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Query: UMLS:C0240066 (iron deficiency)
 7,156 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The iron status of a population of 1564 subjects living in the northwestern United States was evaluated by measurements of transferrin saturation, red cell protoporphyrin, and serum ferritin. The frequency distribution of these parameters showed no distinct separation between normal and iron-deficient subjects. When only one of these three parameters was abnormal (transferrin saturation below 15%, red cell protoporphyrin above 100 mug/ml packed red blood cells, serum ferritin below 12 ng/ml), the prevalence of anemia was only slightly greater (10.9%) than in the entire sample (8.3%). The prevalence of anemia was increased to 28% in individuals with two or more abnormal parameters, and to 63% when all three parameters were abnormal. As defined by the presence of at least two abnormal parameters, the prevalence of iron deficiency in various populations separated on the basis of age and sex ranged from 3% in adolescent and adult males to 20% in menstruating women. It is concluded that the accuracy of detecting iron deficiency in population surveys can be substantially improved by employing a battery of laboratory measurements of the iron status.
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PMID:Evaluation of the iron status of a population. 95 65

The anemia observed in patients with partial gastric resection results from a complex interrelationship of deficiencies of these three important hematemics-iron, vitamin B12, and folic acid. Reliance upon morphological evidence of anemia in the peripheral blood smear may be difficult and confusing since deficiency of one hematemic may mask the coexisting deficiency of another. It is common for deficiencies of more than one hematemic to occur in these patients. A number of studies have demonstrated the masking effect of iron deficiency on concurrent vitamin B12 or folic acid deficiency. In addition, the morphologic hallmarks of iron deficiency may be modified by the presence of deficiencies of either vitamin B12 or folate or both. Full hematologic recovery may not occur until more than one hematemic is given to the patient. It is our policy at the University of Florida to rely on serum levels of these three hematemics, especially vitamin B12 and iron, to detect the cause of the anemia in a patient with partial gastric resection. Less reliance is placed upon the appearance of the peripheral smear because of the masking effect described above. If either the serum iron level or vitamin B12 level is decreased, we treat the patient with a preparation such as ferrous sulfate (300 mg. orally three times a day) and vitamin B12 (100 mug. intramuscularly once a month). We are less concerned with folic acid deficiency because of its relatively infrequent occurrence in this setting and because a good diet will usually suffice as adequate therapy for the folic acid deficiency when present. In patients who have had partial gastric resection but who are not anemic, we assess vitamin B12 absorption by the conventional vitamin B12 urinary excretion test (Schilling test) on a yearly basis since deficiency of this hematemic may lead to serious hematologic and neurologic sequelae. If the patient manifests decreased vitamin B12 absorption uncorrected by the administration of pancreatic extract or antibiotics, this patient is also treated with 100 mug. of vitamin B12 intramuscularly on a monthly basis. We have not evaluated the absorption of food B12 as suggested by Doscherholmen. Perhaps more attention should be paid to this aspect of vitamin B12 absorption in these patients. Indeed, because of the serious complications of vitamin B12 deficiency and the observations that deficiencies of this vitamin may occur even when the absorption of crystalline vitamin B12 is normal in the fasting state (the conventional Schilling test), some authors, such as Rygvold, have suggested that prophylactic vitamin B12 be administered to all patients with partial gastric resection.
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PMID:Hematologic abnormalities following gastric resection. 95 76

A state-wide nutritional health survey of Missouri residents conducted in 1973 included hemoglobin, hematocrit, and serum iron determinations on approximately 1,164 persons and dietary iron intake estimates, based on a diet history, for 530 persons. Based on the criteria used for interpretation of the Ten-State Nutrition Survey data, over 19% of all preschool age white children and over 10% of the white children six to 10 years old had low or deficient hemoglobin levels. Between 8 and 17% of the white males between 10 and 60 years old and over 30% of the white males over 59 years old were anemic. Between 3 and 9% of all white females over 9 years of age had low or deficient hemoglobin levels. The levels of anemia for most age and sex groups of Negroes were at least twice as great as for corresponding groups of white persons. Low or deficient hemoglobin levels within the age and sex groups were associated with low hematocrit and serum iron levels; suggesting that some of the anemia was a reflection of iron deficiency. Estimates of the dietary intake of iron indicated that less that 20% of the females 10 to 35 years old and less than 60% of older females and boys under 17 years of age were consuming the Recommended Dietary Allowances. Over 35% of the preschool children and females between 10 and 60 years old were consuming less than two-thirds of their Recommended Dietary Allowances for iron. At least part of the iron deficiency was, therefore, indicated to be related to insufficient dietary intake.
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PMID:The incidence of anemia in residents of Missouri. 97 4

Alterations in reticulocyte size occur 2-3 days after the onset of iron deficient or megaloblastic erythropoiesis and precede, by several weeks, changes in mean corpuscular volume (MCV). Iron-deficiency anemia induced in a normal subject by repeated phlebotomies was characterized by the initial development of larger than normal reticulocytes followed by an abrupt decrease in reticulocyte size. Microreticulocytes appeared 3 days after the fall in per cent iron saturation and antedated the decrease in MCV to below normal by 6 wk. Mean reticulocyte size was disproportionately smaller than normal in patients presenting with iron deficiency. In contrast, reticulocyte size increased abruptly in a patient (and rats) 2-3 days after administration of methotrexate. Mean reticulocyte size was disproportionately larger than normal in patients presenting with folate or vitamin B12 deficiency. Specific replacement therapy with iron, folate, or vitamin B12 was quickly followed by normalization of reticulocyte size.
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PMID:Reticulocyte size in nutritional anemias. 97 64

