scholarly journals Iron deficiency anemia and megaloblastic anemia in obese patients

2017 ◽  
Vol 55 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Mahmoud Arshad ◽  
Sara Jaberian ◽  
Abdolreza Pazouki ◽  
Sajedeh Riazi ◽  
Maryam Aghababa Rangraz ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Morbid Obesity ◽  
Iron Deficiency ◽  
Vitamin B12 ◽  
Iron Deficiency Anemia ◽  
Megaloblastic Anemia ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
Obese Patients ◽  
B12 Deficiency

Abstract Background. The association between obesity and different types of anemia remained uncertain. The present study aimed to assess the relation between obesity parameters and the occurrence of iron deficiency anemia and also megaloblastic anemia among Iranian population. Methods and Materials. This cross-sectional study was performed on 1252 patients with morbid obesity that randomly selected from all patients referred to Clinic of obesity at Rasoul-e-Akram Hospital in 2014. The morbid obesity was defined according to the guideline as body mass index (BMI) equal to or higher than 40 kg/m2. Various laboratory parameters including serum levels of hemoglobin, iron, ferritin, folic acid, and vitamin B12 were assessed using the standard laboratory techniques. Results. BMI was adversely associated with serum vitamin B12, but not associated with other hematologic parameters. The overall prevalence of iron deficiency anemia was 9.8%. The prevalence of iron deficiency anemia was independent to patients’ age and also to body mass index. The prevalence of vitamin B12 deficiency was totally 20.9%. According to the multivariable logistic regression model, no association was revealed between BMI and the occurrence of iron deficiency anemia adjusting gender and age. A similar regression model showed that higher BMI could predict occurrence of vitamin B12 deficiency in morbid obese patients. Conclusion. Although iron deficiency is a common finding among obese patients, vitamin B12 deficiency is more frequent so about one-fifth of these patients suffer vitamin B12 deficiency. In fact, the exacerbation of obesity can result in exacerbation of vitamin B12 deficiency.

Two Cases of Vitamin B12 Deficiency Anemia Combined with Iron Deficiency Anemia

2003 ◽  
Vol 20 (2) ◽  
pp. 206
Author(s):  
Eun Hae Kim ◽  
Hee Soon Cho ◽  
Chae Hoon Lee ◽  
Kyung Dong Kim ◽  
Myung Soo Hyun
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Iron Deficiency Anemia ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
B12 Deficiency

Does Cell Size Matter?: Utilizing Mean Cell Volume in Hospitalized Patients As a Screen to Determine Common Causes of Anemia Including Iron Deficiency Anemia, Vitamin B12 and Folate Deficiency

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2338-2338 ◽  
Author(s):  
Manika Gupta ◽  
Kathleen Copley ◽  
Michael Keeney ◽  
Ian Chin-Yee
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Cell Volume ◽  
Iron Deficiency Anemia ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Deficiency Anemia ◽  
Mean Cell Volume ◽  
Common Causes ◽  
B12 Deficiency

Abstract Background: The approach to anemia is traditionally based on the Mean Cell Volume. Based on this approach anemia is subdivided into microcytic, normocytic and macrocytic causes. This approach may not accurately discern common causes of anemia in hospitalized patients. Previous studies suggest the MCV may not be a sensitive measurement to differentiate iron deficiency anemia (IDA) and megaloblastic anemia due to vitamin B12 or folate deficiency. Methods: In a retrospective, single-centre study at London Health Sciences Center, all adult patients (age 18 years or older) with confirmed IDA, vitamin B12 and folate deficiency and their associated MCV and RDW values at LHSC over a one year period were reviewed. IDA was defined as hemoglobin less than 115 g/l and ferritin less than 30 (M) and 10 (F). Vitamin B12 deficiency was defined as a value of less than 145. Results: 1119 patients were identified with confirmed IDA, B12 or Folate deficiency. 894 patients had IDA of which 564 patients had low MCV (sensitivity 63.1%) and 797 patients had low MCV or high RDW (sensitivity 89.1%). Of the 96 patients with vitamin B12 deficiency anemia, 12 patients had high MCV (sensitivity 12.5%) and 70 patients had high MCV or high RDW (72.9%). Only one of 2244 patients who had RBC folate measured had an actual folate deficiency. Conclusion: Our results confirm that a normal MCV does not exclude IDA or vitamin B12 deficiency. Clinicians need to be aware of the low sensitivity of the MCV as a screen. The sensitivity of MCV for IDA or vitamin B12 deficiency is improved with indices such as RDW. Folate deficiency is rare in North America and should not be routinely ordered for assessment of nutritional anemia. Disclosures No relevant conflicts of interest to declare.

