Resolution of Unexplained Iron Deficiency Following Successful Eradication of Helicobacter Pylori in Children

2021 ◽  
Author(s):  
Osama Tanous ◽  
Carina Levin ◽  
Parminder S.Suchdev ◽  
Hanqi Luo ◽  
Firas Rinawi
Keyword(s):  
Helicobacter Pylori ◽  
Iron Deficiency ◽  
Iron Status ◽  
Older Age ◽  
Deficiency Anemia ◽  
Reactive Protein ◽  
Gi Symptoms ◽  
Supplement Therapy ◽  
Upper Gastrointestinal ◽  
Baseline Hemoglobin

Abstract Background: Evidence is needed to inform whether Helicobacter pylori (HP) treatment is beneficial in children with refractory iron deficiency. We aimed to assess association between successful HP eradication and resolution of unexplained iron deficiency. Methods: Medical records of children diagnosed with HP infection (based on histopathology) and without significant upper gastrointestinal source of blood loss, were retrospectively reviewed for presence of iron deficiency. Among those with non-anemic iron deficiency (NAID) or iron deficiency anemia (IDA), hemoglobin, ferritin and C-reactive protein (CRP) levels were compared prior and 6-9 months’ post successful HP eradication. Patients with overt bleeding or subsequent iron supplement therapy post HP diagnosis were excluded. Predictors of resolution of iron deficiency following HP eradication were assessed. Results: Among 60 included children (median age 14.8, IQR12.3-16; 62% males), symptoms of anemia were observed in 20%. A total of 21 (35%) had IDA while the remainder 65% had NAID. Following successful HP eradication, 60% of these 60 patients normalized their iron status. There were significant improvements in both hemoglobin and ferritin following HP eradication with hemoglobin increasing from 12.3g/dL to 13.0 g/dL (P<0.001), and ferritin increasing from 6.3μg/l to 15.1 μg/l (P<0.001). In multivariate logistic regression that assessed sex, ethnicity, baseline hemoglobin, anemia or GI symptoms, previous iron therapy, and time from diagnosis to eradication, older age was the only factor associated with resolution of anemia following HP eradication: (OR 1.65, 95% CI 1.16-2.35, P = 0.005).Conclusion: Successful HP eradication could be helpful in improving iron status among children with refractory NAID or IDA. Older age may predict this outcome. Screening for HP should be considered in the workup of refractory IDA or NAID.

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 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

scholarly journals Iron-Containing Contraceptives and Their Effect on Hemoglobin and Biomarkers of Iron Status: A Narrative Review

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2340
Author(s):  
Jordie A. J. Fischer ◽  
Carolina S. Sasai ◽  
Crystal D. Karakochuk
Keyword(s):  
Oral Contraceptive ◽  
Iron Deficiency ◽  
Contraceptive Use ◽  
Iron Status ◽  
Cost Effective ◽  
Narrative Review ◽  
Deficiency Anemia ◽  
Oral Contraceptive Use ◽  
Contraception Use ◽  
Hb Concentration

Oral contraceptive use has been associated with decreased menstrual blood losses; thus, can independently reduce the risk of anemia and iron deficiency in women. Manufacturers have recently started to include supplemental iron in the non-hormonal placebo tablets of some contraceptives. The aims of this narrative review are: (i) to describe the relationship between oral contraceptive use and both anemia and iron status in women; (ii) to describe the current formulations of iron-containing oral contraceptives (ICOC) available on the market; and (iii) to systematically review the existing literature on the effect of ICOC on biomarkers of anemia and iron status in women. We discovered 21 brands of ICOC, most commonly including 25 mg elemental iron as ferrous fumarate, for seven days, per monthly tablet package. Our search identified one randomized trial evaluating the effectiveness of ICOC use compared to two non-ICOC on increasing hemoglobin (Hb) and iron status biomarker concentrations in women; whereafter 12 months of contraception use, there were no significant differences in Hb concentration nor markers of iron status between the groups. ICOC has the potential to be a cost-effective solution to address both family planning needs and iron deficiency anemia. Yet, more rigorous trials evaluating the effectiveness of ICOC on improving markers of anemia and iron deficiency, as well as investigating the safety of its consumption among iron-replete populations, are warranted.