Finger clubbing, protein-losing enteropathy, and iron deficiency were documented in three children with severe gastroesophageal reflux. One patient had Sandifer syndrome and the other two had the rumination syndrome. In each case, surgical repair of the gastroesophageal reflux resulted in immediate clearing of signs of the Sandifer syndrome, gastroesophageal reflux, and anemia and the return of serum protein levels to normal. There was definite regression of the finger clubbing during the ensuing year. It is suggested that finger clubbing, protein-losing enteropathy, Sandifer syndrome, and rumination be viewed as parts of an extended syndrome of unusual presentations of gastroesophageal reflux.
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PMID:Gastroesophageal reflux with protein-losing enteropathy and finger clubbing. 98 11

Microcytic red blood cells (RBC) occur in iron-deficiency anemia, lead poisoning, and the thalassemia syndromes. Micromeasurement of FEP by acid extraction from RBC was performed on RBC of 64 subjects with RBC mean corpuscular volume less than 78 fl as determined on a Coulter S. FEP was also determined on RBC from 25 nonanemic, normocytic subjects for comparison. The 25 nonanemic subjects, 29 subjects with alpha-thalassemia trait and 16 subjects with beta-thalassemia trait had FEP less than 107 mugm/100 ml RBC. Nineteen microcytic subjects with iron-deficiency anemia had FEP of 185--752 mugm/100 ml RBC. Hemolysates from 8 lead intoxication individuals had FEP values similar to those of iron-deficient patients. The fluorescence emission spectra of lysates with high FEP, which were not extracted, were similar in iron deficiency and lead poisoning. The porphyrin that accumulates in these two conditions appears to be zinc protoporphyrin. Micromeasurement of FEP can be used to initially classify microcytic anemias into either a disturbance of globin synthesis or a disturbance in heme synthesis. Iron-deficiency anemia and lead poisoning cause accumulation of identical prophyrin and cannot be distinguished by fluorometric analysis.
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PMID:Classification of microcytic anemia by fluorometric analysis of free erythrocyte porphyrins (FEP). 100 85

Manifest iron-deficiency anaemia is preceded by a latent stage in which normal haemoglobin levels coexist with low serum iron levels. Regular blood donation involves the removal of significant amounts of iron, and in susceptible donors, may aggravate iron deficiency. It is important for a blood transfusion service to be able to identify these susceptible donors. A commercial kit for the determination of serum iron levels was evaluated and found suitable for introduction as a routine screening test for a transfusion service. A survey of serum iron levels of 200 blood donors showed that 12 1/2% had levels below the normal reference range.
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PMID:Iron and blood donation. Evaluation of a kit method for routine use in a blood transfusion service. 101 26

Clinical and laboratory data characterizing post-haemorrhagic anaemia with still normal iron stores and posthaemorrhagic iron deficiency in the manifest, latent or prelatent stage are presented. Initially, increased 59Fe whole-body iron losses (greater than 0.1-3.6%/day) returned to normal range (less than 0.1%/day) after haemostasis. Subsequently, slow increase of haemoglobin and repletion of iron stores occurred under normal diets. Manifest, latent, and prelatent iron deficiencies were corrected much more rapidly by total doses of 12.0, 10.5 and 8.0 g iron (Fe2+ sulfate), respectively, when 2 X 50 mg/day were given in quick-release capsules apart from meals.
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PMID:Posthaemorrhagic iron deficiency. Clinical course, 59Fe whole-body iron losses, and oral iron supplementation. 103 8

The natural history and haematological features of 18 patients with a chronic form of myelomonocytic leukaemia are described. The majority were elderly and, in this series, females predominated. Haematological prodomata, such as unexplained monocytosis, leucopenia, or thrombocytopenia were common, and the clinical onset was insidious. Splenomegaly was variable but tended to increase as the disease progressed. Anaemia was usually less than in the acute disease, unless compounded by iron deficiency. The blood film typically showed a mixed monocytosis and granulocytosis, cells in both lines showing abnormalities. 'Paramyeloid' cells, appearing in Romanowsky stained films intermediate between myelocytes and monocytes, were characteristic, although cytochemical and electron microscopical analysis suggests that these cells may be allotted to one or other cell line. The marrow aspirate was characteristically hypercellular, showed granulocytic hyperplasia, and, in contrast to the well-differentiated blood picture, the proportion of poorly differentiated cells, including blasts, was high. Serum lysozyme levels were usually raised. Five of the 18 cases survived more than 5 years, while 10 lived 2 years or longer. The morphological and clinical features form part of a spectrum including acute myelomonocytic leukaemia, into which several of the patients transformed. Recognition of the syndrome is important because the patients are probably best managed without intensive chemotherapy.
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PMID:Chronic myelomonocytic leukaemia. 105 74

Thirty-three gravidae with anemia in spite of iron and vitamin supplementation were examined, and 31 were found to have low or very low serum zinc concentrations with regard to the week of gestation. Twenty-three of the 33 showed no bone marrow haemosiderin or only traces. Thirty showed moderate or great increase in intracellular cell debris in the bone marrow macrophages, indicating an increase in intramedullary cell destruction. Two women showed low serum vitamin B-12 or folate concentrations and they also showed lowest zinc concentrations recorded in the series. Twelve of the 33 women gave birth to mature infants by normal delivery; 21 developed complications during labour or gave birth to immature, dysmature, or, in one case, malformed infants and/or were not delivered at normal term. Low serum zinc in pregnant women increases maternal morbidity and involves a higher risk to the fetus. It is suggested that an aetiological relationship exists between low serum zinc concentrations and refractory anaemia of pregnancy resulting in increased intramedullary cell destruction. This effect might be aggravated by iron deficiency.
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PMID:Refractory anaemia of pregnancy as an expression of zinc deficiency. 106 50


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