scholarly journals Assessment of bone marrow iron stores using gale's grading and its correlation with iron deficiency anemia

2021 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Bhavneet Kour ◽  
Ishani Gupta ◽  
Roopali Jandial ◽  
Subhash Bhardwaj
Keyword(s):  
Bone Marrow ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Iron Stores ◽  
Bone Marrow Iron

scholarly journals Prevalence of Iron Deficiency Anemia in Biochemically Defined Moderate to Severely Anemic patients in a Tertiary Care Centre

2019 ◽  
Vol 57 (219) ◽  
Author(s):  
Niharika Shah ◽  
Sairil Pokharel ◽  
Deebya Raj Mishra ◽  
Purbesh Adhikari
Keyword(s):  
Bone Marrow ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Status ◽  
Tertiary Care ◽  
Deficiency Anemia ◽  
Iron Store ◽  
Ferritin Concentration ◽  
Functional Iron Deficiency ◽  
Iron Stores

Introduction: Anemia due to iron deficiency and chronic diseases is common occurrence in developing country like Nepal, the latter seen in patients with various inflammatory, autoimmune, and malignant disorders . The Intensive method of marrow iron examination, which this study has employed, provides clinically useful iron status classification in cases of functional iron deficiency. The aim of the study is to find out the prevalence of iron deficiency anemia in biochemically defined moderate to severe anemic patients in tertiary care center. Methods: A descriptive cross-sectional study was done in 43 patients who underwent bone marrow aspiration for evaluation of any cause and had moderate to severe anemia at the same time over a period of one year from Nov 2015 to 2016. Ethical clearance was obtained from Institutional Review Committee. The bone marrow iron stores were assessed by“intensive method” apart from the routinely used Gale’s method. Data was collected and entry were done in Statistical Package for Social Sciences version 24. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The intensive grading system demonstrated normal marrow iron store in 13 (30.2%), depleted iron stores in 3 (7%), functional iron deficiency in 14 (32.6%), and combined deficiency in 13 (30.2%) patients. Mean log ferritin concentration was lower in patients with depleted iron stores (2.2μg/l) than in those with normal (2.7μg/l), and functional iron deficiency (2.4μg/l). The mean log ferritin in combined deficiency was lower than the mean log ferritin concentration in iron store deficiency (1.9μg/l). Conclusions: The prevalence of functional iron deficiency anemia was greatest when the intensive method for assessment of bone marrow iron was used, thus differentiating four different iron status categories, including functional iron deficiency, from actual iron store deficiency, avoiding unnecessary iron supplementation in the former group.

PITFALLS IN THE DIAGNOSIS AND TREATMENT OF IRON DEFICIENCY ANEMIA IN PEDIATRICS

PEDIATRICS ◽  
1964 ◽  
Vol 34 (1) ◽  
pp. 117-121
Author(s):  
David H. Clement
Keyword(s):  
Iron Deficiency ◽  
Physical Examination ◽  
Iron Deficiency Anemia ◽  
Ferrous Iron ◽  
Reticulocyte Count ◽  
Diagnosis And Treatment ◽  
Deficiency Anemia ◽  
Iron Stores ◽  
Mother Loss ◽  
Oral Preparation

Errors in the diagnosis and treatment of iron-deficiency anemia involve several areas. In the history one may overlook anemia in the mother, loss of infant blood from the placental circuit or later as melena, as well as a diet high in milk and low in iron-rich foods. In the physical examination pallor should not be estimated from facial color alone. In the laboratory a reticulocyte count should be determined before as well as during treatment. Regarding treatment it is important to give enough iron (6 mg/kg/day) for long enough to replenish iron stores. An effective, oral preparation of ferrous iron alone in gradually increasing doses is preferred. Failure to respond suggests several possibilities discussed above.

scholarly journals Serum Transferrin Receptor and Its Ratio to Serum Ferritin in the Diagnosis of Iron Deficiency

Blood ◽  
1997 ◽  
Vol 89 (3) ◽  
pp. 1052-1057 ◽  
Author(s):  
Kari Punnonen ◽  
Kerttu Irjala ◽  
Allan Rajamäki
Keyword(s):  
Bone Marrow ◽  
Iron Deficiency ◽  
Transferrin Receptor ◽  
Laboratory Tests ◽  
Bone Marrow Examination ◽  
Deficiency Anemia ◽  
Serum Transferrin ◽  
Iron Stores ◽  
Serum Transferrin Receptor ◽  
Reference Limits

