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

Approximately 50% of cancer patients develop anemia. In the past, the only available treatment option for these patients was transfusion. Since the late 1980s, recombinant human erythropoietin (rHuEPO, epoetin alfa [Epogen, Procrit]) has provided a treatment alternative. Controlled clinical trials have shown that rHuEPO increases hemoglobin and hematocrit levels and reduces the need for transfusions in patients with cancer-related anemia. These controlled trials have suggested (as larger, uncontrolled studies) that the improvements in hemoglobin are associated with increases in energy level, functional status, and overall quality of life. However, only about 50% of patients respond adequately to usual doses of rHuEPO. In the chronic renal failure population, functional iron deficiency is the most common cause of inadequate response to rHuEPO. It has been hypothesized that functional iron deficiency may also occur in cancer patients receiving rHuEPO and may account for the lack of response in up to half of those patients. Studies in renal failure patients have shown that administration of intravenous iron can correct functional iron deficiency more effectively than oral iron and may improve response to rHuEPO. Intravenous iron also reduces the total amount of rHuEPO needed to normalize hematocrit and hemoglobin levels, thereby reducing treatment costs. Ongoing clinical trials are evaluating whether IV iron can also improve rHuEPO responsiveness in patients with cancer-related anemia.
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PMID:Role of iron in optimizing responses of anemic cancer patients to erythropoietin. 1023

This article is a review of literature from Medline and other sources, which shows that coeliac disease is far more prevalent than previously considered. The clinical picture is very diverse, making diagnosis difficult in many patients and calling for great clinical awareness. Even patients with no or few symptoms have biochemical signs of malabsorption, e.g. folate, vitamin, and iron deficiency, and many exhibit osteopenia. Patients with untreated coeliac disease carry a significant risk of developing malignancies. Risk groups for screening are family members, patients with coeliac associated disorders, and patients with uncharacteristic symptoms. Screening among apparently healthy subjects has been carried out for epidemiological purposes, but is not recommended outside protocols. Diagnosing coeliac disease is important because lifelong strict dietary treatment is effective in alleviating symptoms and preventing longterm complications.
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PMID:[Screening for adult celiac disease]. 1038 34

About 50% of cancer patients develop anemia; this incidence rises dramatically in patients with more advanced cancer or in those receiving chemotherapy or radiation therapy. Since the late 1980s, recombinant human erythropoietin (rHuEPO) has provided a safe and effective option for treating cancer-related anemia and fatigue. However, only about 50% of patients treated with rHuEPO adequately respond to therapy. In the chronic renal failure (CRF) population, true iron deficiency is the most common cause of an inadequate response to rHuEPO. Functional iron deficiency occurs when iron cannot be provided rapidly enough to meet the demands of rHuEPO-induced erythropoiesis, despite the presence of adequate bone marrow iron stores. It is hypothesized that functional iron deficiency can also occur in cancer patients receiving rHuEPO and may account for the lack of response in a proportion of the oncology population. Studies in CRF patients have shown that the administration of i.v. iron can correct functional iron deficiency more effectively than oral iron and may improve rHuEPO response. Therefore, it is important to monitor iron status and to address either true or functional iron deficiency prior to and during rHuEPO therapy to optimize the effect of rHuEPO in cancer patients. Studies are currently under way to determine the role of i.v. iron in treating cancer-related anemia.
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PMID:Supplemental Iron: A Key to Optimizing the Response of Cancer-Related Anemia to rHuEPO? 1038 16

Human milk is the preferred feeding for all infants, including premature and sick newborns, with rare exceptions. However, modern technology has produced alternative, "humanized formulae", which closely mimic the composition of human milk. The ingestion of human milk, "humanized formulae" or whole cow's milk has consequences for human nutrition. Gastroesophageal reflux, iron deficiency, calcium and sodium excesses or deficiencies may be influenced by the type and amount of milk fed to the infant. Likewise, neurological development and the likelihood of developing diabetes or cancer may also be influenced by early dietary practices. Until new information is available, we should continue to pattern formulae for older infants after breast milk, but with sufficient protein, calories, lipid and minerals to support optimal growth.
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PMID:Cow's milk versus formula in older infants: consequences for human nutrition. 1056 25

This article is a review of literature from Medline and other sources, which shows that coeliac disease is far more prevalent than previously considered. The clinical picture is very diverse, making diagnosis difficult in many patients and calling for great clinical awareness. Even patients with no or few symptoms have biochemical signs of malabsorption, e.g. folate, vitamin, and iron deficiency, and many exhibit osteopenia. Patients with untreated coeliac disease carry a significant risk of developing malignancies. Risk groups for screening are family members, patients with coeliac associated disorders, and patients with uncharacteristic symptoms. Screening among apparently healthy subjects has been carried out for epidemiological purposes, but is not recommended outside protocols. Diagnosing coeliac disease is important because lifelong strict dietary treatment is effective in alleviating symptoms and preventing longterm complications.
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PMID:[Screening for celiac disease in adults]. 1057 63