scholarly journals Consumption of a Double-Fortified Salt Affects Perceptual, Attentional, and Mnemonic Functioning in Women in a Randomized Controlled Trial in India

2017 ◽  
Vol 147 (12) ◽  
pp. 2297-2308 ◽  
Author(s):  
Michael J Wenger ◽  
Laura E Murray-Kolb ◽  
Julie EH Nevins ◽  
Sudha Venkatramanan ◽  
Gregory A Reinhart ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Status ◽  
Controlled Trial ◽  
Reproductive Age ◽  
Deficiency Anemia ◽  
Control Group ◽  
Attention And Memory ◽  
Double Blind ◽  
Iron Deficient ◽  
Mnemonic Function

Abstract Background: Iron deficiency and iron deficiency anemia have been shown to have negative effects on aspects of perception, attention, and memory. Objective: The purpose of this investigation was to assess the extent to which increases in dietary iron consumption are related to improvements in behavioral measures of perceptual, attentional, and mnemonic function. Methods: Women were selected from a randomized, double-blind, controlled food-fortification trial involving ad libitum consumption of either a double-fortified salt (DFS) containing 47 mg potassium iodate/kg and 3.3 mg microencapsulated ferrous fumarate/g (1.1 mg elemental Fe/g) or a control iodized salt. Participants' blood iron status (primary outcomes) and cognitive functioning (secondary outcomes) were assessed at baseline and after 10 mo at endline. The study was performed on a tea plantation in the Darjeeling district of India. Participants (n = 126; 66% iron deficient and 49% anemic at baseline) were otherwise healthy women of reproductive age, 18–55 y. Results: Significant improvements were documented for iron status and for perceptual, attentional, and mnemonic function in the DFS group (percentage of variance accounted for: 16.5%) compared with the control group. In addition, the amount of change in perceptual and cognitive performance was significantly (P < 0.05) related to the amount of change in blood iron markers (mean percentage of variance accounted for: 16.0%) and baseline concentrations of blood iron markers (mean percentage of variance accounted for: 25.0%). Overall, there was evidence that the strongest effects of change in iron status were obtained for perceptual and low-level attentional function. Conclusion: DFS produced measurable and significant improvements in the perceptual, attentional, and mnemonic performance of Indian female tea pickers of reproductive age. This trial was registered at clinicaltrials.gov as NCT01032005.

Effect of Eradication of Helicobacter pylori and Iron Supplementation on the Iron Status of Children with Iron Deficiency

2010 ◽  
Vol 41 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Ximena Duque ◽  
Segundo Moran ◽  
Robertino Mera ◽  
Mayela Medina ◽  
Homero Martinez ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Iron Deficiency ◽  
Iron Supplementation ◽  
Iron Status

Fortification of tempeh with encapsulated iron improves iron status and gut microbiota composition in iron deficiency anemia condition

2018 ◽  
Vol 48 (6) ◽  
pp. 962-972 ◽  
Author(s):  
Rio Jati Kusuma ◽  
Aviria Ermamilia
Keyword(s):  
Iron Deficiency ◽  
Gut Microbiota ◽  
Iron Deficiency Anemia ◽  
Iron Status ◽  
Deficiency Anemia ◽  
Microbiota Composition ◽  
Iron Fortification ◽  
Iron Matrix ◽  
Content Type ◽  
Gut Microbiota Composition

