scholarly journals Early Screening of Hemoglobinopathy in Indonesia Using Erythrocyte Indices

2017 ◽  
Vol 9 (2) ◽  
pp. 99
Author(s):  
Yenny Surjawan ◽  
Hwee Lian Tan ◽  
Rahajuningsih Dharma Setiabudy ◽  
Wiwik Rositawati
Keyword(s):  
Iron Deficiency ◽  
Sensitivity And Specificity ◽  
High Performance ◽  
Complete Blood Count ◽  
Hemoglobin Concentration ◽  
Early Screening ◽  
Cross Sectional ◽  
Distribution Width ◽  
Ferritin Concentration ◽  
Erythrocyte Indices

BACKGROUND: The mutation spectrums of hemoglobinopathy are different among populations that yield a different result of erythrocyte indices. Calculation of erythrocyte indices with some formula has been reported to differentiate between hemoglobinopathy and non-hemoglobinopathy, but its cut-off should be recalculated specific for each population to gain a better sensitivity and specificity. We aimed to evaluate red blood cell count (RBC), Mentzer index, red cell distribution width (RDW), RDW index (RDWI), Shine and Lal index (S&L) and Green and King index (G&K) to screen hemoglobinopathy in Indonesia.METHODS: A retrospective cross-sectional study was performed on 202 subjects. The diagnosis of hemoglobinopathy was determined based on the results of complete blood count (CBC) data, high-performance liquid chromatography (HPLC) and Hemoglobin H (HbH) inclusion body. The ferritin concentration was checked to determine the status of iron. The erythrocytes indices were analyzed and calculated to predict hemoglobinopathy. RESULTS: A total 202 subjects who met the criteria were involved in this study. Fifty percent showed pure hemoglobinopathy and 4% showed a combination of thalassemia and hemoglobinopathy. The hemoglobin concentration and RBC were significantly higher, and the mean corpuscular volume (MCV) and RDW were significantly lower in hemoglobinopathy compared to iron deficiency. The difference was not significant if the hemoglobinopathy was combined with iron deficiency. By this study's cut-off, the G&K and RDWI showed the highest accuracy, sensitivity, and specificity.CONCLUSION: The new cut-off of erythrocyte index and its calculation to screen hemoglobinopathy in Indonesia showed a higher sensitivity and specificity, especially for G&K and RDWI with cut-off 73 and 228, respectively. The presence of iron deficiency in hemoglobinopathy could decrease the sensitivity.KEYWORDS: hemoglobinopathy, RBC, Mentzer index, RDW, RDWI, S&L, G&K

scholarly journals Effect of Maternal Iron Deficiency Anemia on the Iron Store of Newborns in Ethiopia

Anemia ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Betelihem Terefe ◽  
Asaye Birhanu ◽  
Paulos Nigussie ◽  
Aster Tsegaye
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Serum Ferritin ◽  
Complete Blood Count ◽  
Iron Status ◽  
Hemoglobin Concentration ◽  
Deficiency Anemia ◽  
Iron Store ◽  
Cross Sectional ◽  
Iron Deficient

Iron deficiency anemia among pregnant women is a widespread problem in developing countries including Ethiopia, though its influence on neonatal iron status was inconsistently reported in literature. This cross-sectional study was conducted to compare hematologic profiles and iron status of newborns from mothers with different anemia status and determine correlation between maternal and neonatal hematologic profiles and iron status in Ethiopian context. We included 89 mothers and their respective newborns and performed complete blood count and assessed serum ferritin and C-reactive protein levels from blood samples collected from study participants. Maternal median hemoglobin and serum ferritin levels were 12.2 g/dL and 47.0 ng/mL, respectively. The median hemoglobin and serum ferritin levels for the newborns were 16.2 g/dL and 187.6 ng/mL, respectively. The mothers were classified into two groups based on hemoglobin and serum ferritin levels as iron deficient anemic (IDA) and nonanemic (NA) and newborns of IDA mothers had significantly lower levels of serum ferritin (P=0.017) and hemoglobin concentration (P=0.024). Besides, newborns’ ferritin and hemoglobin levels showed significant correlation with maternal hemoglobin (P=0.018;P=0.039) and ferritin (P=0.000;P=0.008) levels. We concluded that maternal IDA may have an effect on the iron stores of newborns.

