scholarly journals The effect of zinc deficiency and iron overload on endocrine and exocrine pancreatic function in children with transfusion-dependent thalassemia: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Suzan O. Mousa ◽  
Ebtihal M. Abd Alsamia ◽  
Hend M. Moness ◽  
Osama G. Mohamed
Keyword(s):  
Iron Overload ◽  
Zinc Deficiency ◽  
Serum Ferritin ◽  
Serum Zinc ◽  
High Serum ◽  
Exocrine Pancreatic Function ◽  
Normal Serum ◽  
Pancreatic Function ◽  
Serum Lipase ◽  
Endocrine Pancreatic Function

Abstract Background Children with transfusion-dependent thalassemia (TDT) suffer from secondary hemosiderosis and the delirious effects this iron overload has on their different body organs, including the pancreas. They are also more prone to develop zinc deficiency than the general pediatric population. This study aimed to determine the effect of zinc deficiency and iron overload on the endocrine and exocrine pancreas in TDT children. Methods Eighty children, already diagnosed with TDT, were included in this study. We assessed the following in the participant children: serum ferritin, serum zinc, endocrine pancreatic function (oral glucose tolerance test (OGTT), fasting insulin level and from them, HOMA-IR was calculated), and exocrine pancreatic function (serum lipase and serum amylase). Results Forty-four TDT children had a subnormal zinc level, while 36 of them had a normal serum zinc level. TDT children with low serum zinc had significantly more impaired endocrine pancreatic function and an abnormally high serum lipase than children with normal serum zinc, p < 0.05 in all. Serum zinc was significantly lower in TDT children with serum ferritin above the ferritin threshold (≥2500 ng/ml) than those below (59.1 ± 20.2 vs. 77.5 ± 28.13), p = 0.02. TDT children, having a serum ferritin ≥2500 ng/ml, had significantly more frequently impaired endocrine pancreatic function and abnormally high serum lipase than TDT children below the ferritin threshold, p < 0.05 in all. Conclusion In children with transfusion-dependent thalassemia, zinc deficiency aggravates iron-induced pancreatic exocrine and endocrine dysfunction.

The Prevalence of Zinc Deficiency and its Correlation with Iron Status and Economical Living Area in 9 – 12-Year-Old Children

2016 ◽  
Vol 86 (1-2) ◽  
pp. 18-26 ◽  
Author(s):  
Tirang R. Neyestani ◽  
Bahareh Nikooyeh ◽  
Majid Hajifaraji ◽  
Ali Kalayi
Keyword(s):  
Zinc Deficiency ◽  
Serum Ferritin ◽  
Primary Schools ◽  
Iron Status ◽  
Serum Zinc ◽  
Normal Serum ◽  
Deficiency Anemia ◽  
Youden Index ◽  
Cross Sectional ◽  
Increased Risk

Abstract.Objective: This study aimed firstly to assess zinc and iron status of 9–12-year-old children of Tehran and secondly to determine a cut-off for circulating biomarkers of iron status to identify children at increased risk of zinc deficiency. Research methods & procedures: In a cross-sectional study, demographic and anthropometric data from 505 boys and 467 girls aged 9–12 years from Tehran primary schools were obtained and their zinc and iron status was assessed. Results: The prevalence of zinc deficiency, anemia, and iron depletion was 12.4, 14.6, and 9.5%, respectively. Serum zinc con-centration was significantly lower in children with anemia than in their non-anemic peers (p < 0.05). There was no significant association between zinc and iron status and serum high sensitivity C-reactive protein. Zinc-deficient children, compared to those with normal serum zinc, had significantly shorter stature (139.7 (±6.9) vs 141.3 (±7.1) cm, CI: -2.97 – -0.2, p = 0.029). Serum zinc concentration was the predictor of height in the children (p = 0.004, CI: 0.01 – 0.054). A logistic regression model showed an increased risk of low serum zinc and ferritin in children who resided in economically poor regions (OR = 1.65, p = 0.043; OR = 1.92, p = 0.016, respectively). Using ROC curve and Youden index, the optimal cut-off value for serum ferritin to indicate zinc deficiency was 14.9 µg/L (sensitivity = 90%, specificity = 61%). Conclusions: Lowered zinc and iron status among the children in deprived regions is likely to be due to poor quality of diet. Moreover, children with serum ferritin lower than 14.9 µg/L must be carefully assessed for concomitant zinc deficiency.