Abstract The objective of the study was to evaluate the diagnostic efficiency of laboratory tests, including serum transferrin receptor (TfR) measurements, in the diagnosis of iron depletion. The patient population consisted of 129 consecutive anemic patients at the University Hospital of Turku who were given a bone marrow examination. Of these patients, 48 had iron deficiency anemia (IDA), 64 anemia of chronic disease (ACD), and 17 patients had depleted iron stores and an infectious or an inflammatory condition (COMBI). Depletion of iron stores was defined as a complete absence of stainable iron in the bone marrow examination. Serum TfR concentrations were elevated in the vast majority of the IDA and COMBI patients, while in the ACD patients, the levels were within the reference limits reported earlier for healthy subjects. TfR measurement thus provided a reliable diagnosis of iron deficiency anemia (AUCROC 0.98). Serum ferritin measurement also distinguished between IDA patients and ACD patients. However, the optimal decision limit for evaluation of ferritin measurements was considerably above the conventional lower reference limits, complicating the interpretation of this parameter. Calculation of the ratio TfR/log ferritin (TfR-F Index) is a way of combining TfR and ferritin results. This ratio provided an outstanding parameter for the identification of patients with depleted iron stores (AUCROC 1.00). In anemic patients, TfR measurement is a valuable noninvasive tool for the diagnosis of iron depletion, and offers an attractive alternative to more conventional laboratory tests in the detection of depleted iron stores.

Iron Deficiency Anemia in Cancer Patients

2012 ◽  
Vol 08 (02) ◽  
pp. 74
Author(s):  
Mark Janis ◽  
Keyword(s):  
Iron Deficiency ◽  
Cancer Patients ◽  
Iron Deficiency Anemia ◽  
Iron Transport ◽  
The Body ◽  
Deficiency Anemia ◽  
Functional Iron Deficiency ◽  
Iron Stores ◽  
Iv Iron ◽  
Absolute Iron Deficiency

Anemia is highly prevalent, affecting approximately 40 % of cancer patients, and results in a significant decrease in health-related quality of life while also being associated with shorter cancer survival times. A recent survey of 15,000 cancer patients in Europe found that 39 % were anemic at the time of enrolment. In addition, anemia is a recognized complication of myelosuppressive chemotherapy, and it has been estimated that, in the US, around 1.3 million cancer patients who are not anemic at the time of diagnosis will develop anemia during the course of their disease. The etiology of anemia in cancer patients is variable and often multifactorial, and may be the result of an absolute or a functional iron deficiency. Cancer produces an enhanced inflammatory state within the body—causing hepcidin levels to increase and erythropoietin production to decrease—and results in a reduction in erythropoiesis due to impaired iron transport. This type of anemia is known as functional iron deficiency, where the body has adequate iron stores but there are problems with mobilization and transport of the iron. Absolute iron deficiency is when both iron stores and iron transport are low. The National Comprehensive Cancer Network (NCCN) treatment guidelines for cancer-related anemia recommend intravenous (IV) iron products alone for iron repletion in cancer patients with absolute iron deficiency, and erythropoiesis-stimulating agents (ESAs) in combination with IV iron in cancer patients (currently undergoing palliative chemotherapy) with functional iron deficiency. Although IV iron has been demonstrated to enhance the hematopoietic response to ESA therapy, the use of supplemental iron has not yet been optimized in oncology. Here we discuss the significance of iron deficiency anemia in cancer patients and the need to implement tools to properly diagnose this condition, and we provide an overview of the management strategies and recommendations for patients with iron deficiency anemia as outlined in the NCCN guidelines.

Increased plasma transferrin, altered body iron distribution, and microcytic hypochromic anemia in ferrochelatase-deficient mice

Blood ◽  
2006 ◽  
Vol 109 (2) ◽  
pp. 811-818 ◽  
Author(s):  
Saïd Lyoumi ◽  
Marie Abitbol ◽  
Valérie Andrieu ◽  
Dominique Henin ◽  
Elodie Robert ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Iron Deficiency ◽  
Iron Status ◽  
Hypochromic Anemia ◽  
Receptor Expression ◽  
Mutant Mice ◽  
Deficiency Anemia ◽  
Peripheral Tissues ◽  
Iron Distribution ◽  
Iron Stores

Abstract Patients with deficiency in ferrochelatase (FECH), the last enzyme of the heme biosynthetic pathway, experience a painful type of skin photosensitivity called erythropoietic protoporphyria (EPP), which is caused by the excessive production of protoporphyrin IX (PPIX) by erythrocytes. Controversial results have been reported regarding hematologic status and iron status of patients with EPP. We thoroughly explored these parameters in Fechm1Pas mutant mice of 3 different genetic backgrounds. FECH deficiency induced microcytic hypochromic anemia without ringed sideroblasts, little or no hemolysis, and no erythroid hyperplasia. Serum iron, ferritin, hepcidin mRNA, and Dcytb levels were normal. The homozygous Fechm1Pas mutant involved no tissue iron deficiency but showed a clear-cut redistribution of iron stores from peripheral tissues to the spleen, with a concomitant 2- to 3-fold increase in transferrin expression at the mRNA and the protein levels. Erythrocyte PPIX levels strongly correlated with serum transferrin levels. At all stages of differentiation in our study, transferrin receptor expression in bone marrow erythroid cells in Fechm1Pas was normal in mutant mice but not in patients with iron-deficiency anemia. Based on these observations, we suggest that oral iron therapy is not the therapy of choice for patients with EPP and that the PPIX–liver transferrin pathway plays a role in the orchestration of iron distribution between peripheral iron stores, the spleen, and the bone marrow.

