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Query: UMLS:C0162316 (iron deficiency anemia)
 3,806 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a total group of 415 subjects (100 normal controls, 115 with iron deficiency anemia, 100 with the alpha-thalassemia trait, and 100 with the beta-thalassemia trait), the following indexes were analyzed: hemoglobin distribution width, red blood cell distribution width (RDW)-coefficient of variation, and RDW-SD. The hemoglobin distribution width and RDW-coefficient of variation were examined with a laser light scattering system (Technicon H1), whereas the RDW-SD was determined with an impedance autoanalyzer (Sysmex M-2000). All of these parameters helped, to some extent, in the differential diagnosis of microcytic anemia. However, our data suggested a low RDW-SD might provide significantly more value in differentiating thalassemia traits from iron deficiency anemia, as well as from normal controls, while the hemoglobin distribution width gave no help in the differential diagnosis between iron deficiency anemia and the beta-thalassemia trait.
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PMID:Comparison of hemoglobin and red blood cell distribution width in the differential diagnosis of microcytic anemia. 141 42

A prospective study was carried out in 83 patients with microcytic anemia. 43 had iron deficiency anemia, 28 had heterozygous beta thalassemia not associated with iron deficiency (beta-THNID) and 12 had both conditions. The behavior of red blood cell volume distribution width (RDW) was evaluated in all patients. RDW was higher in patients with iron deficiency (20.62 +/- 4.64) and beta-THNID (15.76 +/- 1.41) than in controls (13.29 +/- 0.92) (p less than 0.0001 for both comparisons). There also were statistically significant differences (p less than 0.0001) between both patient groups. In patients with both heterozygous beta thalassemia and iron deficiency (beta-THID), RDW reached similar values to those from patients with only iron deficiency anemia. A significant negative correlation was also found between the transferrin saturation index and RDW (r = -0.614, p less than 0.02). In 34 patients controlled during iron replacement therapy a significant increase of RDW was found after one month of treatment, while hemoglobin concentration and mean corpuscular volume became normal. When 18 was taken as cutoff value for RDW, its positive predictive value was very high in iron deficiency (95%), while it was only 59% in beta-THNID. England's index may help to differentiate between isolated iron deficiency anemia and beta-THID: in patients with RDW higher than 18, the positive predictive value of England's index was 89% for iron deficiency and 57% for beta-THID.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Amplitude of the distribution of erythrocyte size in the differential diagnosis of microcytic anemia]. 233 71

The prevalence of iron deficiency anemia has decreased in recent years because of improved dietary habits. Yet, iron deficiency anemia is still the most common anemia. Among mature adults, anemia of chronic disease is probably more common. Mean corpuscular volume and red cell distribution width, along with a peripheral smear examination, can often distinguish iron deficiency anemia from other common microcytic anemias, such as thalassemia minor. A normal serum iron level excludes iron deficiency anemia and indicates other causes for microcytic anemia. Often, a low serum iron level and total iron-binding capacity are due to chronic disease, and measurement of serum ferritin or a bone marrow stain for hemosiderin will be necessary to diagnose iron deficiency. Iron therapy to restore the red cell mass should be continued until iron stores are replenished.
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PMID:Iron deficiency anemia. How to diagnose and correct. 240 79

A new expert system developed on a Macintosh personal computer using a commercially available artificial intelligence shell was compared with four different discriminant functions (DFs) for the differentiation of microcytic anemia into etiologic categories. Several databases were used with a different composition but all contained at least some samples from thalassemic individuals and from patients with iron deficiency anemia. The DFs analyzed were those proposed by England and Fraser, Green and colleagues, Mentzer, and by Shine and Lal. None of the databases performed satisfactorily when used singly, whereas very high false-positive rates were obtained by one of them. The diagnostic efficiency was somewhat improved by combining several DFs. An expert system using an artificial intelligence "shell" with an "interference engine" was developed using cluster analysis and a set of learning examples. The input necessary for the system to achieve a conclusion consists of MCV, RBC, and RDW as well as a statement as to whether the patient has anemia. Based upon the values of these parameters, the expert system will give an "advice" regarding the probabilities for thalassemia, iron deficiency, and/or other probabilities such as previous transfusions, anemia of chronic disease, laboratory error, etc. In a prospective trial, the system functioned with an accuracy of better than 85%.
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PMID:The use of inference strategies in the differential diagnosis of microcytic anemia. 262 97

