scholarly journals Diagnosis of iron deficiency anemia in children of Northeast Brazil

2010 ◽  
Vol 44 (3) ◽  
pp. 513-519 ◽  
Author(s):  
Antonio Geraldo Cidrão Carvalho ◽  
Pedro Israel Cabral de Lira ◽  
Maria de Fátima Alcântara Barros ◽  
Maria Luiza Martins Aléssio ◽  
Marília de Carvalho Lima ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Receptor ◽  
Hematological Parameters ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Northeast Brazil ◽  
C Reactive Protein ◽  
Ferritin Concentration ◽  
Reactive Protein

OBJECTIVE: To diagnose iron deficiency anemia in children. METHODS: The study was conducted with a sample of 301 children aged six to 30 months attending public daycare centers in the city of Recife, Northeast Brazil, in 2004. The diagnoses of anemia were based on a combination of different hematological and biochemical parameters: hemoglobin, mean corpuscular volume, ferritin, C-reactive protein, transferrin saturation and transferrin receptor. The chi-square test and ANOVA were used in the statistical analysis. RESULTS: Of all children studied, 92.4% had anemia (Hb <110 g/L) and 28.9% had moderate/severe anemia (Hb <90 g/L). Lower levels of hemoglobin were found in children aged 6-17 months. Iron deficiency was found in 51.5% of children using ferritin (<12 μg/L) as parameter. Taking into consideration the combination of hemoglobin level, ferritin and transferrin receptor, 58.1% had anemia with iron deficiency, 34.2% had anemia without iron deficiency and 2.3% had iron deficiency without anemia. Mean ferritin concentration was significantly higher in children with high C-reactive protein when compared with those with normal levels (22.1 vs. 14.8 µg/L). CONCLUSIONS: The use of several biochemical and hematological parameters allowed to diagnosing iron deficiency anemia in two thirds of children, suggesting a need to identify other determinants of anemia without iron deficiency.

The soluble transferrin receptor (sTfR)-ferritin index is a potential predictor of celiac disease in children with refractory iron deficiency anemia

2005 ◽  
Vol 43 (1) ◽  
Author(s):  
Maurizio De Caterina ◽  
Ernesto Grimaldi ◽  
Giovanni Di Pascale ◽  
Giuliana Salerno ◽  
Assunta Rosiello ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Receptor ◽  
Hematological Parameters ◽  
Deficiency Anemia ◽  
Soluble Transferrin Receptor ◽  
Mean Cell Volume ◽  
Age Range ◽  
Normal Controls

AbstractThe soluble transferrin receptor (sTfR) distinguishes iron deficiency anemia from other types of anemia. Refractory iron deficiency anemia is often the onset symptom in malabsorption-induced celiac disease. We evaluated whether sTfR levels distinguish celiac disease-associated iron deficiency anemia from iron deficiency anemia of other origin. To this aim we measured sTfR and ferritin levels and their ratio (the sTfR/ferritin index) and other hematological parameters in 42 anemic children (20 with and 22 without celiac disease) vs. 22 non-anemic children with celiac disease and 31 healthy controls (age range 4–12years). Hemoglobin parameters, mean cell volume, and serum iron and ferritin levels were decreased to a similar extent in the anemic patients (celiac and non-celiac). The sTfR level in non-anemic celiac patients was similar to that of normal controls (1.7±0.35mg/L), whereas it was significantly increased in non-celiac and celiac anemic patients (2.2±0.5mg/L, p<0.05 and 2.7±1.2mg/L, p<0.001, respectively). The sTfR/ferritin index was also increased more in the anemic celiac patients (mean 4.4, range 1.5–12.0) than in anemic non-celiac children (mean 2.6, range 1.4–4.0) compared with non-anemic children (mean 1.2, range 0.7–2.0). Differences were more pronounced when ferritin was <5ng/mL. Thus, the sTfR/ferritin index may be a predictive measure in discriminating anemic patients with celiac disease from those without celiac disease.

scholarly journals Study of Prevalence, Risk Factors and Hematological Parameters in Children Suffering from Iron Deficiency Anemia in a Tertiary Care Centre in Pokhara

2018 ◽  
Vol 1 (2) ◽  
pp. 79-82
Author(s):  
Amrita Ghimire Paudel ◽  
Kalpana Karmacharya Malla ◽  
Shree Krishna Shrestha ◽  
Suresh Raj Paudel ◽  
Deepak Raj Paudel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Binding Capacity ◽  
Hematological Parameters ◽  
Tertiary Care ◽  
Transferrin Saturation ◽  
Dietary Factors ◽  
Physical Growth ◽  
Deficiency Anemia

