P754Iron status indices (transferrin saturation, serum ferritin) in the course of acute myocarditis: relations with neurohormonal activation, cardiac dysfunction and clinical recovery

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Franczuk ◽  
A Kosiorek ◽  
M Tkaczyszyn ◽  
M Drozd ◽  
A Zapolska ◽  
...  
Keyword(s):  
Acute Phase ◽  
Serum Ferritin ◽  
Cardiac Dysfunction ◽  
Troponin I ◽  
Iron Status ◽  
Acute Myocarditis ◽  
Transferrin Saturation ◽  
Control Group ◽  
Neurohormonal Activation

Abstract Introduction Acute myocarditis (MCD) can progress to post-myocarditis cardiomyopathy. Immune response is the major pathophysiological trigger leading to MCD. Optimal iron status is essential for the functioning of immune cells, cardiomyocytes and cardiofibroblasts. Therefore, there are premises to consider iron metabolism as a significant modulator of complex pathophysiology of MCD. Purpose We aimed to assess iron status in the course of MCD and relate it with clinical and laboratory measures. Methods We prospectively enrolled consecutive patients hospitalized for acute MCD in 2 tertiary referral cardiology centers during 2015–2018 and followed them up for 30 weeks. MCD was diagnosed based on the following criteria: 1) new onset symptoms suggestive of myocarditis (effort intolerance, dyspnea, palpitations or chest pain), 2) elevated high sensitivity cardiac troponin I (hs-cTnI), 3) exclusion of obstructive coronary artery disease. Results Study group comprised 41 patients with confirmed MCD [age: 31 (26–34) years, men: 95%] and 15 healthy age- and gender-matched subjects [age: 30 (28–33) years, men: 87%]. All patients survived hospitalization and follow-up, no subject needed ventricular assist device. Patients with MCD had lower LVEF (56±10% vs. 69±14%) and higher CRP [32 (14–8754) vs. 3 (3–3) mg/l], NT-proBNP [452 (240–877) vs. 33 (18–46) pg/ml], hs-cTnI [7.3 (3.3–12.8) vs. 0,01 (0.01–0.01) μg/l] than the control group (all p<0.001). Regarding iron status, MCD group presented higher serum ferritin [213 (121–386) vs. 135 (84–210) μg/l] and lower transferrin saturation (TSAT) [21±10 vs. 28±15%] (all p<0.05). In patients with MCD ferritin correlated with CRP (r=0.46, p<0.01), TSAT correlated neither with CRP nor with ferritin (all p>0.02). Patients with MCD and NT-proBNP >1000 pg/ml had lower TSAT (16±8 vs. 23±9%; p<0.05) and LVEF (47±13 vs. 59±7%; p<0.001) than the remaining subjects. No difference in ferritin was observed (p>0.2). 46% of patients during acute phase of MCD had LVEF≤55% – these patients presented lower TSAT (17±8% vs. 24±10%) and higher NT-proBNP – [577 (436–1657) vs. 358 (167–499) pg/ml] (all p<0.05). After 30 weeks only in 13% patients LVEF≤55% persisted and related to lower baseline TSAT (9±1% vs. 21±9%) and higher CRP (147±113 vs. 52±40 mg/l) (all p<0.05). LVEF≤55% was not related to ferritin (both p>0.2). After 6 weeks of follow-up patients with MCD already presented higher LVEF (61±8%; p<0.05) and haemoglobin [14.7 (14.0–15.7) g/dl], lower CRP [3 (3–3) mg/l], NT-proBNP [34 (25–67) pg/ml], hs-cTnI [0.01 (0.01–0.01)], ferritin [124 (78–168) μg/l] and higher TSAT (26±7%) (all p<0.01). There was no further change in these parameters within the next 24 weeks (all p>0.2). Conclusions Iron status is deranged in acute MCD. Serum ferritin is an indicator of inflammatory response, whereas TSAT relates to neurohormonal activation and cardiac dysfunction. Iron status normalizes within 6 weeks after acute phase of MCD. Acknowledgement/Funding This research was financially supported by the National Science Centre (Poland) grant number 2014/13/B/NZ5/03146.

scholarly journals THERAPEUTIC VALUE OF COMBINED THERAPY WITH DEFERASIROX AND SILYMARIN ON IRON OVERLOAD IN CHILDREN WITH BETA THALASSEMIA