scholarly journals A Study of Erythropoiesis by Combined Morphologic, Quantitative Cytochemical and Autoradiographic Methods

Blood ◽  
1968 ◽  
Vol 31 (3) ◽  
pp. 304-313 ◽  
Author(s):  
S. N. WICKRAMASINGHE ◽  
E. H. COOPER ◽  
D. G. CHALMERS
Keyword(s):  
Cell Cycle ◽  
Bone Marrow ◽  
Iron Deficiency ◽  
Vitamin B12 ◽  
Iron Deficiency Anemia ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
Normal Bone Marrow ◽  
Normal Bone ◽  
B12 Deficiency

Abstract The relationship between the morphology of human erythropoietic cells and their position in interphase has been studied. In normal bone marrow, pro-normoblasts, basophilic normoblasts and early polychromatic normoblasts were present in all stages of interphase. It has been shown that a significant increase in nuclear size occurs as a cell moves through its cell cycle, in both normal and megaloblastic erythropoiesis. The relative distribution of the basophilic erythropoietic cells and the dividing polychromatic cells, in the various stages of interphase, has been determined in normal bone marrow, vitamin B12 deficiency and iron deficiency anemia. In vitamin B12 deficiency, associated with moderate or severe anemia, there was an increased proportion of cells in G2, and there were several cells with DNA contents that were between the 2c and 4c values, which were not in DNA synthesis as judged by 3H-TdR labeling. These abnormalities were most pronounced in the dividing polychromatic cell group. Similar abnormalities were not present in iron deficiency anemia, indicating that these disturbances were not produced by the presence of anemia per se. The possible relationship between these changes in the cell cycle and the ineffective erythropoiesis seen in anemia due to vitamin B12 deficiency has been discussed.

scholarly journals Hematologic Manifestations of Vitamin B12 Deficiency in Swine

Blood ◽  
1951 ◽  
Vol 6 (10) ◽  
pp. 867-891 ◽  
Author(s):  
G. E. CARTWRIGHT ◽  
BETTY TATTING ◽  
JEAN ROBINSON ◽  
N. M. FELLOWS ◽  
F. D. GUNN ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Vitamin B12 ◽  
Liver Damage ◽  
Megaloblastic Anemia ◽  
Macrocytic Anemia ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
Severe Neutropenia ◽  
Pteroylglutamic Acid ◽  
B12 Deficiency

Abstract In an effort to produce a deficiency of vitamin B12 a total of 70 pigs were fed a purified diet containing soybean alpha protein in place of casein. One group of animals was started on the diet at 2 to 7 days of age. A second group began at 21 to 28 days of age. Methionine, iodinate casein, desiccated thyroid and pteroylglutamic acid were added to the diet of certain animals and! omitted from the diet of other pigs. In addition, 9 pigs were gastrectomized. Forty-three of the animals survived for a sufficiently long period of time for adequate evaluation of the results of the experiment. Severe liver damage was observed in 24 of the 25 animals autopsied. The only animal not showing liver damage received vitamin B12 from the beginning of the experiment. Necrosis of the liver cells, fatty infiltration, or both, occurred in the presence of a high fat diet containing apparently adequate amounts of protein, choline, vitamin E and methionine. These pathologic changes were apparently prevented but not reversed by the administration of vitamin B12. Growth of the animals on the above diets without added vitamin B12 was retarded as compared with the growth of animals on the same diet supplemented with this vitamin. The administration of vitamin B12 to the deficient animals resulted in rapid growth. Of the 39 animals not receiving vitamin B12 13 failed to develop anemia, 16 developed a mild anemia and in 10 a moderately severe anemia was present. When present the anemia was normocytic and in 24 pigs was accompanied by a moderately severe neutropenia. Differential cell counts on the sternal marrow were normal except for a slight increase in the proportion of normoblasts. These hematologic alterations were neither consistently or completely corrected by the administration of vitamin B12 in spite of the fact that definite and sometimes marked reticulocyte increases followed. When methionine deficiency was associated with vitamin B12 deficiency, anemia appeared to be more severe. The administration of aureomycin, an "animal protein factor," did not stimulate growth and failed to induce a hemopoietic response. There was no macrocytic anemia, the bone marrow was not megaloblastic, and neurologic disturbances or morphologic alterations in the neutrophils were not observed. These results are in contrast to those obtained in pigs with an experimentally produced deficiency of pteroylglutamic acid. Such animals develop macrocytic anemia, leukopenia and a macronormoblastic type of bone marrow. It is not possible to give with any assurance the reason why megaloblastic anemia was not produced in the "B12-deficient" animals. This may have been due to the fact that (1) the deficiency was not sufficiently severe to result in such a change in the hemopoietic system; or (2) because pteroylglutamic acid prevents the development of megaloblastic anemia even in the absence of vitamin B12.