Introduction: Iron deficiency anemia (IDA) is the most common anemia worldwide. It adversely affects the physical growth, cognition, behavior and the immune status of infants and children. There are limited number of studies in Nepal analyzing its prevalence, risk factors and diagnosis in pediatric population. Restriction of analgesics intake, increased intake of iron rich food and deworming are important determinants in the disease management. Methods: Hospital based prospective comparative study was conducted in the Department of Pediatrics in Manipal Teaching Hospital from December 2014 to December 2016 enrolling all children aged 6 months to 5 years with anemia. Demographic profile, clinical features and information regarding risk factors were noted along with detailed physical examination. Iron profile was done to confirm diagnosis of IDA. Data was analyzed using SPSS 21. Results: Out of 168 anemic children, 110 (65.45%) children were diagnosed as IDA. Dietary factors, pica and intake of analgesics/antipyretics were major risk factors. Serum iron, serum ferritin, transferrin saturation were low whereas total iron binding capacity was high in IDA. Conclusion: Iron deficiency anemia is a common, preventable and easily treatable disease which has potentially serious consequences if not treated. Non compliance to exclusive breastfeeding in the first 6 months of life, introduction of cow’s/buffalo’s milk in the first year, pica and rampant use of analgesics/antipyretics are major risk factors.  

scholarly journals SIGNIFICANCE OF INFLAMMATION MARKERS DETERMINED IN PREGNANT WOMEN WITH ANEMIC SYNDROME AND OBESITY

2018 ◽  
Vol 20 (5) ◽  
pp. 639-646
Author(s):  
Т. S. Prokhorenko ◽  
A. P. Zima ◽  
T. V. Saprina ◽  
N. N. Musina ◽  
N. S. Shakhmanova ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Iron Deficiency ◽  
Pregnant Women ◽  
Chronic Diseases ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Obese Women ◽  
C Reactive Protein ◽  
Anemia Of Chronic Disease ◽  
Reactive Protein

The purpose of the present study was to specify a role of inflammatory mediators in pathogenesis of various types of anemia in pregnant obese women. We determined IL-1, IL-6, TNFα, C-reactive protein and hepcidin concentrations in blood serum of pregnant women with obesity depending on the type of anemic syndrome, either iron-deficiency anemia, or anemia of chronic diseases. We showed that the content of IL-6 in blood of the obese women exceeds the value of this index in healthy pregnant women (p < 0.05), and it does not depend on the presence and type of anemic syndrome. We found that the C-reactive protein concentration in pregnant women with obesity is higher than reference values (p < 0.05). Moreover, the contents of C-reactive protein in blood serum of pregnant women with anemia of chronic diseases is significantly higher (p < 0.05) than in women with iron deficiency anemia. Hepcidin concentration in blood of pregnant women with obesity and anemia of chronic disease was a specific feature: its content was significantly higher than in healthy pregnant women (p < 0.05), or in pregnant women with anemia-free obesity (p < 0.05). Hepcidin levels also exceeded 2-fold its contents in serum from pregnant women with obesity and iron deficiency anemia (p < 0.05). We have found that only pregnant women with obesity and anemia of chronic diseases have shown a positive correlation between the concentrations of C-reactive protein and blood levels of hepcidin (r = 0.733, p < 0.05), or IL-6 (r = 0.679, p < 0.05).The discussion concerns potential mechanisms of evolving anemia of chronic disease combined with subclinical inflammation in pregnant women with metabolic disorders. We conclude that a combination of obesity with gestational diabetes is a risk factor of anemia of chronic diseases in pregnant women. Development of an algorithm for differential diagnosis of iron deficiency anemia and anemia of chronic diseases in this cohort of patients is advisable for future studies in the area.

An Effective and Efficient Testing Protocol for Diagnosing Iron-deficiency Anemia Preoperatively

2020 ◽  
Vol 133 (1) ◽  
pp. 109-118 ◽  
Author(s):  
Obianuju Okocha ◽  
Hardik Dand ◽  
Michael J. Avram ◽  
BobbieJean Sweitzer
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Blood Count ◽  
Complete Blood Count ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Patient Visit ◽  
Single Patient ◽  
Traditional Practice ◽  
Ferritin Concentration