2013 ◽  
Vol 5 (1) ◽  
pp. e2013065 ◽  
Author(s):  
Adel Abd elhaleim Hagag
Keyword(s):  
Iron Overload ◽  
Serum Ferritin ◽  
Iron Status ◽  
Iron Chelator ◽  
University Hospital ◽  
Beta Thalassemia ◽  
Control Group ◽  
Healthy Children ◽  
Number Of Patients

abstractBackground: Beta thalassemia is an inherited hemoglobin disorder resulting in chronic hemolytic anemia requiring life-long blood transfusion that cause iron overload. Silymarin plays a role as oral iron chelator and hepatoprotective agents in thalassemic patients.The aim of this work was to determine silymarin value as an iron chelator in thalassemic patients with iron overload.Patients and Methods: This study was conducted on 40 children with beta thalassemia major under follow-up at Hematology Unit, Pediatric Department, Tanta University Hospital having serum ferritin level more than 1000 ng/ml and was divided in two groups. Group IA: Received oral Deferasirox (Exjade) and silymarin for 6 months. Group IB: Received oral Deferasirox (Exjade) and placebo for 6 months and 20 healthy children serving as a control group in the period between April 2011 and August 2012 and was performed after approval from research ethical committee center in Tanta University Hospital and obtaining an informed written parental consent from all participants in this research. Results: Serum ferritin levels were markedly decreased in group IA cases compared with group IB (P= 0.001). Conclusion: From this study we concluded that, silymarin in combination with Exjade can be safely used in treatment of iron-loaded thalassemic patients as it showed good iron chelation with no sign of toxicity. Recommendations: Extensive multicenter studies in large number of patients with longer duration of follow up and more advanced methods of assessment of iron status is recommended to clarify the exact role of silymarin in reduction of iron over load in children with beta thalassemia.  

scholarly journals Serum iron and serum ferritin levels in cholelithiasis: a randomized study

2018 ◽  
Vol 5 (4) ◽  
pp. 1411
Author(s):  
Bhavinder Kumar Arora ◽  
Anuj Kumar Yadav
Keyword(s):  
Serum Ferritin ◽  
Serum Iron ◽  
Iron Status ◽  
Gallstone Disease ◽  
Transferrin Saturation ◽  
Control Group ◽  
Case Group ◽  
Iron Store ◽  
Female Population ◽  
Low Serum

Background: The role of iron in the pathogenesis of gallstone disease has not been well established so far. Iron deficiency has been shown to alter the activity of several hepatic enzymes, leading to increased cholesterol saturation of bile in gall bladder and hence promoting cholesterol crystallization.Serum iron, total iron binding capacity and transferrin saturation are not good indicators of iron status in individuals. In infection free situation, serum ferritin is an ideal indicator for diagnosis of iron deficiency.Methods: The study was conducted as a prospective study in the department of Surgery. The study population was divided into two groups; Case group with 200 patients with gallstone disease and control group with 50 patients without gallstone disease. Serum iron and ferritin contents of both groups will be analyzed and compared with each other.Results: In this study the gallstones are more prevalent in female population than males in ratio of 5.4:1. Serum iron in males was low in 41.93% not comparable 20.8% of control suggesting that low serum iron is not associated with Cholelithiasis in male. In males, serum ferritin was low in 64.5% of cases and 16.66% of controls. Serum ferritin levels were normal in 35.50% of cases and 66.66% of controls and above normal in 16.66% of controls suggesting that low serum ferritin is associated with gall stones in males. In this study, low serum iron was seen in 23.07% of females comparable to 23% low serum iron in control females and low ferritin was seen in 35.50% of female cases as compare to 15.38% of controls.Conclusions: It was concluded that a low body store of serum iron is a risk factor for cholelithiasis in females and serum iron, serum ferritin may be used as marker of iron store so that low serum iron status could be diagnosed at early stage.

scholarly journals Influence of malaria on markers of iron status in children: implications for interpreting iron status in malaria-endemic communities

1997 ◽  
Vol 78 (5) ◽  
pp. 751-760 ◽  
Author(s):  
Bhabani S. Das ◽  
David I. Thurnham ◽  
Deba B. Das
Keyword(s):  
Acute Phase ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Liver Function Tests ◽  
Control Group ◽  
Asymptomatic Malaria ◽  
Nutritional Indices ◽  
Community Studies ◽  
Symptomatic Malaria ◽  
Blood Haemoglobin