Iron deficiency anaemia commonly presents in patients who are asymptomatic. In the absence of published guidelines the search for a cause in such cases is frequently uncoordinated, and risks delay in the diagnosis of pathologies requiring urgent attention. This audit was undertaken to determine how thoroughly patients referred to the gastrointestinal unit in a district general hospital between 1990 and 1995 had been investigated, and to draw up guidelines for future practice on the basis of its results. From the case notes of 334 patients examined endoscopically for anaemia 126 were identified as having both proved iron deficiency and a lack of clinical pointers to its cause. The percentage and details of diagnoses made during initial study and a median follow up period of 28 months were ascertained, together with the certified diagnoses of patients who had died. A cause of iron deficiency was identified in 48 (38%) of patients, 22 with cancer. Ten others received a diagnosis during follow up, of whom three died from the condition to which their anaemia had been attributed. Death certificates supplied diagnoses of potential relevance in three further cases. The main gaps in endoscopic coverage consisted of omitting duodenal biopsy or colonoscopy after negative upper gastrointestinal endoscopy. Moreover, diagnosis of certain extraintestinal pathologies, including cancers, was sometimes delayed for lack of liaison between gastroenterologists and other specialists. These and other points have been addressed in the guidelines now proposed.
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PMID:Audit of the investigation of iron deficiency anaemia in a district general hospital, with sample guidelines for future practice. 1072 59

Ferritin is the principal iron storage protein participating in iron metabolism. As serum ferritin levels often reflect the amount of storage iron in the body, physicians have measured serum ferritin in order to evaluate iron deficiency or overload. Although a rise in serum ferritin concentration occurs in iron overload, hyperferritinemia without it has been reported in some inflammatory diseases and malignancies. Some cytokines have been reported to be responsible for the elevation of ferritin production. Studies on serum isoferritin in adult Still's disease and other diseases, especially measurements of the proportion of glycosylated ferritin, have been widely accepted. Pathophysiological properties of the increased serum ferritin are not clear. However, we should be aware that the hyperferritinemia is not a result, but is profoundly participating in the disease process.
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PMID:[Hyperferritinemia and diseases]. 1086 14

Serum transferrin receptor is considered as a reliable marker of iron status particularly when iron deficiency is associated with chronic disorders such as inflammation, infection or malignancy. The present study aims to illustrate the performances of a new fully automated assay using immunonephelometry. The intra and between-assay precision was found to be very good (CVs < 4%). In healthy subjects there was no statistically significant difference between men and women. With a cut-off of 1.76 mg/l for diagnosing iron deficiency either alone or combined with anemia of chronic diseases, the sensitivity and specificity were respectively 82% and 96.8%. Unlike conventional biochemical and hematological tests, soluble transferrin receptor was unaffected by confounding pathologies. In genetic hemochromatosis the concentration of soluble transferrin receptor was mostly decreased due to the regulatory effect of iron intracellular level. Our study confirms the reliability of soluble transferrin receptor for the assessment of iron status. It is now possible to assay soluble transferrin receptor, ferritin and transferrin on the same apparatus within 15 minutes.
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PMID:Assessment of iron status with a new fully automated assay for transferrin receptor in human serum. 1095 28

We encountered two patients who presented with hypochromic-microcytic anemia and were refractory to iron therapy. The symptoms were suggestive of anemia of chronic disease (ACD); however, there was no evidence of any such disease, either inflammatory or malignant. These patients were reminiscent of patients originally described as having primary defective iron reutilization. The hematologic picture consisted of hypochromic-microcytic anemia, low serum iron, low to normal iron binding capacity, high serum ferritin, and increased bone marrow iron in the absence of ringed sideroblasts. These patients had symptomatic anemia and received danazol (200 mg orally) three times per day to which they responded very well with an increase of approximately 3 g in the hemoglobin concentration over 1 year and amelioration of their symptoms. Danazol was well tolerated and did not cause any virilizing side effects. Doses were lowered in maintenance after 1 year to 200 mg once per week, and responses were sustained up to 36 months of follow-up duration. In the differential diagnosis of hypochromic-microcytic anemia, especially in postmenopausal women, one has to consider this type of treatable anemia when more common types such as iron deficiency, chronic inflammation, malignancy, sideroblastic anemia, or thalassemia have been ruled out.
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PMID:Treatment of primary defective iron-reutilization syndrome: revisited. 1098 70

Iron deficiency remains a major health risk in the United States, despite the apparent availability of a high-quality diet. In the United States, at least 7.8 million adolescent girls and premenopausal women are iron-deficient. Worldwide, the challenge of identifying and treating iron deficiency is enormous. Physicians involved in the primary care and in the obstetric and gynecologic care of women of all ages must be aware of the nature of the problem and the correct approach to screening, diagnosis, and treatment. The potential benefit to newborns and infants and to their mothers is substantial. Furthermore, a thorough diagnostic evaluation has considerable potential for uncovering a potentially lethal disease, such as gastrointestinal malignancy, in a curable phase.
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PMID:Iron deficiency in pregnancy, obstetrics, and gynecology. 1100 34


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