scholarly journals Evaluation of Reticulated Haemoglobin (CHr) as a diagnostic parameter in Iron Deficiency Anemia

Author(s):  
C. C. Kariyawasan ◽  
D. J. U. S. Samarasekara ◽  
N. Vithanage ◽  
D. M. C. Dissanayake ◽  
S. A. C. D. Ranatunga ◽  
...  

Introduction: Iron deficiency anemia (IDA) is the commonest nutritional deficiency in all parts of the world. In developing countries, the commonest cause is inadequate dietary intake [1]. The red cell indices raise the suspicion of iron deficiency state due to the microcytic, hypochromic changes and the wide red cell distribution width. The iron studies are confirmatory of an iron deficiency state, but are not accurate in the presence of infection, inflammation or malignancy as they are acute phase proteins and are affected in these states making the serum iron studies unreliable under these conditions. The reticulocyte haemoglobin content (CHr) indicates the iron available in the marrow for the production of Hb and are not affected by the above-mentioned situations and therefore has been recommended as a reliable marker of iron status in the body. The value for CHr given in the literature was 25pg [3]. Objectives: General objective was to evaluate the significance of CHr in the diagnosis of IDA. The Specific objectives were to compare CHr with the other conventional iron parameters including serum iron, serum ferritin, TS and TIBC and evaluate any significance of CHr with RBC indices (MCV, MCH and MCHC) and age. Methodology: A retrospective analytical study performed at the Department of Haematology of a Tertiary care hospital in Sri Lanka. Data was obtained from the patient records of those referred to the Haematology department for management of iron deficiency during the period of 9 months commencing from April 2019 to January 2020. Data from 178 adult patients both males and females (16 to 84 years) diagnosed with IDA (S. Ferritin < 20ng/ml) (Hb < 12g/dl in men and Hb <11.5g/dl in women) were randomly selected. In pregnant females the S. Ferritin level considered was <30ng/ml and the Hb level was <11g/dl in the first trimester and 10.5g/dl in the 2nd and third trimester [4]. Blood count and CHr was analyzed using Mindray fully automated analyzer BC 6800, Serum iron and TIBC was measured with Mindray BS 480 and Serum ferritin with Advia Centaur Xp. TS was calculated by dividing serum iron by TIBC and multiplying by 100. A data extraction sheet was used to enter the investigations with the results. Statistical Analysis: Data were double entered and were analyzed using Statistical Package for Social Sciences (SPSS) version 20. Descriptive statistical methods were used to calculate the median and the mean ± standard deviation of Hb, serum iron, serum ferritin, TIBC, TS, MCV, MCH, MCHC and CHr. Pearson’s correlation was used to evaluate the correlation between variables. Coefficient of determination (R Sq) was used to a statistical measure of how close the data are to the fitted regression line. P < 0.05 was considered significant. Conclusion: Significant positive correlations were observed between the CHr and haematological parameters such as Hb, MCV, MCH, and MCHC and biochemical parameters including serum iron, serum ferritin, and TS (p value < 0.001). Negative correlation was seen between the CHr and TIBC and there was no correlation with age. The mean value of CHr was 22.4 ±4.16pg and median was 22.2 pg.  

Author(s):  
Sajjad H. Naqvi ◽  
Syed Faizan-ul-Hassan Naqvi ◽  
Iftikhar H. Naqvi ◽  
Muhammad Farhan ◽  
Tanveer Abbas ◽  
...  

Author(s):  
Kirtan Krishna ◽  
Achint Krishna ◽  
Divya Teja G. N.