To investigate Fe nutritional indices in malaria infection in children, haematology (blood haemoglobin, plasma ferritin, transferrin, Fe, and transferrin saturation), acute phase markers (albumin and caeruloplasmin) and liver function tests were studied in fifty consecutive cases of severe and mild falciparum malaria, fifty matched controls and twenty-three cases of asymptomatic malaria. Blood haemoglobin and transferrin were lower, while ferritin and transferrin saturation were higher, in groups with symptomatic malaria in comparison with the control group. The differences were greatest with the severest form of the disease. There were no differences between any of the groups in plasma Fe. Plasma transferrin correlated directly with albumin in asymptomatic, mild and severe malaria groups (r0.48, 0.65 and 0.83;P< 0.05,P< 0.01 andP< 0.001 respectively), and inversely with caeruloplasmin (r−0.65, −0.34 and −0.43;P< 0.01,P< 0.05 andP< 0.01 respectively). For ferritin, the correlation was inverse with albumin (r−0.65, −0.57 and −0.64;P< 0.01,P< 0.001 andP< 0.001 respectively and direct with caeruloplasmin (r0.83, 0.21 and 0.49,P< 0.001, NS andP< 0.001 respectively). Multiple regression analysis on data from all patients combined indicated that albumin, and to a lesser extent alanine aminotransferase (EC2.6.1.2) activity, explained 62 % of the variance in transferrin. Caeruloplasmin, parasite count and albumin explained 59 % of the variance in ferritin, and transferrin and unconjugated bilirubin explained 62 % of the variance in Fe values. In conclusion, these data suggest that low transferrin and high ferritin values are primarily due to the acute phase response. High transferrin saturation and lack of differences in plasma Fe between the groups are probably due to Fe released from lysed erythrocytes. Finally, in both symptomatic and asymptomatic malaria, indices of Fe status can be misleading and may be especially problematic in community studies in malaria-endemic areas where asymptomatic malaria may be common.

scholarly journals Assessment of Iron Status in Association with Excess Alcohol Consumption

1995 ◽  
Vol 32 (6) ◽  
pp. 527-531 ◽  
Author(s):  
C Ford ◽  
F E Wells ◽  
J N Rogers
Keyword(s):  
Serum Ferritin ◽  
Alcohol Intake ◽  
Matched Control ◽  
Iron Status ◽  
Iron Concentration ◽  
Transferrin Saturation ◽  
Control Group ◽  
Ferritin Concentration ◽  
Serum Ferritin Concentration ◽  
Rule Out

Biochemical evidence of iron overload (transferrin saturation greater than 60% and/or serum ferritin concentration greater than 1000 μg/L) was observed in 16% of patients admitted to an alcohol withdrawal unit. No subjects in an age and sex matched control group showed such biochemical changes. Whilst changes in serum ferritin concentration closely correlated with aspartate aminotransferase activity and could be explained by alcohol induced liver damage, the increased transferrin saturation was not similarly explained. In nine patients withdrawal of alcohol resulted in a decrease in transferrin saturation and serum ferritin, the former due to a reduction in serum iron concentration. In patients with high alcohol intake biochemical measures of iron status may be misleading and a decrease in both transferrin saturation and serum ferritin concentration after withdrawal of alcohol may help to rule out the possible diagnosis of hereditary haemochromatosis.

scholarly journals IRON STATUS IN PREECLAMPSIA

2008 ◽  
Vol 15 (01) ◽  
pp. 74-80
Author(s):  
TASNEEM ZAFAR ◽  
ZAFAR IQBAL
Keyword(s):  
Serum Ferritin ◽  
Serum Iron ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Correlation Study ◽  
Total Iron ◽  
Control Group ◽  
Iron Binding ◽  
Iron Binding Capacity

