Analytical comparison of ELISA and mass spectrometry for quantification of serum hepcidin in critically ill patients

Aim: To compare methods of quantifying serum hepcidin (based on MS and ELISA) and their ability to diagnose true iron deficiency anemia in critically ill patients. Materials & methods: Serum hepcidin was measured in 119 critically ill patients included in the HEPCIDANE clinical trial, using either an ultra-sensitive ELISA kit (from DRG) or two different MS methods. Results: The results show a good correlation between the different methods studied. The Bland–Altman analysis and the Kappa test for clinical groups show a good or very good agreement between the different tests. Conclusion: ELISA or MS show a satisfactory commutability to quantify serum hepcidin. This is of great importance for the determination of therapeutic strategies in iron deficiency.

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Evaluation of the First Commercial Hepcidin ELISA for the Differential Diagnosis of Anemia of Chronic Disease and Iron Deficiency Anemia in Hospitalized Geriatric Patients

ISRN Hematology ◽

10.5402/2012/567491 ◽

2012 ◽

Vol 2012 ◽

pp. 1-3 ◽

Cited By ~ 20

Author(s):

Inge Geerts ◽

Pieter Vermeersch ◽

Etienne Joosten

Keyword(s):

Differential Diagnosis ◽

Chronic Disease ◽

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Geriatric Patients ◽

Deficiency Anemia ◽

Anemia Of Chronic Disease ◽

Elisa Kit ◽

Serum Hepcidin ◽

Hospitalized Geriatric Patients

Introduction. Anemia is a frequent problem in hospitalized geriatric patients, and the anemia of chronic disease (ACD) and iron deficiency anemia (IDA) are the 2 most prevalent causes. The aim of the study was to assess the possible role of serum hepcidin in the differential diagnosis between ACD and IDA. Methods. We investigated serum hepcidin, iron status, anemia, and C-reactive protein in 39 consecutive geriatric patients with ACD and IDA. Serum hepcidin levels were determined using a commercial ELISA kit (DRG Instruments, Marburg, Germany). We also measured hepcidin in 26 healthy controls. Results. The serum hepcidin levels were not significantly higher in the 28 patients with ACD as compared to the 11 patients with IDA. Conclusions. The serum hepcidin levels measured using the commercial ELISA kit (DRG) do not appear to increase in older patients with ACD. It should be noted that an assay-specific problem could explain our results.

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Diagnostic accuracy of serum hepcidin for iron deficiency in critically ill patients with anemia

Intensive Care Medicine ◽

10.1007/s00134-010-1794-8 ◽

2010 ◽

Vol 36 (6) ◽

pp. 1044-1048 ◽

Cited By ~ 53

Author(s):

Sigismond Lasocki ◽

Gabriel Baron ◽

Fathi Driss ◽

Mark Westerman ◽

Hervé Puy ◽

...

Keyword(s):

Iron Deficiency ◽

Diagnostic Accuracy ◽

Critically Ill ◽

Critically Ill Patients ◽

Serum Hepcidin

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Serum Hepcidin: Its Correlation with Serum Ferritin, Serum Iron and Hemoglobin in Patients of Iron Deficiency Anemia

Immunology Endocrine & Metabolic Agents - Medicinal Chemistry ◽

10.2174/187152221402150408110832 ◽

2015 ◽

Vol 14 (2) ◽

pp. 105-113

Author(s):

Sajjad H. Naqvi ◽

Syed Faizan-ul-Hassan Naqvi ◽

Iftikhar H. Naqvi ◽

Muhammad Farhan ◽

Tanveer Abbas ◽

...

Keyword(s):

Iron Deficiency ◽

Iron Deficiency Anemia ◽

Serum Ferritin ◽

Serum Iron ◽

Deficiency Anemia ◽

Serum Hepcidin

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

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3303 ◽

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

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Performance of Automated Telemetry in Diagnosing QT Prolongation in Critically Ill Patients

American Journal of Critical Care ◽

10.4037/ajcc2021568 ◽

2021 ◽

Vol 30 (6) ◽

pp. 466-470

Author(s):

Enrique Calvo-Ayala ◽

Vince Procopio ◽

Hayk Papukhyan ◽

Girish B. Nair

Keyword(s):

Critically Ill ◽

Critically Ill Patients ◽

Demographic Data ◽

Area Under The Curve ◽

Qt Prolongation ◽

Altman Analysis ◽

Poor Agreement ◽

Bland Altman Analysis ◽

Prolonged Qt ◽

Definition Of

Background QT prolongation increases the risk of ventricular arrhythmia and is common among critically ill patients. The gold standard for QT measurement is electrocardiography. Automated measurement of corrected QT (QTc) by cardiac telemetry has been developed, but this method has not been compared with electrocardiography in critically ill patients. Objective To compare the diagnostic performance of QTc values obtained with cardiac telemetry versus electrocardiography. Methods This prospective observational study included patients admitted to intensive care who had an electrocardiogram ordered simultaneously with cardiac telemetry. Demographic data and QTc determined by electrocardiography and telemetry were recorded. Bland-Altman analysis was done, and correlation coefficient and receiver operating characteristic (ROC) coefficient were calculated. Results Fifty-one data points were obtained from 43 patients (65% men). Bland-Altman analysis revealed poor agreement between telemetry and electrocardiography and evidence of fixed and proportional bias. Area under the ROC curve for QTc determined by telemetry was 0.9 (P < .001) for a definition of prolonged QT as QTc ≥ 450 milliseconds in electrocardiography (sensitivity, 88.89%; specificity, 83.33%; cutoff of 464 milliseconds used). Correlation between the 2 methods was only moderate (r = 0.6, P < .001). Conclusions QTc determination by telemetry has poor agreement and moderate correlation with electrocardiography. However, telemetry has an acceptable area under the curve in ROC analysis with tolerable sensitivity and specificity depending on the cutoff used to define prolonged QT. Cardiac telemetry should be used with caution in critically ill patients.