Evaluation of Twenty Four Discriminant Indices for Differentiating Beta-Thalassemia Trait from Iron Deficiency Anemia in Egyptians

2019 ◽  
Author(s):  
Shaimaa Abdelmalik Pessar
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Complete Blood Count ◽  
Deficiency Anemia ◽  
Beta Thalassemia ◽  
True Negative ◽  
Cross Sectional ◽  
Diagnostic Reliability ◽  
Distribution Width ◽  
Thalassemia Trait

Background: Many Red Blood Cell (RBC) indices have been developed based on mathematical formulae to discriminate beta-thalassemia trait (βTT) from iron deficiency anemia (IDA). The latter two conditions represent the most common causes of microcytic hypochromic anemia in Egypt. This study aimed To evaluate the diagnostic reliability of 24 published discriminant indices for differentiating βTT from IDA in Egyptians. Materials and Methods: A cross sectional study included a total of 166 subjects (108 IDA & 58 βTT) aged 1-18 years were recruited from Hematology laboratory of  Pediatric Hospital, Ain Shams University, Cairo, Egypt. A full diagnostic algorithm was performed using complete blood count, hemoglobin electrophoresis by High Performance Liquid Chromatography (HPLC), iron profile and PCR detection of 22 mutations common for βTT. Twenty-four formulas were applied and their performance characteristics were calculated for each index. Results: The highest accuracy (True positive + True negative/ All cases) & Youden's Index (Sensitivity+Specificity-100) were for Red Cell Distribution Width (RDWI) and Hameed index closely followed by Keikhaei index while the least performance was for RDW-SD, RDW-CV and Shine & Lal indices. Conclusion The superiority of an index over another in distinguishing βTT from IDA allowed only partially better selection of cases warranting further confirmatory molecular studies. None of the studied formulae provided a surrogate test for Hb electrophoresis as mass screening.

scholarly journals Red cell distribution width and mortality in pediatric sepsis

2017 ◽  
Vol 56 (6) ◽  
pp. 320 ◽  
Author(s):  
Trina Devina ◽  
Munar Lubis ◽  
Erna Mutiara ◽  
Gema Nazri Yanni ◽  
Rina Amalia C. Saragih ◽  
...  
Keyword(s):  
Complete Blood Count ◽  
Cross Sectional Study ◽  
Red Cell Distribution Width ◽  
Hematological Parameter ◽  
Red Cell ◽  
Cell Distribution ◽  
Chi Square ◽  
Cross Sectional ◽  
Distribution Width ◽  
Pediatric Sepsis

Background Red cell distribution width (RDW) is a hematological parameter routinely obtained as part of the complete blood count. Recently, RDW has emerged as a potential independent predictor of clinical outcomes in adults with sepsis. However, RDW as a mortality predictor in pediatric populations has not been well established.Objective To determine the relationship between RDW value and mortality outcomes in pediatric sepsis patients.Methods We performed a cross-sectional study of 40 consecutive pediatric patients with sepsis admitted to the PICU from December 2013 to March 2014. All patients’ RDW were collected within 24 hours of sepsis diagnosis. We determined the association between RDW and hemoglobin (Hb) using Spearman’s correlation. The RDW values of 11.5-14.5% were considered to be normal while those > 14.5% were considered to be elevated. We compared mortality and PICU length of stay (LoS) between the normal and elevated RDW groups using Chi-square and Mann-Whitney tests.Results The median age of patients was 34 months (range 2 months to 17 years). There were 28 (70%) male subjects. Subjects’ median RDW was 14.8% (range 11.2-27.8%) and was not correlated with Hb (r=0.056; P=0.73). Mortality rates in the normal and elevated RDW groups were 40% and 45%, respectively. There were no significant associations between RDW group and mortality (P=0.749) or PICU LoS (P=0.350).Conclusion Unlike in adults, RDW values are not correlated with mortality in pediatric sepsis patients. 