Background: Postpartum iron deficiency anemia is common in India as a consequence of postpartum hemorrhage.  Recent studies have evaluated the use of parenteral iron as a better tolerated treatment modality. Compared with oral iron supplements, parenteral iron is associated with a rapid rise in serum ferritin and hemoglobin and improved maternal fatigue scores in the postpartum period.  Parenteral iron may be considered for the treatment of postpartum anemia. The objective of the study was to evaluate the efficacy, safety, and tolerability of intravenous ferric carboxymaltose, in women with postpartum anemia.Methods: A clinical observational study was undertaken in a tertiary care hospital,  50 women within six weeks of delivery with Hb ≥6 gm/dl and ≤10 gm/dl received 1000 mg/week,  over 15 minutes or less, repeated weekly to a calculated replacement dose (maximum 2500 mg) . Hemoglobin and serum ferritin levels were recorded prior to treatment and on day 21 after completion of treatment.Results: Ferric carboxymaltose-treated subjects achieved a hemoglobin greater than 12 gm/dL in a short time period (21 days), achieve a hemoglobin rise of ≥3 gm/dL more quickly, and attain higher serum ferritin levels. It is also associated with better patient compliance, and shorter treatment period. Drug-related adverse events occurred less frequently with ferric carboxymaltose. The only noted disadvantage was that it is more expensive when compared to other iron preperations.Conclusions: Intravenous ferric carboxymaltose was safe and well tolerated with good efficacy and better patient compliance in the treatment of postpartum iron deficiency anemia.


Author(s):  
Novita Indayanie ◽  
Banundari Rachmawati

Anemia chronic disease is the second common cause after iron deficiency anemia with hemoglobin levels below the referencevalue. The pathogenesis of anemia should be determined for treatment. Hematinics and or erythropoietin are other treatments besidestransfusion. The transfusion is started when Hb≤7g/dL. The PRC transfusion of 4ml/kg could increase Hb level by 1 g/dL, or 1 unit andcould increase 3–5% of hematocrit. The objective of this study was to know the correlation of PRC unit with delta Hb and erythrocytesin anemia of chronic disease. The 60 samples examined were from patients of the Kariadi Hospital Semarang suffering from anemia ofchronic disease and who were transfused with PRC from January up to March 2014. The study subjects comprised 28 men (46.7%) and32 women (53.3%), with a mean age of 47 years. The number of PRC given was between one (1) to four (4) units. The mean delta Hbwas 3.48 and the mean delta erythrocytes was about 1.03 (0.1 to 2.3). There was a significant correlation between PRC units and deltaHb (r:0.856, p:0.000), as well as delta erythrocytes (r:0.716, p:0.000). Based on this study, it can be concluded that PRC units have avery strong correlation with delta Hb and as well as with delta erythrocytes in patients suffering from anemia of chronic disease


Author(s):  
Novita Indayanie ◽  
Banundari Rachmawati

Anemia chronic disease is the second common cause after iron deficiency anemia with hemoglobin levels below the reference value. The pathogenesis of anemia should be determined for treatment. Hematinics and or erythropoietin are other treatments besidestransfusion. The transfusion is started when Hb≤7g/dL. The PRC transfusion of 4ml/kg could increase Hb level by 1 g/dL, or 1 unit and could increase 3–5% of hematocrit. The objective of this study was to know the correlation of PRC unit with delta Hb and erythrocytes in anemia of chronic disease. The 60 samples examined were from patients of the Kariadi Hospital Semarang suffering from anemia of chronic disease and who were transfused with PRC from January up to March 2014. The study subjects comprised 28 men (46.7%) and 32 women (53.3%), with a mean age of 47 years. The number of PRC given was between one (1) to four (4) units. The mean delta Hb was 3.48 and the mean delta erythrocytes was about 1.03 (0.1 to 2.3). There was a significant correlation between PRC units and delta Hb (r:0.856, p:0.000), as well as delta erythrocytes (r:0.716, p:0.000). Based on this study, it can be concluded that PRC units have a very strong correlation with delta Hb and as well as with delta erythrocytes in patients suffering from anemia of chronic disease


Author(s):  
Atta Ullah ◽  
Ali Muhammad Yousafzai ◽  
Gul Nabi Khan ◽  
Nasir Iqbal ◽  
Bashir Ahmad