Purpose Iron deficiency anemia (IDA) is one of the most major micronutrient deficiencies worldwide. Food fortification is one strategy for reducing IDA in the population despite concern regarding the gut pathogenic bacteria overgrowth. The purpose of this study was to evaluate the effect of iron encapsulation in banana peel matrix on iron status and gut microbiota composition in iron deficiency anemia. Design/methodology/approach Anemia was induced in 35 male Sprague Dawley rats of age two weeks by the administration of iron-free diet for two weeks. Rats then randomly divided into control, iron-fortified tempeh (temFe) dose 10 and 20 ppm, iron matrix-fortified tempeh dose 10 and 20 ppm and iron matrix fortified tempeh dose 10 and 20 ppm with probiotic mixture. Blood was drawn at Weeks 2 and 6 for hemoglobin and serum iron analysis. Rats were sacrificed at the end of Week 6, and cecal contents were collected for Lactobacillus, Bifidobacteria and Enterobactericeae analysis. Findings Hemoglobin and serum iron were significantly increased (p < 0.05) in all iron-fortified group with the highest value found in iron matrix dose 20 ppm (10.71 ± 0.15 g/dl and 335.83 ± 2.17 µg/dl, respectively). The cecal Lactobacillus and Bifidobacteria did not differ significantly between groups. Cecal Enterobactericeae was significantly different (p < 0.05) among groups with the lowest level in the temFe-20 (2.65 ± 0.78 log CFU) group. Research limitations/implications The use of commercial inoculum instead of pure Rhizopus oligosporus mold for developing the fortified tempeh may impact the effect of product on cecal gut microbiota composition, as different molds and lactic acid bacteria can grow in tempeh when using commercial inoculum. Social implications In Indonesia, iron fortification is conducted primarily in noodles and flour that limits the impact of iron fortification for reducing IDA in population. Iron fortification in food that was daily consumed by people, that is, tempeh, is potential strategy in reducing IDA in population. Originality/value Tempeh fortification using encapsulated iron improved iron status and gut microbiota composition in iron deficiency anemia.

scholarly journals Occurrence of neonatal diarrhea in calves with iron-deficiency anemia

2019 ◽  
Vol 73 (1) ◽  
pp. 1-9
Author(s):  
Radisa Prodanovic ◽  
Sreten Nedic ◽  
Oliver Radanovic ◽  
Vesna Milicevic ◽  
Ivan Vujanac ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Status ◽  
Enterotoxigenic Escherichia Coli ◽  
Deficiency Anemia ◽  
Fecal Samples ◽  
Gut Function ◽  
History Of ◽  
Neonatal Calves ◽  
Diarrheic Calves

Introduction. Neonatal calves are often deficient in iron. Accumulating evidence indicates that iron status is associated with disease pathologies including diarrhea. Our objective was to examine the association between iron status and gut function in neonatal calves with and without a history of calf diarrhea. Materials and Methods. Calves were divided into two groups based on their history of diarrhea; the first group were diarrheic calves (n=6) and the second group were non-diarrheic healthy calves (n=6). Blood samples (n=12) were collected at day 12 of age and erythrogram determination and measurements of serum iron and total iron binding capacity were performed. Hematological values were measured using an automatic analyzer, and biochemical properties were determined spectrophotometrically. Fecal samples were obtained from all calves and pH measured using semi quantitative test strips as well as being examined by bacterial cultivation for enterotoxigenic Escherichia coli, Salmonella spp. and Clostridium perfringens, by RT-PCR for the presence of bovine rotavirus, bovine coronavirus and bovine viral diarrhea virus, and by microscopy for the presence of Cryptosporidium parvum. Results and Conclusions. There were significant iron-related changes for most hematological indices in diarrheic calves; and iron (Fe) deficiency and microcytic, hypochromic anemia were diagnosed. The pH of the feces was significantly higher in diarrheic calves than in the non-diarrheic healthy group (P<0.01). All fecal samples were negative for the analyzed enteric pathogens. According to the results obtained, calves experiencing iron deficiency anemia exhibit changes in gut function leading to diarrhea as compared with a matched group of healthy calves.

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