scholarly journals Clinical thresholds for diagnosing iron deficiency: comparison of functional assessment of serum ferritin to population based centiles

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Gorkem Sezgin ◽  
Paul Monagle ◽  
Tze Ping Loh ◽  
Vera Ignjatovic ◽  
Monsurul Hoq ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Serum Ferritin ◽  
Age Groups ◽  
Hemoglobin Concentration ◽  
Population Based ◽  
Reference Intervals ◽  
Deficiency Anemia ◽  
Distribution Width ◽  
Iron Deficient ◽  
Lower Limits

Abstract Low serum ferritin is diagnostic of iron deficiency, yet its published lower cut-off values are highly variable, particularly for pediatric populations. Lower cut-off values are commonly reported as 2.5th percentiles, and is based on the variation of ferritin values in the population. Our objective was to determine whether a functional approach based on iron deficient erythropoiesis could provide a better alternative. Utilizing 64,443 ferritin test results from pediatric electronic health records, we conducted various statistical techniques to derive 2.5th percentiles, and also derived functional reference limits through the association between ferritin and erythrocyte parameters: hemoglobin, mean corpuscular volume, mean cell hemoglobin concentration, and red cell distribution width. We find that lower limits of reference intervals derived as centiles are too low for clinical interpretation. Functional limits indicate iron deficiency anemia starts to occur when ferritin levels reach 10 µg/L, and are largely similar between genders and age groups. In comparison, centiles (2.5%) presented with lower limits overall, with varying levels depending on age and gender. Functionally-derived limits better reflects the underlying physiology of a patient, and may provide a basis for deriving a threshold related to treatment of iron deficiency and any other biomarker with functional outcomes.

scholarly journals Neonatal Growth, Neurotrophine, Zinc, and Ferritin Concentration in Normal and Iron Deficience Pregnancy: An Observational Analitic Study

2019 ◽  
Vol 7 (7) ◽  
pp. 1114-1118 ◽  
Author(s):  
Yusrawati Yusrawati ◽  
Defrin Defrin ◽  
Hudila Rifa Karmia
Keyword(s):  
Iron Deficiency ◽  
Learning Ability ◽  
Enzyme Linked Immunosorbent Assay ◽  
Cross Sectional ◽  
Ferritin Concentration ◽  
Significance Level ◽  
Umbilical Blood ◽  
Zinc Levels ◽  
Maternal Iron ◽  
In Pregnancy

BACKGROUND: Anemia in pregnancy was one of the national problems. Insufficient iron deposits before pregnancy and inadequate iron intake during pregnancy could lead to iron deficiency anaemia in pregnancy, followed by iron deficiency in neonates. AIM: This study aimed to assess the molecular relationship of maternal iron deficiency with the function of the neonatal central nervous system to know the cognitive aspects of learning ability of children. METHODS: This study was an observational analytic study with cross-sectional design underwent in RSUP Dr M. Djamil Padang, RSI Ibnu Sina Padang, and RSU BMC Padang. The sample size was 80 pregnant women at term. After a maternal and neonatal physical examination, maternal and umbilical blood samples were obtained to assess maternal ferritin levels and neonates ferritin, neurotrophin and zinc levels using the Enzyme-Linked Immunosorbent Assay (ELISA). Data were analysed using the IBM SPSS Statistics for Windows. The independent sample t-test was performed to assess the relationship for normally distributed data and Mann-Whitney test for abnormal data distribution with significance level p < 0.05. RESULTS: There were differences in mean neonatal ferritin (p < 0.001), neonatal neurotrophin (p < 0.001), and neonatal zinc (p < 0.001) to normal maternal ferritin levels (≥ 15 μg/ml) and low maternal ferritin levels (< 15 μg/ml). The difference in mean neonatal head circumference (0.92; CI95% -0.79-0.98) was associated with neonatal ferritin levels. CONCLUSIONS: The mean neonatal ferritin, neurotrophin, and zinc levels were found lower in iron deficiency maternal. Maternal iron deficiency correlates with neonate growth, iron deficiency, and neurotrophin expression that affected neonate cognition.