scholarly journals Reticulocyte size in nutritional anemias

Blood ◽  
1976 ◽  
Vol 48 (5) ◽  
pp. 669-677 ◽  
Author(s):  
DR Clarkson ◽  
EM Moore
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Mean Corpuscular Volume ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
Initial Development ◽  
Abrupt Decrease ◽  
Iron Saturation ◽  
Iron Deficient ◽  
B12 Deficiency

Abstract Alterations in reticulocyte size occur 2–3 days after the onset of iron deficient or megaloblastic erythropoiesis and precede, by several weeks, changes in mean corpuscular volume (MCV). Iron-deficiency anemia induced in a normal subject by repeated phlebotomies was characterized by the initial development of larger than normal reticulocytes followed by an abrupt decrease in reticulocyte size. Microreticulocytes appeared 3 days after the fall in per cent iron saturation and antedated the decrease in MCV to below normal by 6 wk. Mean reticulocyte size was disproportionately smaller than normal in patients presenting with iron deficiency. In contrast, reticulocyte size increased abruptly in a patient (and rats) 2–3 days after administration of methotrexate. Mean reticulocyte size was disproportionately larger than normal in patients presenting with folate or vitamin B12 deficiency. Specific replacement therapy with iron, folate, or vitamin B12 was quickly followed by normalization of reticulocyte size.

scholarly journals Multifactorial Etiology of Anemia in Celiac Disease and Effect of Gluten-Free Diet: A Comprehensive Review

Nutrients ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 2557 ◽  
Author(s):  
Martín-Masot ◽  
Nestares ◽  
Diaz-Castro ◽  
López-Aliaga ◽  
Alférez ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Iron Deficiency ◽  
Vitamin B12 ◽  
Clinical Manifestations ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
Intestinal Biopsy ◽  
B12 Deficiency ◽  
Endomysial Antibodies ◽  
Inflammatory Bowel

Celiac disease (CD) is a multisystemic disorder with different clinical expressions, from malabsorption with diarrhea, anemia, and nutritional compromise to extraintestinal manifestations. Anemia might be the only clinical expression of the disease, and iron deficiency anemia is considered one of the most frequent extraintestinal clinical manifestations of CD. Therefore, CD should be suspected in the presence of anemia without a known etiology. Assessment of tissue anti-transglutaminase and anti-endomysial antibodies are indicated in these cases and, if positive, digestive endoscopy and intestinal biopsy should be performed. Anemia in CD has a multifactorial pathogenesis and, although it is frequently a consequence of iron deficiency, it can be caused by deficiencies of folate or vitamin B12, or by blood loss or by its association with inflammatory bowel disease (IBD) or other associated diseases. The association between CD and IBD should be considered during anemia treatment in patients with IBD, because the similarity of symptoms could delay the diagnosis. Vitamin B12 deficiency is common in CD and may be responsible for anemia and peripheral myeloneuropathy. Folate deficiency is a well-known cause of anemia in adults, but there is little information in children with CD; it is still unknown if anemia is a symptom of the most typical CD in adult patients either by predisposition due to the fact of age or because biochemical and clinical manifestations take longer to appear.

scholarly journals Vitamin B12-deficiency anemia in infants: clinical presentation, current diagnostic and treatment

2019 ◽  
Vol 18 (3) ◽  
pp. 70-77
Author(s):  
M. A. Lunyakova ◽  
V. G. Demikhov ◽  
S. N. Dronova ◽  
Yu. Yu. Kalinina ◽  
O. N. Zhurina
Keyword(s):  
Vitamin B12 ◽  
Megaloblastic Anemia ◽  
Vitamin B12 Deficiency ◽  
Personal Data ◽  
Failure To Thrive ◽  
Cobalamin Deficiency ◽  
Deficiency Anemia ◽  
Developmental Skills ◽  
B12 Deficiency ◽  
Long Term Prognosis

Vitamin B12 (cobalamin) deficiency in infants exclusively breastfed is usually the result of its deficiency in the mothers (vegetarians or in the presence of unrecognized pernicious anemia or malabsorption syndrome). Cobalamin is crucial for the normal development of the nervous system, the production of erythrocytes and the synthesis of DNA. The classic manifestation of its deficiency is megaloblastic anemia and, in advanced cases, pancytopenia. However, infants often present neurological symptoms (fatigue, failure to thrive, regress of developmental skills, lethargy, motor disorders), as a consequence of inadequate myelination of the brain. Cobalamin treatment is effective in the most children, however, the neurological deficit varying degrees may persist. The long-term prognosis depends on overall duration of vitamin B12 deficiency and severity of symptoms. The article presents our own interesting clinical observations. Parents gave their permission for using personal data for clinical research and publications.