Serum Immunoreactive Pancreatic Lipase and Cationic Trypsinogen for the Assessment of Exocrine Pancreatic Function in Older Patients With Cystic Fibrosis

PEDIATRICS ◽  
1986 ◽  
Vol 77 (3) ◽  
pp. 301-306
Author(s):  
Geoffrey Cleghorn ◽  
Lynne Benjamin ◽  
Mary Corey ◽  
Gordon Forstner ◽  
Francesco Dati ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pancreatic Lipase ◽  
Elevated Serum ◽  
Serum Levels ◽  
Exocrine Pancreatic Function ◽  
Pancreatic Function ◽  
Exocrine Function ◽  
Serum Lipase ◽  
Significant Difference ◽  
Cationic Trypsinogen

Indirect and qualitative tests of pancreatic function are commonly used to screen patients with cystic fibrosis for pancreatic insufficiency. In an attempt to develop a more quantitative assessment, we compared the usefulness of measuring serum pancreatic lipase using a newly developed enzyme-linked immunosorbent immunoassay with that of cationic trypsinogen using a radioimmunoassay in the assessment of exocrine pancreatic function in patients with cystic fibrosis. Previously, we have shown neither lipase nor trypsinogen to be of use in assessing pancreatic function prior to 5 years of age because the majority of patients with cystic fibrosis in early infancy have elevated serum levels regardless of pancreatic function. Therefore, we studied 77 patients with cystic fibrosis older than 5 years of age, 41 with steatorrhea and 36 without steatorrhea. In addition, 28 of 77 patients consented to undergo a quantitative pancreatic stimulation test. There was a significant difference between the steatorrheic and nonsteatorrheic patients with the steatorrheic group having lower lipase and trypsinogen values than the nonsteatorrheic group (P &lt;.001). Sensitivities and specificities in detecting steatorrhea were 95% and 86%, respectively, for lipase and 93% and 92%, respectively, for trypsinogen. No correlations were found between the serum levels of lipase and trypsinogen and their respective duodenal concentrations because of abnormally high serum levels of both enzymes found in some nonsteatorrheic patients. We conclude from this study that both serum lipase and trypsinogen levels accurately detect steatorrhea in patients with cystic fibrosis who are older than 5 years but are imprecise indicators of specific pancreatic exocrine function above the level needed for normal fat absorption.

scholarly journals Dysgeusia Due to Zinc Deficiency After Pancreaticoduodenectomy Requiring Continuous Intravenous Zinc Supplementation: a Case Report and Literature Review

2021 ◽  
Author(s):  
Hironobu Hata ◽  
Yojiro Ota ◽  
Katsuhiko Uesaka ◽  
Yutaka Yamazaki ◽  
Tsubasa Murata ◽  
...  
Keyword(s):  
Zinc Deficiency ◽  
Oral Surgery ◽  
Oral Care ◽  
Serum Zinc ◽  
Zinc Level ◽  
Normal Serum ◽  
Acrodermatitis Enteropathica ◽  
Proximal Jejunum ◽  
Zinc Levels ◽  
Serum Zinc Levels

Abstract Background: Zinc is mainly absorbed in the duodenum and proximal jejunum, which are removed during pancreaticoduodenectomy (PD). Little is known about the adverse oral events and skin disorders caused by zinc deficiency after PD. Herein, we reviewed studies regarding the development of zinc deficiency after PD and presented the case of a patient with zinc deficiency after PD, who required home intravenous zinc replacement.Case presentation: A 73-year-old woman with glossitis, taste disorder, and acrodermatitis enteropathica-like eruption on her fingers presented to the Division of Dentistry and Oral Surgery 69 days after PD. Her serum zinc level markedly decreased to 30 μg/dL. Oral zinc administration was inadequate to treat hypozincemia after PD; therefore, multi-trace elements were injected intravenously under readmission. Her serum zinc levels recovered, and the lesions gradually improved. Furthermore, a central venous port was implanted to maintain normal serum zinc levels, and she continued self-injecting zinc at home.Conclusion: Zinc deficiency after PD rarely occurs. The clinical oncologist community, including dentists responsible for the oral care of cancer patients, should be aware of dysgeusia associated with zinc deficiency after cancer surgery, as well as that induced by chemotherapy or head and neck radiation therapy.

Estimation of Serum Ferritin Levels in Patients with Acute Coronary Syndrome in Amritsar, India

2021 ◽  
Vol 8 (26) ◽  
pp. 2260-2264
Author(s):  
Shaina Gakhar ◽  
Manish Chandey ◽  
Gurinder Mohan
Keyword(s):  
Acute Coronary Syndrome ◽  
Hospital Stay ◽  
Serum Ferritin ◽  
Systolic Function ◽  
High Serum ◽  
Normal Serum ◽  
Healthy Controls ◽  
Coronary Syndrome ◽  
Developing Heart ◽  
The Difference

