scholarly journals Relationship of Iron Deficiency and Serum Ferritin Levels with Pulmonary Hypertension: The Jackson Heart Study

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0167987 ◽  
Author(s):  
Matthew Jankowich ◽  
Beth Elston ◽  
Samuel K. Evans ◽  
Wen-Chih Wu ◽  
Gaurav Choudhary
CHEST Journal ◽  
2016 ◽  
Vol 150 (4) ◽  
pp. 1150A
Author(s):  
Matthew Jankowich ◽  
Samuel Evans ◽  
Elizabeth Elston ◽  
Wen-Chih Wu ◽  
Gaurav Choudhary

2019 ◽  
Vol 130 (12) ◽  
pp. 2879-2884
Author(s):  
Steven A. Curti ◽  
Joseph A. DeGruy ◽  
Christopher Spankovich ◽  
Charles E. Bishop ◽  
Dan Su ◽  
...  

PEDIATRICS ◽  
1983 ◽  
Vol 72 (2) ◽  
pp. 214-219
Author(s):  
Ray Yip ◽  
Samuel Schwartz ◽  
Amos S. Deinard

Elevation of erythrocyte protoporphyrin (EP) level is one of the consequences of iron deficiency. As the EP test has been established to be a screening test for lead poisoning, the screening capability of the EP test for iron deficiency was investigated. A total of 4,160 children between ages 6 months to 12 years had EP determined together with serum ferritin and hematocrit. Comparing the relationship of EP to serum ferritin and using a serum ferritin value ≤15 µg/L as the criterion of iron deficiency, the optimal cutoff limit for the EP test appears to be 35 µg/dL of whole blood. At this level, 88% of the subjects with low levels of serum ferritin can be detected (sensitivity), in contrast to the 53% detected at a higher cutoff value (≥50 µg/dL) used to screen for lead toxicity, or to the 59% detected by age-related hematocrit value. At an EP screening level of 35 µg/dL of whole blood, 90% of the subjects with normal serum ferritin level are correctly determined to be screen negative (specificity). The predictive value of low levels of serum ferritin for all subjects above screening level is 38%. In general, an elevated EP level, by itself, represents inadequate iron supply for hematopoiesis and signals iron deficiency regardless of whether the serum ferritin value is below the diagnostic level or not. A trial course of orally administered iron is suggested for children who are found to have an elevated EP value, with an increase in hemoglobin or hematocrit value serving, retrospectively, as confirmation of prior iron deficiency.


2020 ◽  
Vol 10 (4) ◽  
pp. 204589402096124
Author(s):  
Suvasini Lakshmanan ◽  
Matthew Jankowich ◽  
Wen-Chih Wu ◽  
Siddique Abbasi ◽  
Alan R Morrison ◽  
...  

Background Adiponectin is a polypeptide hormone related to obesity, and a known modulator of pulmonary vascular remodeling. Association between plasma adiponectin levels and pulmonary hypertension (PH) has not been studied in African Americans (AAs) who are disproportionately affected by obesity. The relationship between adiponectin and heart failure (HF) and mortality, outcomes associated with PH, is unclear. Methods We performed cross-sectional and longitudinal analysis to examine if there is an association between plasma adiponectin and PH and associated clinical outcomes, in participants of Jackson Heart Study (JHS). JHS is a prospective observational cohort study of heart disease in AAs from Jackson, Mississippi. Results Of the 3161 participants included in the study, mean age (SD) was 56.38 (12.61) years, 1028 were men (32.5%), and mean (SD) BMI was 31.42 (7.05) kg/m2. Median (IQR) adiponectin was 4516.82 (2799.32–7065.85) ng/mL. After adjusting for potential confounders including BMI, higher adiponectin levels were associated with increased odds of PH (adjusted odds ratio per log increment in adiponectin, (1.81; 95% CI, 1.41–2.32). High adiponectin levels were also associated with associated HF admissions (adjusted hazard ratio [HR] per log increment in adiponectin, 1.63, 95% CI, 1.24–2.14) and mortality (adjusted HR per log increment in adiponectin, 1.20; 95% CI 1.02–1.41). Conclusions Elevated plasma adiponectin levels are associated with PH, HF admissions and mortality risk in AAs. High adiponectin levels may help identify an at-risk population that could be evaluated for targeted prevention and management strategies in future studies


2017 ◽  
Vol 35 (2) ◽  
pp. 75-79
Author(s):  
Sharmistha Ghosal

Background and objective: Febrile Seizure (FS) is the commonest seizure disorder among under 5 children. Iron deficiency is a documented risk factor of FS and as the data about the relationship of iron deficiency with FS among Bangladeshi children is scanty, this study was undertaken to assess the association of Serum Ferritin to simple FS.Materials and Methods: This case control study was conducted at the department of pediatrics of SSMC & Mitford Hospital during 7th May 2011 to 6th January 2012 on consecutive 120 children aged between five months to six years who fulfilled the inclusion criteria were considered as cases. Similar number of age and sex matched children admitted with fever without seizures were taken as controls. All candidates were gone through CBC with RBC indices and serum ferritin and iron deficiency anemia was diagnosed on the basis of mentioned tests.Results: The results showed that majority of the cases were male (66.7%) and most of them were between 13-24 months of age (51.7%). Mean duration of convulsion was less than 5 minutes in 70% of the cases. Level of Hb was low in both the cases and controls but the other RBC indices for anemia like MCV, MCH, MCHC and serum ferritin were significantly lower among the febrile seizures group in comparison to controls. The chi-square test is indicated as a significant difference between two groups and odds ratio is 6.0 which signifies that febrile seizure group were 6.0 times more likely to develop iron deficiency anemia compared to control group.Conclusion: The findings suggest that children with febrile seizure have association with iron deficiency anemia (which is evident by microcytic hypochromic anemia and low serum ferritin level) .This means low serum ferritin and presence of anemia can serve as a risk factor for febrile seizure in children.J Bangladesh Coll Phys Surg 2017; 35(2): 75-79