scholarly journals Reticulocyte size in nutritional anemias

Blood ◽  
1976 ◽  
Vol 48 (5) ◽  
pp. 669-677
Author(s):  
DR Clarkson ◽  
EM Moore
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Mean Corpuscular Volume ◽  
Vitamin B12 Deficiency ◽  
Deficiency Anemia ◽  
Initial Development ◽  
Abrupt Decrease ◽  
Iron Saturation ◽  
Iron Deficient ◽  
B12 Deficiency

Alterations in reticulocyte size occur 2–3 days after the onset of iron deficient or megaloblastic erythropoiesis and precede, by several weeks, changes in mean corpuscular volume (MCV). Iron-deficiency anemia induced in a normal subject by repeated phlebotomies was characterized by the initial development of larger than normal reticulocytes followed by an abrupt decrease in reticulocyte size. Microreticulocytes appeared 3 days after the fall in per cent iron saturation and antedated the decrease in MCV to below normal by 6 wk. Mean reticulocyte size was disproportionately smaller than normal in patients presenting with iron deficiency. In contrast, reticulocyte size increased abruptly in a patient (and rats) 2–3 days after administration of methotrexate. Mean reticulocyte size was disproportionately larger than normal in patients presenting with folate or vitamin B12 deficiency. Specific replacement therapy with iron, folate, or vitamin B12 was quickly followed by normalization of reticulocyte size.

scholarly journals HUBUNGAN POLA KONSUMSI ZAT BESI DENGAN KADAR HEMOGLOBIN PADA IBU HAMIL DI BPS KABUPATEN PRINGSEWU LAMPUNG TAHUN 2015

2018 ◽  
Vol 3 (1) ◽  
pp. 86
Author(s):  
Sumi Anggraeni
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Pregnant Women ◽  
Iron Deficiency Anemia ◽  
Vitamin B12 Deficiency ◽  
Rapid Test ◽  
Hereditary Diseases ◽  
Deficiency Anemia ◽  
Cross Sectional ◽  
Pregnancy And Childbirth

Abstrak: Hasil kajian beberapa penelitian, perdarahan pada ibu hamil dan persalinan merupakan komplikasi dari anemia selama kehamilan. Penyebab anemia menurut WHO tahun 2012 adalah defisiensi besi, kurangnya asam folat, defisiensi vitamin B12, infeksi dan penyakit keturunan. Anemia karena defisiensi besi merupakan penyebab utama dari anemia. anemia defisiensi besi dapat dilihat dari kadar hemoglobin dan kadar feritin yang rendah. Rendahnya hemoglobin disebabkan oleh pola konsumsi dan kepatuhan minum zat besi, terutama di negara berkembang. Tujuan dari penelitian ini adalah mengetahui hubungan pola konsumsi zat besi dengan kadar hemoglobin pada ibu hamil di BPS Pringsewu Lampung tahun 2015. Desain penelitian  menggunakan analitik observational dengan pendekatan crossectional. Sampel dalam penelitian ini adalah ibu hamil dengan usia 32 minggu yang berjumlah 108 orang, dan alat ukur menggunakan kuesioner wawancara dan hemoglobin rapid test. Hasil penelitian diperoleh tidak ada hubungan pola konsumsi zat besi dengan kadar hemoglobin pada ibu hamil (p=0,323). Abstract: A review of several studies, bleeding during pregnancy and childbirth is a complication of the anemia during pregnancy. The cause of anemia according to the WHO in 2012 is iron deficiency, lack of folic acid, vitamin B12 deficiency, infectious and hereditary diseases. Iron deficiency anemia is a major cause of anemia. Iron deficiency anemia can be seen in the levels of hemoglobin and ferritin levels are low. Low hemoglobin caused by consumption patterns and adherence to iron, especially in developing countries. The purpose of this study was to determined the relationship of consumtion patterns of iron with hemoglobin levels in pregnant women in BPS Pringsewu Lampung 2015. This research design using analytical observational with cross-sectional approach. The sample in this study were pregnant women aged 32 weeks, amounting to 108 people, and measuring devices used questionnaires and interviews hemoglobin rapid test. The results obtained no relationship consumtion patterns of iron with hemoglobin levels in pregnant women (p = 0.323)

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