scholarly journals Iron Fortification of Whole Wheat Flour Reduces Iron Deficiency and Iron Deficiency Anemia and Increases Body Iron Stores in Indian School-Aged Children

2012 ◽  
Vol 142 (11) ◽  
pp. 1997-2003 ◽  
Author(s):  
Sumithra Muthayya ◽  
Prashanth Thankachan ◽  
Siddhivinayak Hirve ◽  
Vani Amalrajan ◽  
Tinku Thomas ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Wheat Flour ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Iron Fortification ◽  
Indian School ◽  
Whole Wheat Flour ◽  
Iron Stores ◽  
School Aged Children ◽  
Whole Wheat

scholarly journals Socio-economic status, iron deficiency anemia and COVID-19 disease burden – an appraisal

2021 ◽  
Vol 19 (1) ◽  
pp. 52-58
Author(s):  
Kusum Ghosh ◽  
◽  
Diptendu Chatterjee ◽  
Abhisikta Ghosh Roy ◽  
Arup Ratan Bandyopadhyay ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Infectious Diseases ◽  
Iron Deficiency Anemia ◽  
Economic Status ◽  
Case Fatality ◽  
Therapeutic Interventions ◽  
Deficiency Anemia ◽  
Iron Stores ◽  
Socio Economic Status ◽  
Mild Anemia

Introduction. Severe Acute Respiratory Syndrome-2, possesses varying degrees of susceptibility and lethality worldwide and WHO declared this as a pandemic of this century. Aim. In this background, the aim of this present narrative is to provide a complementary overview of how low iron stores and mild anemia offers protection from infectious diseases like COVID-19 by restricting the viral replication and also to suggest some potential adjuvant therapeutic interventions. Material and methods. Therefore, we performed a literature search reviewing pertinent articles and documents. PubMed, Google Scholar, Chemrxiv, MedRxiv, BioRxiv, Preprints and ResearchGate were investigated. Analysis of the literature. Recent studies reported drastic systemic events taking place that contribute to the severe clinical outcomes such as decreased hemoglobin indicating anemia, hypoxia, altered iron metabolism, hypercoagulability, oxidative stress, cytokine storm, hyper-ferritinemia and thus Multi Organ Failure, reportedly hailed as the hallmark of the COVID-19 hyper- inflammatory state. Interestingly it is globally observed that, countries with higher Socio-economic status (SES) have considerably lower prevalence of Iron Deficiency Anemia (IDA) but higher Case Fatality Rate (CFR) rate due to COVID-19 while, low SES countries characterized by the higher prevalence of IDA, are less affected to COVID-19 infection and found to have less CFR, which is almost half to that of the higher SES counterpart. Conclusion. Present review presumed that,low iron stores and mild anemia may play a beneficial role in some cases by offering protection from infectious diseases as low iron restricts the viral replication.Thus, suggested iron chelation or iron sequestration as an alternative beneficial adjuvant in treating COVID-19 infection.

scholarly journals A Case of Acute Ischemic Stroke Associated with Hookworm Anemia.

2021 ◽  
Author(s):  
Jiang-qiong Ke ◽  
Huicong Huang ◽  
Guangyao Zhou ◽  
Yan Li ◽  
Shengmin Shao ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Ischemic Stroke ◽  
Iron Deficiency ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Cerebral Stroke ◽  
Parasitic Diseases ◽  
Normal Brain

Abstract Background: Hookworm disease discovered in a patient presenting with cerebral infarction due to severe iron-deficiency anemia and confirmed by gastroduodenoscopy has not been reported especially with negative stool routine. Case presentation: We report a male patient who presented himself to us with acute cerebral stroke verified as hookworm disease. Routine laboratory tests revealed low Hemoglobin (Hb) concentration but stool routine and occult blood test were normal. Brain magnetic resonance imaging (MRI) showed left-sided parietal-occipital lobe and centrum semiovale (“watershed”) infarction verified the diagnosis of acute ischemic stroke. Bone marrow aspiration showed proliferative bone marrow image with obvious red system hyperplasia. Gastroduodenoscopy discovered adult hematophagic hookworms in the bulb and descending part of duodenum of the patient. A series of conservative drug treatment was initiated and the patient was subsequently treated with albendazole after the gastroduodenoscopy. Twenty-five days later, the patient's physical function improved gradually and he was discharged without neurological deficit. Conclusion: Hookworm disease could be manifest in acute ischemic stroke. It was concluded that patients with severe iron-deficiency anemia should also be examined for rare intestinal parasitic diseases. Screening for these intestinal parasitic diseases in patients presenting with cerebral infarction and anemia could effectively avoid misdiagnosis and make increase the efficacy of treatment.

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