scholarly journals Anemia in children with chronic renal failure Special attention erythrocyte indices and iron deficiency anemia

2016 ◽  
Vol 46 (4) ◽  
pp. 154
Author(s):  
Adi Suryanto B ◽  
Partini P Trihono ◽  
Agus Firmansyah
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Descriptive Study ◽  
Deficiency Anemia ◽  
Normocytic Anemia ◽  
Cross Sectional ◽  
Erythrocyte Indices

Background Anemia in chronic renal failure (CRF) has beenproved to influence the quality of life, increasing morbidity andmortality. Early diagnosis and prompt treatments of anemia aremandatory to manage CRF appopriately. So far data of anemia inCRF in Indonesia is limited.Objective To find out the profile of anemia in children with CRF atCipto Mangunkusumo Hospital (CMH), Jakarta, with special atten-tion in erythrocyte indices and iron deficiency anemia.Methods Cross-sectional descriptive study was carried out onpatients with CRF and anemia in CMH since October 2003 to April2004.Results There were 20 CRF patients, aged between 1 year 3 month-15 year old, mostly were above 10 year old, 11 patients were malesand 9 were females. The most frequent etiologies were urinarytract infection (UTI) in 10 cases and nephrotic syndrome in 6 cases.Of those 20 patients, 14 suffered from anemia with erythrocyteindices, normochrome normocytic in 9 patients and hypochromemicrocytic in 5 patients. Of 14 anemic patients only 1 patient suf-fered from iron deficiency anemia of less than 10 mg/l and transferinsaturation of less than 12%. Based on serum iron (SI) concentra-tion only, 7 patients were diagnosed as having iron deficiency ane-mia.Conclusion Most patients with chronic renal failure havenormochrome normocytic anemia. Hypochromic microcytic irondeficiency anemia is scarcely found in this group of patients.

scholarly journals Correlation Ofmaternal Serum Ferritin With Cord Blood Dopamine Concentration

2018 ◽  
Vol 3 (2) ◽  
pp. 53
Author(s):  
Wulan Dewi Rizky ◽  
Vaulinne Basyir ◽  
Rima Semiarty
Keyword(s):  
Iron Deficiency ◽  
Cord Blood ◽  
Serum Ferritin ◽  
Maternal Serum ◽  
P Value ◽  
Cross Sectional ◽  
Ferritin Concentration ◽  
Dopamine Concentration ◽  
Correlation Test ◽  
Study Results

Anemia in pregnancy is a common health problems today, where iron deficiency is the main cause. Iron deficiency will affect the various organs and metabolic pathways, especially the central dopamine pathway. Dopamine is a neurotransmitter that is found in brain and affects human interpersonal actions and correlations. The purpose of this study was to determine the correlation of maternal serum feritin with cord blood dopamine concentration. The design of this study was cross sectional, observe 30 pregnant women with their babies born in Rika Hardi, SSiTmaternity clinic. Samples were selected by consecutive sampling. Ferritin and dopamine concentration was checked at BalaiLaboratoriumKesehatan West Sumatera, where ferritin concentration by ECLIA and dopamine concentration by ELISA. Data were analyzed with Spearman correlation test to find the correlation of maternal serum feritin with cord blood dopamine concentration. The study results obtained, mean concentration of maternal serum ferritin 33,21±26,08 ng/mL and cord blood dopamine concentration 172,27±27,21 ng/L. Correlation test of maternal serum feritin with cord blood dopamine concentration had p value = 0,301 (p>0,05). In this study, we can conclude that there is no correlation between maternal serum feritin with cord blood dopamine concentration.Further research is needed by considering various factors that affect maternal ferritin concentration such as food intake and iron supplementation, and which affect dopamine concentration, such as stress and adequate sleep.

