.86 for men (2.03 to 4.06, p<0.00001) and 1.03 for each g/L reduction in Hb (1.01 to 1.04, p<0.0001) respectively. An association with MCV was also revealed, with an OR of 1.03 for each fl reduction (1.01 to 1.05, p<0.02). The model was confirmed to be robust by an internal validation exercise. In the pilot study of high-risk cases, FIT was also predictive of GI cancer (OR 6.6, 95% CI 1.6 to 51.8), but the sensitivity was low at 23.5% (95% CI 6.8% to 49.9%). An app based on the model was developed.ConclusionThis predictive model may help rationalise the use of investigational resources in IDA, by fast-tracking high-risk cases and, with appropriate safeguards, avoiding invasive investigation altogether in those at ultra-low predicted risk.


1980 ◽  
Vol 43 (2) ◽  
pp. 375-379 ◽  
Author(s):  
F. Delpeuch ◽  
A. Cornu ◽  
P. Chevalier

1. Serum prealbumin, transferrin and iron concentrations were measured in ninety-two north Cameroonian children under 5 years of age. The results were grouped according to the blood haemoglobin concentration range in order to show the interactions of anaemia with prealbumin and transferrin concentrations.2. Transferrin concentration showed a significant negative correlation with serum Fe and percentage saturation of transferrin values. Prealbumin concentration showed a significant direct correlation with haemoglobin but did not correlate with either serum Fe or percentage saturation of transferrin.3. It is concluded that in regions where Fe-deficiency anaemia is endemic transferrin concentration may be of little value in determining nutritional status. On the contrary, prealbumin seems to be more useful.


2021 ◽  
Author(s):  
Guy Nicholls ◽  
Rajan Mehta ◽  
Karen Mcveagh ◽  
Matt Egan

BACKGROUND An iron infusion pathway using Ferrinject®(ferric carboxymaltose) was implemented at Southend University Hospital for pre-operative surgical patients with iron deficiency anaemia undergoing major surgery. This was based on a treatment algorithm proposed by Munting et al, based on the international consensus statement on peri-operative management of anaemia and NICE guidelines. This states intravenous iron is indicated when oral iron is poorly tolerated, ineffective, there is insufficient time to surgery, or due to functional iron deficiency. OBJECTIVE Our objective was to study the degree of change in adult haemoglobin concentration (Hb g/L) after infusion at the time of surgery. METHODS Data was retrospectively collected on all surgical patients that received an iron infusion pre-operatively for iron deficiency anaemia from July 2019 to April 2020. Non-surgical patients, obstetrics, paediatrics and those without a post infusion haemoglobin level were excluded. Data collected included: pre and post infusion Hb, ferritin, and transferrin (post infusion results closest to surgery were collected), correct or incorrect dose of IV iron received (dose based on baseline Hb and weight) and any adverse reactions noted. RESULTS 32 surgical patients with iron deficiency anaemia received intravenous iron between July 2019 and April 2020 prior to surgery. The average pre and post iron infusion haemoglobin concentration across the cohort was 97 g/L and 114 g/L respectively (18% increase p= 0.001). 2 (6%) patients had a post transfusion Hb ≥ 130 g/L prior to surgery after infusion. 9 patients had both a pre and post infusion ferritin level recorded which showed an increase from 12 μg/L pre infusion to 94 μg/L (p=0.02) post infusion. 23 (72%) patients were did not receive the full dose of IV iron based on their Hb and weight. 75% of patients received an iron infusion >2 weeks prior to surgery with 25% < 2 weeks before their surgery. There was an average increase in Hb of 22% (21 g/L 95% CI 13-28) and 5% (5 g/L 95% CI 1-10) (p=0.03) respectively across the two groups. There were no documented adverse reactions to the infusion. CONCLUSIONS IV iron is an effective intervention to improve haemoglobin concentration in iron deficiency anaemia despite the majority of cases not receiving the full dose of IV iron based on their baseline Hb and weight. Increasing interval time between infusion and surgery was associated with a greater increase in Hb with only a minimal increase seen if given less than 2 weeks before.


2021 ◽  
Vol 8 (7) ◽  
pp. 969
Author(s):  
Ajay V. Dhapale ◽  
Omkar Kamble

Background: Alteration of HbA1c in other conditions such as haemolytic anaemia, pregnancy and haemoglobinopathy has raised questions about its correlation with iron stores. The aim of the study was to correlate iron deficiency anaemia with glycosylated haemoglobin levels among non-diabetics.Methods: The present study was an observational study among non-diabetic patients of iron deficiency anaemia attending our outpatient department. The study was conducted in the department of medicine of a tertiary care hospital in Maharashtra. All the non-diabetic patients more than 18 years with iron deficiency anaemia were included in the present study. Patients with acute coronary syndromes, chronic liver, chronic kidney diseases, malignancies, haemolytic anaemia, pregnancy, HIV positive with known end stage cardiopulmonary disease were excluded from the study.Results: About 86.33% of the patients had mild to moderate anaemia and 10.7% had severe anaemia in the present study. The average values of haemoglobin, serum ferritin, total iron binding capacity, mean corpuscular volume, mean corpuscular haemoglobin, and mean corpuscular haemoglobin concentration and hematocrit significantly improved after the treatment. With treatment of anaemia, glycosylated haemoglobin, fasting blood sugars and post prandial blood sugars also improved significantly when compared to baseline (p<0.001).Conclusions: The average values of haemoglobin, serum ferritin, total iron binding capacity, mean corpuscular volume, mean corpuscular haemoglobin, and mean corpuscular haemoglobin concentration and hematocrit significantly improved after the treatment. With treatment of anaemia, glycosylated haemoglobin, fasting blood sugars and post prandial blood sugars also improved significantly when compared to baseline.


Author(s):  
M Coetzee ◽  
A Van Marle

We read the recent paper by Mogongoa on efficacy of oral iron therapy in geophagic women with interest. The author must be congratulated on a detailed study. In summary, the study divided 84 geophagic women with iron deficiency anaemia into two groups, one which stopped geophagia, and one which continued with geophagia, while receiving oral iron supplements. After ten weeks of gradually escalating doses of oral iron the participants’ average iron status and haemoglobin had not improved significantly. Response to iron therapy was defined as a rise of the haemoglobin concentration by 2 g/dL within three weeks. In the group that had stopped geophagia 9.3% (4/43) participants had an increase of 2 g/dL in haemoglobin over the ten weeks, while in the group that continued with geophagia only one participant (2.9% = 1/35) had a similar improvement. The author concluded that “oral iron therapy was not effective in geophagia cases of iron deficiency anaemia” in the abstract and “in this study oral iron therapy was not effective for the correction of iron deficiency anaemia in geophagic Botshabelo females” in the conclusions. We wish to point out that this conclusion might not be entirely correct.


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