Abstract: The aim of this study was to find out the incidence of anemia in pregnant women of Swat District; to analyze the iron variations and its dietary effects.Data were collected during the periods of January &ndash; September 2016. The study of samples comprised of 250 pregnant women in the different trimester. Blood sample from each woman was collected and full blood count (FBC) was conducted through Mindray BC-3000 plus hem analyzer for all pregnant individuals. Confirmed anemic cases were then examined for IDA with serum ferritin, serum iron, total iron binding capacity (TIBC) through Randox kit and serum transferrin saturation was estimated by formula (serum ferritin saturation =serum iron &times;100/TIBC). The total number of participants in the first trimester were 50, among them 26 women were suffer from iron deficiency anemia (IDA) with 52% weightage of prevalence rate, (mean Hb concentration 9.602 &plusmn; 0.87 g/dl). The rates of IDA were 63.3%; ( mean Hb concentration 8.48 &plusmn; 1.24 g/dl) and 54%; ( mean Hb concentration 9.18 &plusmn; 1.28 g/dl), among 150 and 50 participants in the second and third trimester, respectively. A significant correlation was found between serum ferritin and Hb, serum ferritin against MCV and serum ferritin against MCH. The high prevalence of anemia was found 78.2% in the age group from 26-30 followed by 78.2% in the age group 36-40 years compared to those of other age groups in the second trimester. In this study the prevalence of IDA in third trimester is lower compared to first and second trimester.


2015 ◽  
Vol 39 (2) ◽  
pp. 66-71
Author(s):  
Jamal A. AL Jabbar Attawi

     This research aimed at identifying the relationship of iron-deficiency anemia caused by insufficient dietary intake and the iron-deficiency anemia caused by parasitic worms such as hookworms. Whole blood was drawn from 40 specimens; 20 males and 20 females, normal healthy controls with age ranges 8-50 year. Blood samples were collected from 80 patients with symptoms of anemia, with age range from 10-50 year. After fecal examination, they were divided into two groups: Group one, iron-deficiency anemia with non-parasitic; and group two, iron-deficiency anemia with parasitic. Blood samples were divided into two container, one for the hemoglobin, other for serum ferritin and elements of iron, zinc in tubes without anticoagulants. Results demonstrated a significant decrease in the levels of serum iron, serum ferritin, and hemoglobin in male and female patients (in group one without parasitic worms) as compared with control groups. Furthermore (in two groups with and without parasitic worms), a significant decrease in the level of serum zinc in male and female patients as compared with control group. A significant decrease in the levels of serum iron, ferritin and hemoglobin were observed in male and female patients with iron-deficiency anemia caused by parasitic hookworms compared with control group. The worm burden was classified as light, moderate and heavy as estimated by egg counts per gram of faeces, so results showed the median increase with developing of iron deficiency anemia from parasitic hookworms.


Biomedicine ◽  
2020 ◽  
Vol 39 (2) ◽  
pp. 268-273
Author(s):  
N. L Sharanya Raj ◽  
U Ajay Sharma ◽  
M. L Revathi Devi ◽  
S. M Purushothama ◽  
S. N Manjunath ◽  
...  

Introduction and Aim: Iron deficiency anemia is the commonest cause of anemia in developing country like India in all age groups. It is most easy to prevent as well as to treat. Its diagnosis and treatment are based on serum ferritin levels in developed countries which is not possible in India at primary healthcare setting. This study was undertaken to explore if red cell indices could replace serum ferritin in detecting iron deficiency. Materials and Methods: Study of association of red cell indices like Mean Corpuscular Volume (MCV), Mean Corpuscular hemoglobin (MCH), Mean Corpuscular hemoglobin Concentration (MCHC), Red cell Distribution Width (RDW) and Hemoglobin concentration (Hb%) with iron deficiency anemia and the correlation of these Red cell indices and Hb% with serum ferritin was done in 220 anemia patients of all age groups with Hb% <12g/dL. Results: Descriptive data showed skewed distribution of serum ferritin. Statistically significant reduction in all red cell indices values among iron deficiency anemia patients and statistically significant correlation of all red cell indices values except red cell distribution width with serum ferritin was found. Conclusion: Unlike developed countries we can use simple estimation of hemoglobin concentration along with red cell indices for diagnosing iron deficiency anemia in primary healthcare setting of India.  


2020 ◽  
Vol 11 (2) ◽  
pp. 43-50
Author(s):  
Tatiana I. Tsidaeva ◽  
Kristina G. Tomaeva ◽  
Sergey N. Gaidukov ◽  
Nikolai N. Rukhliada ◽  
Aida A. Cheldieva ◽  
...  