Several groups of authors have derived discriminant functions (DFs) based on red cell indices (primarily MCH, MCV, and RDW) that can be used to differentiate iron deficiency from thalassemia minor. The Technicon H*1 analyzer provides a direct MCHC measurement (termed the CHCM), in addition to the conventional computed value (Hgb/PCV). To evaluate the clinical utility of red cell discriminant analysis, chart review was performed in 176 cases for which hemoglobin characterization and quantitation studies had been requested. Six published discriminants were evaluated for cases of clearly defined iron deficiency anemia and thalassemia minor. Overall diagnostic efficiency ranged from 50%-82%, and the diagnostic performance of three of the discriminants failed to achieve statistical significance. Mean values for both MCHC and CHCM were significantly lower in patients with iron deficiency than in patients with other causes of microcytic anemia. It was also observed that MCHC was significantly greater than CHCM in patients with iron deficiency anemia, but not in patients with other causes of microcytic anemia. Both MCHC and the difference between MCHC and CHCM showed potential value as parameters for the differential diagnosis of iron deficiency from other causes of microcytic anemia. It was noted, however, that in 67% of the cases studied, the use of a DF could not have resolved the diagnosis to the extent that hemoglobin characterization and quantitation studies were no longer indicated.
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PMID:The clinical utility of discriminant functions for the differential diagnosis of microcytic anemias. 262 Jan 1

Animals with hereditary abnormalities of hematopoiesis are quite useful in the study of regulatory pathways of megakaryocytopoiesis and platelet formation. Seven such animal models are analyzed here. The Wistar Furth rat has been recently discovered to have reduced platelet number, but large mean platelet volume, and is, therefore, a model of hereditary macrothrombocytopenia. Study of the Wistar Furth rat may help to elucidate the process of platelet formation. Two mouse mutants the S1/S1d and W/Wv, have macrocytic anemia with reduced megakaryocyte number, but normal platelet count. In these mice, the platelet count is maintained by increased platelet production per megakaryocyte. These models demonstrate that factors other than platelet level are monitored in the feedback regulation of megakaryocytopoiesis and platelet production, and further study should lead to a better understanding of the regulation of megakaryocyte size. The Belgrade rat has severe microcytic anemia with decreased megakaryocyte number. Megakaryocyte size is increased, but platelet count is moderately reduced and thus the megakaryocyte-platelet picture resembles that of severe iron deficiency anemia. A more in depth examination of this model should delineate the effects of iron deficiency and hypoxia on megakaryocytopoiesis. The grey collie dog has cyclic hematopoiesis with large asynchronous fluctuations in all blood cell counts at approximately 2-week intervals. Megakaryocytes have not been studied. This model should be a tool to define the relationships between hematopoietic growth factors and differentiation of the various hematopoietic cell lineages. The br/br rabbit has a transient disturbance in fetal megakaryocytopoiesis and brachydactyly due to spontaneous amputation. Further study of this model may provide a better understanding of fetal megakaryocyte development and establish whether an association exists between the abnormal megakaryocytes and the limb amputations. The nude mouse with its severe T-lymphocyte deficiency has been studied to ascertain whether T cells play a regulatory role in normal and acute thrombocytopenia-stimulated megakaryocytopoiesis. The question of whether T cells or their products are responsible for reactive thrombocytosis in chronic inflammation could be examined with this model. These animal mutants have provided and should continue to provide important models for understanding the regulation of megakaryocytopoiesis and platelet production.
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PMID:Animal models with inherited hematopoietic abnormalities as tools to study thrombopoiesis. 264 83

The RBC distribution width has been reported to be of value in the discrimination of iron deficiency anemia from other microcytic anemias, but studies in pediatric populations are lacking. A population of 734 normal children was studied to establish age-appropriate normal values for RBC distribution width. The RBC distribution width of 47 patients with microcytic anemia was then evaluated. RBC distribution width was elevated in 19 of 22 patients with iron deficiency but was also increased in six of 14 patients with thalassemia trait and two of 11 patients with anemia secondary to inflammatory disease. The resulting discrimination was better than that obtained by using Mentzer's index or the discriminant function in the patients studied. The RBC distribution width, albeit a less then perfect tool, can be of value in evaluating pediatric patients with microcytic anemia.
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PMID:Red blood cell distribution width in pediatric microcytic anemias. 361 97