Objective: To evaluate iron status in pregnancy induced hypertension and role of iron in the etiologyand pathogenesis of pre-eclampsia. Design: Coefficient correlation study. Place and Duration. At Department ofBiochemistry, Frontier Medical College, Abbottabad with collaboration of Department of Obstetrics and Gynecology,Ayub Medical Complex, Abbottabad from March 2006-March 2007. Material and Methods: Study was performed onhundred pregnant women of age ranging between 15-35 years and having gestational age between28 to 34 weeks.Fifty obstetric patients were identified as having pre-eclampsia. Fifty healthy pregnant subjects were taken as controls,having uncomplicated pregnancies and were normotensive throughout gestation and without proteinuria. Results:Results depicts that mean age of pre-eclamptic group was significantly low (P<0.001) as compared to control. Bothparameters, Hemoglobin and Haematocrit were significantly higher (P<0.05) in pre-eclamptic as compared to controls.Serum iron, serum ferritin and transferrin saturation were significantly higher (P<0.001) in pre-eclamptic in comparisonwith control group. Total iron binding capacity and unsaturated iron binding capacity were significantly lower (P<0.001)in pre-eclamptic group when compared to control group. Correlation coefficient between serum iron, total iron bindingcapacity (TIBC), serum ferritin, unsaturated iron binding capacity (UIBC) and systolic and diastolic blood pressure inpre-eclamptic group showed no significant positive correlation in any parameter. Conclusion: It is concluded thathemoglobin, haematocrit, serum iron, serum ferritin and transferrin saturation are significantly increased in pregnantwomen that later develops pre-eclampsia. Excess iron is postulated as casual factor in the oxidative stress ie; in itsradical form, which may be involved in the pathogenesis of pre-eclampsia. Therefore, iron status of pregnant womenshould be assessed before giving iron supplements as these may cause more harm than benefit.

Melatonin Improves Erythropoietin Hyporesponsiveness via Suppression of Inflammation

2019 ◽  
Vol 14 (3) ◽  
pp. 203-208
Author(s):  
Evan Noori Hameed ◽  
Haydar F. Hadi AL Tukmagi ◽  
Hayder Ch Assad Allami
Keyword(s):  
Iron Status ◽  
Transferrin Saturation ◽  
Control Group ◽  
Base Line ◽  
Inadequate Response ◽  
Inflammatory Parameters ◽  
Tnf Α ◽  
Before And After ◽  
And Control ◽  
Controlled Clinical Study

Background: Inadequate response to Erythropoietin Stimulating Agents (ESA) despite using relatively larger doses regimen represents a potential risk factor of Cardiovascular (CV) related mortality in addition to health-care economic problems in anemic patients with Chronic Kidney Disease (CKD). Erythropoietin (EPO) hyporesponsiveness related to inflammation has been increased progressively. Melatonin is well known as a potent anti-inflammatory agent. Therefore, the current study was designed to evaluate whether melatonin could improve anemic patients response to EPO. Methods: This single controlled clinical study was carried out in 41 CKD patients with hemoglobin (Hb) levels less than 11g/dl divided randomly in a 1:1 ratio into 2 groups; treatment group who received 5mg melatonin plus their regular treatments and control group who received their regular treatments only. Hematological and iron status parameters include Hb level, serum iron (S. iron), Transferrin Saturation Ratio (TSAT) and serum ferritin (S. ferritin) in addition to inflammatory parameters that include tissue necrotic factor alfa (TNF-α), interleukin-1beta (IL-1β) and interleukin-6 (IL-6) determined before and after 12 weeks of treatment. Results: Melatonin remarkably increases the Hb level with a significant increase in S. iron and TSAT compared to baseline. The elevation of S. iron and TSAT was significantly higher in the melatonin group. Additionally, all inflammatory markers estimated were reduced significantly by melatonin compared to base line and control group. Conclusion: The results of the current study showed that melatonin has an advantageous effect on improving EPO response in anemic patients with CKD.

scholarly journals Osmotic Fragility in Essential Hypertension Revisited: A Correlation with Iron Status and Lipid Profile

2019 ◽  
Author(s):  
Hussein Kadhem Al-Hakeim ◽  
Zainab Hussein Alhillawi ◽  
Sahatha Raoof Al-Ani
Keyword(s):  
Essential Hypertension ◽  
Lipid Profile ◽  
Total Cholesterol ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Osmotic Fragility ◽  
Control Group ◽  
Vascular Walls ◽  
Healthy Control ◽  
Iron Parameters