The aim of the study: to study the frequency of anemia in pregnant women with different somatotypes and to develop a model for predicting the risk of this pathology. Materials and methods. 390 women were examined. Of the women studied 110 were mаcrosomatotype, 173 mesosomatotype, and 107 microsomatotype. Somatometry was performed according to R.N. Dorokhov for women in early pregnancy (before 910 weeks of gestation). In blood test the level of hemoglobin, red blood cells, and hematocrit is determined using the Medonic M-series hematological automatic analyzer. Serum iron levels were determined colorimetrically with ferrosine. Serum ferritin levels were determined spectrophotometrically using ELISA methods. Results. It was found that iron deficiency anemia was significantly more common in pregnant women of macro-and microsomatic body type compared to women with mesosomatotypes (p 0.05). Pregnant women with severe anemia were not found. There were iron deficiency anemia of mild and moderate severity, and latent iron deficiency. Hematological parameters (hematocrit, serum iron, serum ferritin) were significantly lower in pregnant women with latent iron deficiency compared to women without anemia (p 0.05). Using multiple regression analysis, we obtained the regression equation (formula), which predicts the development of iron deficiency anemia in pregnant women of different somatotypes. Conclusions. The calculations according to the presented formula, allows to predict with high accuracy the prognosis of iron deficiency anemia in pregnant women, and also allows to form among patients a high-risk group for the development of this disease in the first trimester of pregnancy when the pregnant woman is registered in the womens consultation, which will contribute to more effective implementation of therapeutic and preventive measures to prevent the development of this pathology.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sarika Verma ◽  
Ruchika Gupta ◽  
Madhur Kudesia ◽  
Alka Mathur ◽  
Gopal Krishan ◽  
...  

Background. Coexistence of iron deficiency anemia (IDA) and beta thalassemia trait (BTT) has been the topic of few studies. However, no study from our country was found evaluating the effect of iron therapy in patients with concomitant IDA and BTT. Methods. Over a period of two years, 30 patients with concomitant IDA and BTT were included. All the patients had a complete blood count, serum iron studies, and thalassemia screening using BIORADTM hemoglobin testing system. The patients received oral iron therapy in appropriate dosages for a period of twenty weeks, after which all the investigations were repeated. Appropriate statistical methods were applied for comparison of pre- and posttherapy data. Results. All except two patients were adults with a marked female preponderance. Oral iron therapy led to statistically significant improvement in hemoglobin, red cell indices (P<0.05), and marked change in serum iron, ferritin, and HbA2 levels (P<0.001). There was a significant reduction in the total iron binding capacity levels. Conclusion. The present study shows the frequent occurrence of iron deficiency anemia in patients with beta thalassemia trait, which can potentially confound the diagnosis of the latter. Hence, iron deficiency should be identified and rectified in patients with suspicion of beta thalassemia trait.


2018 ◽  
Vol 7 (1) ◽  
pp. 1-5
Author(s):  
Rinku Joshi ◽  
Dhan Bahadur Shrestha ◽  
Drishti RL Shah ◽  
Sitaram Khadka

Background and aim: Iron deficiency refers to the reduction of iron stores that precedes overt iron deficiency anemia. Iron deficiency anemia (IDA) is the commonest nutritional deficiency around the globe. Though etiology of IDA is multifaceted, and results from the iron demands which is not met by iron absorption in the body, regardless of the reason. This study was aimed to observe the several hematologic parameters among IDA cases presented to a tertiary level referral hospital of Nepal army.Methods: This prospective hospital based study was conducted among cases of iron deficiency anemia presented to a hematology clinic for six-month duration. With the help of semi-structured questionnaire demographic variables, presenting complaints, baseline laboratory parameters, iron profile and etiology of iron deficiency anemia were recorded. The collected data were entered in SPSS version 22 and analyzed.Results: In the six-month study period, there were 175 IDA cases who presented to hematology clinic. IDA was more common in females accounting 78% of 175 cases while rest were male. Mean value of parameters of iron profile were all significantly lower than normal range except TIBC which was significantly raised clinching the diagnosis of IDA. Weakness was the commonest mode of presentation (83, 47.4%). Poor intake was the main culprit of IDA (88, 50.3%). Most of the cases (82, 46.9%) belonged to moderate anemia group. Severity of anemia was associated with platelet count and total leucocyte count (p<0.05) while it was not associated with iron profile values (p>0.05).Conclusion: In adult group, IDA is more common in women and non-specific symptoms like weakness is the commonest mode of presentation. Poor dietary intake is the main cause of IDA in our context. Among IDA cases, most of them belonged to moderate anemia.


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