2017 ◽  
Vol 120 (9) ◽  
pp. 1533-1540 ◽  
Author(s):  
Obiora Egbuche ◽  
Heather R. Millard ◽  
Benjamin Renelus ◽  
Axiyan Maihemuti ◽  
Solomon K. Musani ◽  
...  

2017 ◽  
Vol 128 (6) ◽  
pp. 1438-1444 ◽  
Author(s):  
Jonathan E. Sorrel ◽  
Charles E. Bishop ◽  
Christopher Spankovich ◽  
Dan Su ◽  
Karen Valle ◽  
...  

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4810-4810
Author(s):  
Oswaldo Castro ◽  
Caterina Minniti ◽  
Xiaomei Niu ◽  
Mehdi Nouraie ◽  
Craig Sable ◽  
...  

Abstract Considerable evidence suggests that hemolysis may be a cause of vasculopathy in sickle cell disease (SCD) and be associated with pulmonary hypertension risk in both adult and pediatric SCD patients. We recently treated an SCD adult for iron deficiency. Reticulocytes, LDH, and AST were normal or near normal before iron treatment but increased markedly with iron supplementation without a commensurate increase in the hemoglobin concentration. This and similar cases in the literature suggest that iron deficiency decreases hemolysis in SCD. To test this hypothesis we examined the association of serum ferritin concentration with hemolytic parameters and tricuspid regurgitant jet velocity (TRV) in 234 SCD children enrolled in a prospective multi-center study of the prevalence and significance of pulmonary hypertension. All studies were done in children who were outpatients and in the steady state of their disease. There were 32 children with ferritin concentrations < 50 ng/ml and 202 with ferritins of 50 ng/ml or higher. We chose the < 50 ng/ml ferritin cut off value because it would be expected to include both patients with iron deficiency whose serum ferritin concentration was in the deficient range and those whose ferritin was in the low normal range as a result of sickle-related inflammation. The table shows that patients in the lower ferritin group were older and had lower MCV, fewer transfusions, lower hemolytic markers (including a hemolytic index generated by principal component analysis of LDH, AST, total bilirubin and reticulocytes), and a trend to less severe anemia. The differences remained after adjustment for the number of blood transfusions. Comparison of children with SCD at steady state according to serum ferritin concentration. Results in mean or geometric mean and 95% confidence interval unless otherwise stated. Ferritin <50 N= 32 Ferritin 50 + N=202 P value P value (Adjusted for # transfusions) Age, y 13.6 (12.3–14.9) 11.7 (11.0–12.4) 0.039 0.002 Female, N (%) 14 (44) 96 (48) 0.69 0.59 SC and Sb+-Thal, N (%) 12 (37) 45 (23) 0.08 0.26 > 4 blood Tx, N (%) 3 (10) 67 (34) 0.011 - Interleukin-6 ng/ml 0.5 (0.3–1.2) 0.6 (0.5–0.8) 0.6 0.6 TRV, m/sec 2.17 (2.05–2.29) 2.28 (2.24–2.32) 0.033 0.020 Hemoglobin, g/dl 9.7 (9.0–10.5) 9.3 (9.0–9.5) 0.20 0.16 MCV, fl 77.4 (73.0–81.8) 85.9 (84.4–87.5) 0.0001 0.0008 Reticulocytes (×103/mm3) 166 (137–202) 208 (188–229) 0.022 0.06 Tot. Bilirubin (mg/dl) 1.7 (1.3–2.2) 2.3 (2.1–2.5) 0.029 0.051 LDH (mU/ml) 342 (284–411) 386 (364–410) 0.14 0.11 AST (mU/ml) 35 (29–42) 40 (38–42) 0.09 0.046 Hemolytic index −0.6 (−1.2–0.1) 0.1 (−0.1–0.4) 0.018 0.023 Plasma interleukin-6 concentrations were not different between the two groups suggesting that the differences in TRV and hemolyis were not due to increased inflammation in the high ferritin group. To further account for the effect of multiple transfusions on ferritin level we also analyzed patients who had fewer than 5 blood transfusions in their lifetime. Twenty-six patients with < 5 transfusions and ferritin < 50 ng/ml were significantly older (13.5 vs 10.5 y, P=0.004), tended to have higher Hb level (10.1 vs 9.4 g/dl, P=0.08) and had lower TRV (2.15 vs 2.29 m/s, P=0.017), MCV (77 vs 84 fl, P=0.008), and hemolytic index (−0.8 vs −0.1, P=0.028) than 131 of their counterparts who had ferritin of 50 ng/ml or higher. These results suggest that incipient or latent iron deficiency may develop as SCD children grow to early adolescence and be associated with lower hemolytic rate and TRV without a noticeable adverse effect on their anemia.


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