Background Iron-deficiency anemia is a common perioperative condition and increases perioperative morbidity and mortality. Timely diagnosis and treatment are important. This retrospective cohort study tested the hypothesis that a newly developed preprocedure evaluation protocol diagnoses more patients with iron-deficiency anemia than the traditional practice of obtaining a complete blood count followed by iron studies. Methods The preprocedure anemia evaluation is an order for a complete blood count and reflex anemia testing, which can be completed with a single patient visit. A hemoglobin concentration of 12 g/dl or less with serum ferritin concentration less than 30 ng/ml or transferrin saturation less than 20% defined iron-deficiency anemia. Northwestern Medicine’s database was queried for preoperative clinic patients, age 16 to 89 yr, before (2015 to 2016) and after (2017 to 2018) protocol implementation. The proportion of patients diagnosed with iron-deficiency anemia before and after the preprocedure anemia evaluation implementation was compared. Results Before implementing the protocol, 8,816 patients were screened with a traditional complete blood count. Subsequent iron studies at the providers’ discretion diagnosed 107 (1.2%) patients with iron-deficiency anemia. Some patients were still screened with a complete blood count after implementing the protocol; 154 of 4,629 (3.3%) patients screened with a complete blood count and 738 of 2,828 (26.1%) patients screened with the preprocedure anemia evaluation were diagnosed with iron-deficiency anemia. The preprocedure anemia evaluation identified a far larger proportion of patients with iron-deficiency anemia than did the traditional complete blood count when compared both before (relative risk [95% CI], 21.5 (17.6 to 26.2); P &lt; 0.0001) and after (7.8 [6.6 to 9.3]; P &lt; 0.0001) its implementation. Conclusions The preprocedure anemia evaluation improved identification of iron-deficiency anemia preoperatively. It is more effective and efficient, allowing anemia evaluation with a single patient visit. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Using Soluble Transferrin Receptor and Taking Inflammation into Account When Defining Serum Ferritin Cutoffs Improved the Diagnosis of Iron Deficiency in a Group of Canadian Preschool Inuit Children from Nunavik

Anemia ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Huguette Turgeon O’Brien ◽  
Rosanne Blanchet ◽  
Doris Gagné ◽  
Julie Lauzière ◽  
Carole Vézina
Keyword(s):  
Iron Deficiency ◽  
Transferrin Receptor ◽  
Binding Capacity ◽  
Iron Status ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Soluble Transferrin Receptor ◽  
Iron Depletion ◽  
Reactive Protein ◽  
Iron Deficient

The prevalence of iron depletion, iron deficient erythropoiesis (IDE), and iron deficiency anemia (IDA) was assessed in preschool Inuit children using soluble transferrin receptor (sTfR) and traditional indicators of iron status while disregarding or taking inflammation into account when defining SF cutoffs. Iron depletion was defined as follows: (1) SF < 15 μg/L regardless of the C-reactive protein (CRP) level and (2) SF < 15 or <50 μg/L with CRP ≤ 5 or >5 mg/L, respectively. IDE corresponded to iron depletion combined with total iron binding capacity > 72 μmol/L and/or transferrin saturation < 16%. Iron depletion and IDE affected almost half of the children when accounting for inflammation, compared to one-third when the SF cutoff was defined regardless of CRP level (P<0.0001). The prevalence of IDE adjusted for inflammation (45.1%) was very similar to the prevalence observed when sTfR was used as a sole marker of IDE (47.4%). The prevalence of anemia was 15%. The prevalence of IDA (IDE + hemoglobin < 110 g/L) was higher when accounting for than when disregarding inflammation (8.0% versus 6.2%,P=0.083). Using sTfR and different SF cutoffs for children with versus without inflammation improved the diagnosis of iron depletion and IDE. Our results confirm that Inuit children are at particularly high risk for iron deficiency.

scholarly journals The significance of soluble transferrin receptors in diagnosing iron deficiency anemia

2015 ◽  
Vol 23 (3) ◽  
pp. 275-283
Author(s):  
Ivan Tijanić ◽  
Miodrag Vučić ◽  
Lana Mačukanović Golubović
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Receptor ◽  
Roc Analysis ◽  
Area Under The Curve ◽  
Deficiency Anemia ◽  
Control Group ◽  
Transferrin Receptors ◽  
Soluble Transferrin Receptor ◽  
Ferritin Concentration