scholarly journals Cell Blood Count Alterations and Patterns of Anaemia in Autoimmune Atrophic Gastritis at Diagnosis: A Multicentre Study

2019 ◽  
Vol 8 (11) ◽  
pp. 1992 ◽  
Author(s):  
Marco Vincenzo Lenti ◽  
Edith Lahner ◽  
Gaetano Bergamaschi ◽  
Emanuela Miceli ◽  
Laura Conti ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Atrophic Gastritis ◽  
Blood Count ◽  
Serum Vitamin ◽  
Pernicious Anaemia ◽  
Micronutrient Deficiencies ◽  
Cross Sectional ◽  
Distribution Width ◽  
Autoimmune Atrophic Gastritis

Background: Autoimmune atrophic gastritis (AAG) leads to iron and/or vitamin B12 malabsorption, with subsequent haematological alterations which could represent the sole clinical manifestation. We aimed to assess patterns of anaemia and micronutrient deficiencies in patients with AAG at the time of diagnosis. Methods: Observational, multicentre, cross-sectional study including consecutive adult patients diagnosed with AAG within the last ten years. Cell blood count, red cell distribution width, serum vitamin B12, and ferritin were collected. Multivariate analysis for predictive factors of anaemia was computed. Results: 654 AAG patients (mean age 59.2 ± 13.8 years, female (F): male (M) ratio = 2.3:1) were included. Anaemia was present in 316 patients (48.3%; mean age 60.1 ± 15.8 years, F:M ratio = 2.3:1). Pernicious anaemia (132/316 cases, 41.7%) was more common in males (27.1% versus 12.4%; p = 0.001) and in older patients (63.0 ± 14.6 versus 58.9 ± 14.9 years; p = 0.014), while iron deficiency anaemia (112/316 cases, 35.4%) was more common in females (16.9% versus 10.0%; p = 0.039) and in younger patients (56.8 ± 16.6 versus 60.2 ± 14.6 years; p = 0.043). The prevalence of iron deficiency was equally distributed between anaemic and non-anaemic patients (p = 0.9). Anisocytosis (odds ratio: 10.65, 95% confidence interval: 6.13–18.50, p < 0.0001) was independently associated with anaemia. Conclusions: Anaemia is a common manifestation in AAG patients, mostly due to micronutrient deficiencies. Scant haematologic alterations and micronutrient deficiencies may precede overt anaemia.

scholarly journals Effects of Pubertal Status and Inflammation on the Use of Ferritin to Define Iron Deficiency in Children With Overweight or Obesity

2019 ◽  
Vol 12 ◽  
pp. 117863881983906
Author(s):  
Maria Luz Muzzio ◽  
Ezequiel S Lozano Chiappe ◽  
Laura Kabakian ◽  
Florencia Ferraro ◽  
Ines Landó ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Metabolism ◽  
Complete Blood Count ◽  
Pubertal Development ◽  
Transferrin Saturation ◽  
Cross Sectional Study ◽  
National Guidelines ◽  
Cross Sectional ◽  
Dietary Recall ◽  
Inflammatory State