The diagnostic potential of the combined use of zinc-protoporphyrin (ZPP), mean corpuscular volume (MCV) and haemoglobin measurements for discriminating between iron deficiency anaemia, beta-thalassaemia minor and lead poisoning has been studied. Lead poisoning could be identified by ZPP greater than 50 micrograms/dl in the presence of normal MCV or ZPP greater than 150 micrograms/dl in the presence of microcytosis (MCV less than 80 fl) with a sensitivity of 97% and specificity 94%. Beta-thalassaemia minor was identified by the coexistence of microcytosis and ZPP less than 50 micrograms/dl with a sensitivity of 91% and specificity 79%. Iron deficiency anaemia defined by the combination of microcytosis and ZPP ranging from 50 to 150 micrograms/dl was identified with a sensitivity of 95%, but the specificity was only 51%, with many of the patients overlapping with thalassaemia minor. This problem did not exist in iron-deficiency anaemia with haemoglobin less than 10 g/dl as at that range no patients with uncomplicated thalassaemia minor have been encountered. A great advantage of the combined use of ZPP, MCV and haemoglobin for the initial screening of microcytic anaemia is its ease of performance and low cost. However, this information should only be regarded as presumptive evidence of disease, requiring subsequent confirmation by appropriate direct measurements such as transferrin saturation, serum ferritin, haemoglobin electrophoresis, or blood lead determinations.
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PMID:Combined use of zinc protoporphyrin (ZPP), mean corpuscular volume and haemoglobin measurements for classifying microcytic RBC disorders in children and young adults. 407 41

ITF282, a soluble iron succinyl-protein complex, orally administered to the rat elevates the concentration of iron in the serum to a greater extent than ferritin. The serum iron increase induced by ITF282 is delayed when compared with ferrous sulphate. The ITF282 absorption process, like that of ferritin, proceeds along the physiological pathways without bypassing the transfer system of the intestinal mucosal cells since no further increase of serum metal is observed when giving high doses of ITF282 to the rat pretreated with a saturating dose of ferrous sulphate. Hypochromic and microcytic anemia induced in growing rats by bleeding and feeding a low iron diet is sensitive to both prophylactic and therapeutic oral treatment with ITF282. Iron deficiency anemia and cardiomegaly induced in suckling rats by feeding the pregnant and lactating dams with the low iron diet are reversed by oral treatment of the dams with ITF282. Comparative investigations of the therapeutic efficacy of ITF282 and ferritin made on uncomplicated iron deficiency anemia show that the drugs, p.o. administered during 4 weeks, are equally effective. Preliminary toxicological data in the rat, after single and chronic administrations, show that ITF282 is well tolerated. These findings prove that ITF282 gives an adequate supply of iron from which to make hemoglobin.
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PMID:Pharmacological and toxicological studies on an iron succinyl-protein complex (ITF282) for oral treatment of iron deficiency anemia. 633 27

In iron deficiency anaemia basic red cell content of ferritin is appreciably reduced. This variable was determined in 62 patients with rheumatoid arthritis to evaluate conventional laboratory indices for iron deficiency in the anaemia of rheumatoid arthritis. For 23 patients with rheumatoid arthritis and normocytic anaemia irrespective of plasma ferritin concentration, red cell ferritin content did not differ significantly from that for non-anaemic patients with rheumatoid arthritis. For 27 patients with rheumatoid arthritis and microcytic anaemia, the mean red cell ferritin content for patients with a plasma ferritin concentration in the 13-110 micrograms/l range was appreciably reduced. It was indistinguishable from that for patients with rheumatoid arthritis and classical iron deficiency anaemia, indicated by plasma ferritin concentrations of less than 12 micrograms/l. In contrast, the mean red cell ferritin content for patients with rheumatoid arthritis, microcytic anaemia, and plasma ferritin concentrations above 110 micrograms/l did not differ from that for patients with rheumatoid arthritis and normocytic anaemia. Oral treatment with iron in patients with rheumatoid arthritis, microcytic anaemia, and appreciably reduced red cell ferritin concentrations was accompanied by significant increases in haemoglobin concentration (p less than 0.01), mean corpuscular volume (p less than 0.01), and red cell ferritin contents (p less than 0.05). This treatment, however, did not produce any appreciable change in haemoglobin concentration in patients with rheumatoid arthritis, normocytic anaemia, and normal red cell ferritin contents. These findings suggest that the indices for iron deficiency in patients with rheumatoid arthritis and anaemia should include peripheral blood microcytosis together with a plasma ferritin concentration of less than 110 micrograms/l.
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PMID:Red cell ferritin content: a re-evaluation of indices for iron deficiency in the anaemia of rheumatoid arthritis. 643 23


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