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Comparative Study of the Effects of Lactoferrin versus Oral Iron Therapy in Obese Children and Adolescents with Iron Deficiency Anemia

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2131138 ◽

2021 ◽

pp. 104-114

Author(s):

Manal Mahmoud Atia ◽

Rasha Mohamed Gama ◽

Mohamed Attia Saad ◽

Mohammed Amr Hamam

Keyword(s):

Iron Deficiency ◽

Children And Adolescents ◽

Iron Deficiency Anemia ◽

Interleukin 6 ◽

Oral Iron ◽

Iron Therapy ◽

Deficiency Anemia ◽

Obese Children ◽

Oral Iron Therapy ◽

Serum Hepcidin

Greater prevalence of iron deficiency (ID) has been observed in overweight and obese children and adolescents. Hepcidin acts as a key regulator of iron metabolism. Hepcidin synthesis increases in response inflammatory cytokines especially Interleukin-6 (IL-6). Considering that obesity represents a low grade chronic inflammatory state, a high concentration of hepcidin has been found in obese children. Elevated hepcidin level in obese children is associated with diminished response to oral iron therapy. Lactoferrin is an iron-binding multifunctional glycoprotein and has strong capacity to modulate the inflammatory response by its capacity to reduce pro-inflammatory cytokine expression in vivo, including IL-6 and hepcidin. Aim of the Work: To compare the efficacy of lactoferrin versus oral iron therapy in treatment of obese children and adolescents with iron deficiency anemia and the effect of therapy on serum hepcidin and interleukin 6 levels. Methodology: This prospective randomized clinical trial was conducted on 40 obese children and adolescents aged between 6 –18 years suffering from iron deficiency anemia (IDA). They were equally randomized into one of 2 groups. Group A received regular oral lactoferrin in a dose of 100 mg/day. Group B received regular oral iron supplementation (Ferric hydroxide polymaltose) in a dose of 6 mg elemental iron/kg /day.Baseline investigations included complete blood count (CBC), iron profile (Serum ferritin, serum iron, total iron binding capacity (TIBC), transferrin saturation), serum Interleukin 6, and serum hepcidin. Reevaluation of CBC was done monthly while iron status parameters, serum IL-6 and serum hepcidin were reevaluated after 3 months of receiving regular therapy. Results: Significant elevations in hemoglobin, MCV, MCH, Serum ferritin, serum iron and transferrin saturation with lactoferrin therapy compared to oral iron therapy. Significantly Lower TIBC after 3 months of lactoferrin therapy while the decrease in TIBC was insignificant in the iron therapy group.Lower serum hepcidin and IL6 after 3 months of lactoferrin therapy with no significant change in serum hepcidin and IL6 after iron therapy. Conclusion: This study clearly demonstrated the superiority of lactoferrin over iron use as oral in the treatment of iron deficiency anemia in obese children not only for the better response of hematological and iron status parameters and less gastrointestinal side effects but also for its effect on decreasing inflammatory biomarkers as hepcidin and IL6.

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Effects of Oral Vitamin C on Hepcidin Levels and Erythropoietin Requirements in Functional Iron Deficiency Anemia among Hemodialysis Patients

QJM ◽

10.1093/qjmed/hcab100.015 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Mahmoud Mohamed Zaki Ali ◽

Maha Abd ElMoniem Behairy ◽

Reem Mohsen El Sharabasy ◽

Ahmed Hamed Ahmed Gharib

Keyword(s):

Iron Deficiency ◽

Vitamin C ◽

Iron Deficiency Anemia ◽

Hemodialysis Patients ◽

Deficiency Anemia ◽

Study Group ◽

Oral Vitamin ◽

Functional Iron Deficiency ◽

Serum Hepcidin ◽

Hs Crp

Abstract Background Hepcidin has long been postulated as a key regulatory peptide in iron homeostasis. Its reduced clearance and elevated levels in hemodialysis (HD) patients lead to functional iron deficiency (FID) and ESA resistance. Vitamin C may be used as adjuvant therapy in FID anemia, but there are limited studies investigating the direct relation between vitamin C and hepcidin levels in HD patients. We aimed to test the reducing effect of Oral vitamin C therapy on hepcidin levels among hemodialysis patients with functional iron deficiency anemia. Patients and Methods This study is an open label randomized controlled clinical trial. It was conducted in the hemodialysis units of Ain Shams University hospitals. 48 adult prevalent HD patients were included and were divided into two groups. Group 1 (study group) included 31 patients who received the conventional treatment of erythropoietin stimulating agents (ESAs) together with oral supplementation of vitamin C 500 mg every other day for 3 months in addition to IV iron therapy. Group 2 (control group) included 17 patients who received only the conventional therapy of ESAs according to their hemoglobin (Hb) levels in addition to IV iron therapy. Laboratory parameters including serum hepcidin levels, highly sensitive CRP (hs-CRP) titer, CBC, kidney function tests and iron indices were measured at the baseline of the study and after 3 months. Results Oral vitamin C therapy resulted in a statistically significant reduction in both hepcidin and hs-CRP levels in the study group after 3 months. The study group showed a significant reduction in serum iron and ferritin levels (P < 0.05). A Decrease in EPO requirements and elevation of hemoglobin level were observed in the study group but were not statistically significant as a short term effect of oral vitamin C, in comparison to the control group. A highly significant correlation was observed between serum hepcidin and hs-CRP (R=0.46, P<0.01). Conclusion Oral vitamin C may be a promising therapy in decreasing serum hepcidin and hs-CRP levels in prevalent hemodialysis patients with functional iron deficiency anemia.

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