AbstractIntroduction. In recent years, determination of soluble transferrin receptor levels has been emerging as a test that can reliably indicate iron deficiency in various states, and that is non-invasive and easy to use. The aim of this study was: to determine reference values of soluble transferrin receptor concentrations in serums in our population, to examine the reliability of this method in the diagnosis of anemia due to iron deficiency and associated iron deficiency in anemia accompanying malignant hemopathies, and to identify possible limitations of the test in certain conditions.Material and Methods. The prospective research included 86 patients with anemia: 46 patients with iron deficiency anemia, and 40 patients with malignant hemopathies. The control group consisted of 40 healthy persons aging over 18.Results. Ferritin values were reduced in 76.1% of patients, while higher levels of soluble transferrin receptors appeared in 100% of patients with iron deficiency anemia. In patients with reduced serum ferritin levels, the soluble transferrin receptor/log ferritin index was statistically significantly higher than in patients in whom ferritin concentration was in the normal range (p <0.001). ROC analysis of patients with iron deficiency anemia showed that the soluble transferrin receptor/log ferritin index (AUC 0.977) and levels of soluble transferrin receptors (AUC 0.931) occupied the largest area under the curve. The best diagnostic parameter for detecting iron deficiency in patients with malignant hemopathies by ROC analysis is the soluble transferrin receptor/log ferritin index (AUC 0.770).Conclusion. Soluble transferrin receptors are useful in the diagnosis of iron deficiency anemia, especially when ferritin values are not reduced. The calculation of soluble transferrin receptor/log ferritin index is even more reliable. In patients with malignant hemopathies, the associated iron deficiency could be best indicated by soluble transferrin receptor/log ferritin index.

scholarly journals POS0567 HEPCIDIN IS POTENTIAL BIOMARKER TO DISTINGUISH BETWEEN IRON DEFICIENCY ANEMIA AND ANEMIA OF INFLAMMATION IN RHEUMATOID ARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 518.2-518
Author(s):  
E. Galushko ◽  
A. Semashko ◽  
A. Gordeev ◽  
A. Lila
Keyword(s):  
Rheumatoid Arthritis ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Complete Blood Count ◽  
Deficiency Anemia ◽  
Reactive Protein ◽  
Potential Biomarker ◽  
Serum Hepcidin ◽  
Proper Diagnosis ◽  
Anemia Of Inflammation

Background:Anemia of inflammation (AI) and iron deficiency anemia (IDA) are the two most prevalent forms of anemia in patients with rheumatoid arthritis (RA). Diagnosis becomes challenging if AI is associated with true ID (AI/ID), as there is still a lack of a gold standard for differentiation between AI and AI/ID. However, as therapies to overcome anemia differ, proper diagnosis and understanding of underlying pathophysiological regulations are necessary.Objectives:The aim of the study was to evaluate the clinical efficiency of hepcidin, a key regulator of iron metabolism, in the diagnosis of IDA, as well as the differential diagnosis of AI/ID and AI in patients with RA.Methods:The study was undertaken 96 patients with RA, 67 of them were diagnosed anemia according to WHO criteria (104,3±21,4 g/l). Anemic patients and anemia-free patients with RA (n=29) were comparable (p>0.05) in age (44.4±14.8 and 49.8±9.3 years), disease duration (73.5±65.4 and 59.8±48.3 months) and DAS28 (6.3±1.6 and 5.9±1.9). All cases were subjected to following tests: complete blood count with peripheral smear, serum C-reactive protein, serum interleukin-6, iron studies, serum soluble transferrin receptor (sTfR), and serum hepcidin. Patients with RA and anemia were divided two groups: 25 patients with IDA and 42 - with AI. The AI cases were subdivided into pure AI and AI with coexistent ID (n=15).Results:The mean serum hepcidin concentration was significantly increased in pure AI patients (123.85±25.8 ng/mL) as compared to those in IDA patients (63.9±22.8 ng/mL, P < 0.05) and anemia-free patients with RA (88.1±39.09 ng/mL). Also, compared to pure AI patients [normal sTfR levels (<3 µg/mL)], the serum hepcidin concentration was reduced significantly in AI patients with ID [high sTfR levels (≥3 µg/mL)] with a mean of 79.0±23.97 ng/mL.Conclusion:Hepcidin measurement can provide a useful tool for differentiating AI from IDA and also help to identify an iron deficiency in AI patients. This might aid in the appropriate selection of therapy for these patients.Disclosure of Interests:None declared

The value of soluble transferrin receptor and Tfr-Ferritin index in the differential diagnosis of iron deficiency anemia

2009 ◽  
Vol 42 (4-5) ◽  
pp. 343-344
Author(s):  
Tulay Keskin ◽  
Ozlem Hurmeydan ◽  
Yalcin Onder ◽  
Lale Dagdelen ◽  
Nazli Caner ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Transferrin Receptor ◽  
Deficiency Anemia ◽  
Soluble Transferrin Receptor
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