Background: Essential hypertension is a major public health associated with increase pressure on the vascular walls and red blood cells (RBCs). In the present work, osmotic fragility (OF) of RBCs was reexamined in the means of its correlation with two risk factor; iron status and lipid profile. Experimental: OF, iron status parameters, and lipid profile components were measured in 60 patients and compared with the results of 30 controls. Results: The results showed a significant increase in all iron indices of hypertensive patients in comparing with healthy control group except TIBC, UIBC, and transferrin concentrations, which decrease in these patients in comparing with control group. Serum TGs, total cholesterol, VLDLc, and LDLc were increased while there is no significant in serum HDLc in patients to comparing with control group. There is no significant change in OF between patients and controls where p=0.173. The iron status parameters and lipid profile components were dependent on sex and smoking state. Hemoglobin and PCV were correlated significantly with total cholesterol and LDLc. Transferrin saturation showed a positive correlation with cholesterol, LDLc, and TGs, but negatively correlated with HDLc. No significant correlation between all the measured parameters and OF in HT patients. There is a significant correlation between serum ferritin and systolic BP and between Hb and systolic BP. Conclusion: No significant effect on the OF in HT patients. HT patients have elevated level of iron parameters in comparing with controls. OD has no correlation with iron status parameters or with lipid profile components.

scholarly journals Prevalence and pattern of Iron deficiency in patient with heart failure with reduced ejection fraction

2019 ◽  
Vol 7 (2) ◽  
pp. 10-16
Author(s):  
Aditya Mahaseth ◽  
Jay Narayan Shah ◽  
Bikash Nepal ◽  
Biplave Karki ◽  
Jeet Ghimire ◽  
...  
Keyword(s):  
Heart Failure ◽  
Iron Deficiency ◽  
Ejection Fraction ◽  
Serum Ferritin ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Functional Iron Deficiency ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Absolute Iron Deficiency

Background and Objectives: Iron Deficiency is the commonest nutritional deficiency worldwide, affecting more than one-third of the population, its association with Heart Failure with or without anemia is of growing interest. As iron supplementation improves prognosis in patients with Heart Failure, Iron Deficiency is an attractive therapeutic target – a hypothesis that has recently been tested in clinical studies. This study is designed to estimate the prevalence and pattern of iron deficiency (ID) in heart failure (HF) with reduced ejection fraction patients with or without anemia. Material and methods: It was a single center hospital based cross sectional observational study. A total of 60 male and female patients with diagnosis of heart failure based on the Framingham Criteria, who gave consent for the study were included. They underwent laboratory evaluation including hemoglobin concentration, serum iron, transferrin saturation percentage, serum ferritin, total iron binding capacity. Serum ferritin <100 μg/l was used to diagnose absolute ID. Functional ID was defined as a serum ferritin level of 100–300 μg/l and a transferrin saturation of <20 %. Anemia was defined as hemoglobin (Hb) <13 g/dl for males and <12 g/dl for females, based on World Health Organization definition. Results: Using the above definitions iron deficiency was found in 28 (46.67%) patients. 36.67% patients had absolute iron deficiency and 10% patients had functional iron deficiency. Females had a higher non statistically significant iron deficiency than males 63.16% vs 39.02%. 15 patients (48.38%) with iron deficiency did not have anemia, and 11 (35.5%) of those patients had absolute iron deficiency. Conclusion: Iron deficiency is prevalent in patients with heart failure and reduced ejection fraction irrespective of anemia and hemoglobin levels. Many of those patients can have functional iron deficiency. Measurement of iron status should be a routine during workup of heart failure patients and further studies are needed to determine the prognostic value of iron status measurement and the influences of treatment of iron deficiency in heart failure patients. Many such trials are now underway.  

scholarly journals Iron Status in Hypogammaglobulinemia

1985 ◽  
Vol 78 (10) ◽  
pp. 838-841
Author(s):  
Hasan I Atrah
Keyword(s):  
Iron Deficiency ◽  
General Population ◽  
Intravenous Immunoglobulin ◽  
Serum Ferritin ◽  
Iron Status ◽  
Transferrin Saturation ◽  
The State ◽  
Serum Samples ◽  
Serum Igg

Iron, transferrin and ferritin were measured in serum samples from 16 patients with primary hypogammaglobulinemia. Transferrin saturation was low in 12 patients (75%) and serum ferritin was low in 9 patients (56.25%). Both parameters were low, confirming the state of iron deficiency, in 6 patients (37.5%). These figures are highly significant ( P < 0.01) when compared with the prevalence of iron deficiency in the general population. Eight patients were maintained on intravenous immunoglobulin infusions and the rest on intramuscular immunoglobulin injections, their mean serum IgG being 4.4 g/l and 2.6 g/l respectively. There was no difference in the prevalence of iron deficiency between the two groups.

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