BACKGROUND India is leading the world in incidence, prevalence, complications and mortality due to coronary artery disease (CAD). Various risk factors for acute coronary syndrome (ACS) are diabetes, hypertension, dyslipidaemia, smoking and obesity. It has been proposed that high serum ferritin levels are associated with enhancement in myocardial ischaemic response along with decreased ischaemic threshold in the setting up of acute ischaemic conditions. In this study, we wanted to measure and compare serum ferritin levels in patients of acute coronary syndrome and healthy controls to know the association between serum ferritin levels and risk of acute coronary syndrome. METHODS 60 patients of acute coronary syndrome admitted at Sri Guru Ram Das Hospital, Vallah Sri Amritsar were taken as cases and 60 age and sex matched healthy controls were taken. Serum ferritin levels were measured in both the cases and controls and were compared. RESULTS Most of the patients of ACS were in the age group of 51 - 60 years. Hypertension was the most common risk factor observed followed by diabetes mellitus (DM). Mean serum cholesterol levels were higher in cases. The most common vessel involved in ACS was left anterior descending artery (LAD). The difference in mean serum ferritin levels of cases and controls was statistically significant with higher levels in cases as compared to controls. These patients also had higher risk of developing heart failure and had a longer hospital stay. CONCLUSIONS The difference between serum ferritin levels in cases of ACS and controls was statistically significant. People with raised serum ferritin levels are at a greater risk of developing ACS as compared to those with normal serum ferritin levels. KEYWORDS Acute Coronary Syndrome, Serum Ferritin, Systolic Function, Diastolic Function, Mortality, Hospital Stay

Normal Serum Ferritin Levels in a Patient with HEMPAS Syndrome and Iron Overload

1982 ◽  
Vol 78 (1) ◽  
pp. 97-101 ◽  
Author(s):  
Shaista Faruqui ◽  
Andreas Abraham ◽  
Marion R. Berenfeld ◽  
Thomas G. Gabuzda
Keyword(s):  
Iron Overload ◽  
Serum Ferritin ◽  
Normal Serum

Binding of Human Serum Ferritin to Concanavalin A

1979 ◽  
Vol 56 (1) ◽  
pp. 83-87 ◽  
Author(s):  
M. Worwood ◽  
S. J. Cragg ◽  
M. Wagstaff ◽  
A. Jacobs
Keyword(s):  
Iron Overload ◽  
Human Serum ◽  
Isoelectric Focusing ◽  
Serum Ferritin ◽  
Concanavalin A ◽  
Hepatic Necrosis ◽  
Normal Serum ◽  
Normal Heart ◽  
Massive Hepatic Necrosis

1. A high proportion of the ferritin in normal serum binds to concanavalin A. Binding is prevented by the addition of α-d-methylglucoside to the reaction mixture. 2. Ferritin in extracts of normal heart, liver and spleen or serum ferritin from patients with massive hepatic necrosis does not bind to concanavalin A. 3. Isoelectric focusing of preparations of serum ferritin from patients with primary haemochromatosis shows that the ferritin fraction binding to concanavalin A consists, predominantly, of the more acidic isoferritins. 4. These findings suggest that carbohydrate residues may be added to ferritin during its secretion into the plasma. Glycosylation may account for the heterogeneity of serum ferritin on isoelectric focusing. 5. Direct release of intracellular ferritin from damaged tissue may be indicated by an increase in the proportion of circulating ferritin which does not bind to concanavalin A. Such an increase has been found in sera from patients with iron overload.

Ferritin L-subunit Gene Mutation and Hereditary Hyperferritinaemia Cataract Syndrome: A Case Report and Literature Review 

2021 ◽  
Author(s):  
Yunfan Yang ◽  
Ting Lin ◽  
Xincuan Chen
Keyword(s):  
Serum Ferritin ◽  
Vision Loss ◽  
Iron Concentration ◽  
Transferrin Saturation ◽  
Elevated Serum ◽  
Point Mutations ◽  
Genetic Mutation ◽  
High Serum ◽  
Normal Serum ◽  
Dominant Disease

Abstract Background: Hereditary hyperferritinaemia cataract syndrome (HHCS) is an autosomal dominant disease characterized by high serum ferritin levels and juvenile bilateral cataracts. It is often caused by mutations in the Iron Response Element (IRE) of the ferritin L-subunit (FTL) gene. Most of the mutations are point mutations located in the upper stem and the conserved hexanucleotide of the hairpin structure of IRE, only a few mutations are deletions. Case presentation: Here we report a 73-year-old woman who presented to clinic with persistently elevated serum ferritin and family history of juvenile bilateral cataracts in four generations. DNA sequencing analyses identified a heterozygous c.-167C>T mutation in the 5’ untranslated region (UTR) of the FTL gene. Her daughter and granddaughter were also confirmed to have the same genetic mutation.Conclusion: HHCS should be considered in the differential diagnosis of hyperferritinemia, especially in the presence of normal serum iron concentration and transferrin saturation. For patients with unexplained hyperferritinemia and bilateral cataracts who have experienced early vision loss, the establishment of genetic counseling is essential to diagnose other family members who are at risk in time, so as to avoid unnecessary liver biopsy and venesection.

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