Background and aims: A worldwide increase in childhood overweight (OW) and obesity (OB) has been reported. OB is an inflammatory state which affects iron metabolism and the sensibility of the tests to detect iron deficiency (ID). Our aim was to evaluate the adequacy of current ferritin cut-offs to define ID in children with OW/OB. Methods: This cross-sectional study included 152 children (54% girls) aged (median [Q1-Q3]) 11 (8-13) years with OW/OB. Complete blood count and iron metabolism were evaluated. Low ferritin, transferrin saturation (TSat), and anemia were defined by age- and sex-specific cut-offs recommended by National Guidelines. Iron intake was assessed in a subgroup (n = 80) by a 24-hour dietary recall. Analyses were made according to pubertal development and ferritin tertiles. Results: The overall prevalence of low ferritin, TSat, and anemia was 2.6%, 23.8%, and 5.2%, respectively. Among pre-pubertal children (n = 87), the frequency of low TSat rose across ferritin tertiles ( P < .05), whereas it decreased among pubertal children (n = 65; P < .005). Cases of anemia among pre-pubertal children were found in the highest ferritin tertile, whereas 4/6 anemia cases in pubertal children were found in the lowest ferritin tertile (<39 µg/L). Pubertal children within the lowest ferritin tertile + low TSat (n = 11) showed lower hemoglobin (–9%; P < .005) and hematocrit (–8%, P < .01) than those in the same tertile + normal TSat (n = 16). The overall prevalence of children with ferritin < 39 µg/L + low TSat was 9.2%. Conclusions: Higher ferritin cut-off values are required to define ID in children with OW/OB. Such cut-off remains to be validated in larger, multi-ethnic cohorts of children with OW/OB.

scholarly journals Prediction of Iron Deficiency by Red Cell Distribution Width, Mean Corpuscular Volume and Haemoglobin Concentration in Pregnant Women

2019 ◽  
Vol 9 (2) ◽  
pp. 111-116
Author(s):  
Gazi Sharmin Sultana ◽  
Syed Aminul Haque ◽  
Farzana Akonjee Mishu ◽  
Md MA Muttalib ◽  
Md Quddusur Rahman
Keyword(s):  
Iron Deficiency ◽  
Pregnant Women ◽  
Mean Corpuscular Volume ◽  
Complete Blood Count ◽  
Haemoglobin Concentration ◽  
Deficiency Anemia ◽  
Corpuscular Volume ◽  
Distribution Width ◽  
Latent Iron Deficiency ◽  
Iron Profile

Background: Red cell distribution width (RDW) is a routine parameter in fully automated hematology auto analyzer, can give the idea of iron deficiency before haemoglobin and mean corpuscular volume in early iron deficiency or latent stage. Patient can be benefited by doing complete blood count including RDW for the diagnosis of early iron deficiency as a cheaper test than iron profile. This study was aimed to predict early iron deficiency by RDW, mean corpuscular volume and haemoglobin concentration in pregnant women. Methods: In this study, 190 pregnant women were included from Gynae and Obstetric outdoor of Bangabandhu Sheikh Mujib Medical University from august 2008-2009. Complete blood count including haemoglobin percentage, mean corpuscular volume and RDW and iron profile were done. RDW was compared with haemoglobin concentration and mean corpuscular volume in various stages of iron deficiency. Results: RDW was more significant than haemoglobin concentration in latent iron deficiency when haemoglobin level was normal (p<0.05). In mild and moderate iron deficiency anemia, RDW was increased progressively though haemoglobin level was reduced. RDW was more significant than mean corpuscular volume level in latent iron deficiency, mild and moderate iron deficiency anemia. The difference of mean corpuscular volume and RDW was statistically significant (p<0.05) in latent iron deficiency, mild iron deficiency anaemia and moderate iron deficiency anaemia (p value of 0.001, 0.001 and 0.011). In this study RDW had sensitivity 82.3% and specificity 97.4%. haemoglobin concentration and mean corpuscular volume had sensitivity 56.6% and 29.2 % and specificity 90.9% and 98.7 % respectively. Based on the receiver-operator characteristic (ROC) curves RDW had the best area (0.925) under curve compared to haemoglobin and mean corpuscular volume. Conclusion: Latent iron deficiency without other existing disease like haemoglobinopathy, early folate / vit B12 deficiency could be predicted early by increased RDW when haemoglobin concentration and mean corpuscular volume were normal. Birdem Med J 2019; 9(2): 111-116

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