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

To determine the etiology of hypoferremia in recently sedentary hunter-gatherers, a community located in the Kalahari Desert of Botswana was studied. Iron profiles of 106 Basarwa (Bushmen, San) volunteers were examined. Hematocrits were measured in the field. The remaining blood was processed for transportation to a research medical laboratory for further studies. Subnormal serum iron values were present, depending on the subpopulation, in 50-52% of the volunteers. Transferrin saturation was subnormal in 35-49% of those tested. The absence of subnormal serum ferritin levels indicates that dietary iron deficiency is not the cause of the hypoferremia. Instead, serum ferritin was greater than 50 micrograms/l (a level indicative of anemia of chronic disease/inflammation) in 92% of the hypoferremic adult Basarwa. We suggest that by depriving microbes of needed iron, the frequency of the anemia of infections and chronic disease in this population might be a response to, and defense against, a chronically high pathogen load in a community that has not yet incorporated sanitation practices appropriate for sedentary aggregations.
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PMID:Etiology of hypoferremia in a recently sedentary Kalahari village. 848 Aug 65

When microcytosis is present in patients with anemia of chronic disease, the mean corpuscular volume (MCV) rarely if ever falls below 70 fL. The lowest MCV previously reported is 67 fL. We describe a patient with anemia of chronic disease with severe microcytosis and an MCV of 61 fL. After correction of the chronic disorder, complete correction of the hematologic values occurred. In patients with a low total iron binding capacity, iron therapy should not be instituted without clearly establishing the presence of iron deficiency irrespective of the degree of microcytosis.
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PMID:Case report: severe microcytosis associated with the anemia of chronic disease. 881 Feb 20

Because anemia is a condition rather than a disease, an underlying cause must be determined when anemia is identified. Microcytic anemia is a common category of anemia. Iron deficiency anemia is the most common type of microcytic anemia and is also the most common anemia. The clinical presentation of anemia varies according to its severity. Anemias resulting from chronic disease and thalassemia are also relatively common types of microcytic anemia and should be differentiated from iron deficiency to avoid repeated unnecessary trials of iron therapy. Low serum ferritin is the best single laboratory parameter for the diagnosis of iron deficiency. Serum iron, total iron binding capacity and hemoglobin electrophoresis, if necessary, can help differentiate the type of microcytic anemia in patients with normal or elevated levels of serum ferritin. If the evaluation identifies iron deficiency as the type of anemia, the underlying cause must be investigated.
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PMID:Microcytic anemia. 916 44

During the last few years the measurement of serum-soluble transferrin receptor (sTfR) has been introduced as a tool to detect iron deficiency and as an analyte to differentiate between anemia caused by iron deficiency (IDA) and that caused by chronic disease (ACD). Commercially available methods have emerged to make diagnostics by sTfR more readily accessible. We documented the analytical performance of a newly introduced IDeA sTfR immunoenzymometric assay (IEMA) by Orion Diagnostica. We also evaluated its clinical performance in 98 consecutive anemic patients, with information derived from bone marrow aspirate samples as the reference for iron status. The clinical usefulness of two other commercially available sTfR assays was assessed for comparison. The analytical performance and clinical applicability of the IDeA were sufficient to support reliable clinical work. We conclude that IDA and iron deficiency in the presence of inflammatory states can be differentiated efficiently from ACD with this new commercial test to measure sTfR.
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PMID:Evaluation of new immunoenzymometric assay for measuring soluble transferrin receptor to detect iron deficiency in anemic patients. 929 46

Algorithms for the differential diagnosis of anemias are commonly based on suspected incidences and simple laboratory parameters. Especially microcytic anemias are diagnosed using algorithms created in Mediterranean or Northern American regions. In a West German region we observe relatively high diagnostic uncertainty regarding common forms of anemias. As a hypothesis, this may be a result of inadequate algorithms not designed for regions with high incidences of anemias of chronic disease and low incidences of thalassemias. To further elucidate diagnostic problems we here report the frequencies of anemias in university hospital outpatients. Based on these data, the diagnostic values of different erythrocyte indices and of red cell distribution width in the differential diagnosis of anemias were calculated. 4525 patient files were reviewed retrospectively. 872 patients presented with anemia, 107 of which were hereditary forms and 765 of other forms. In hereditary anemias the frequency of thalassaemias (50 patients) and corpuscular hemolytic anemias (49 patients) was the same. Nearly half of the other anemias were covered by anemias of chronic disease and true iron deficiency anemias. Several indices intended to separate thalassemias from other microcytic anemias were tested for relevance. Sensitivity was between 0.75 and 0.85. Specificity was between 0.78 and 0.95. Red cell distribution width was not significantly different between thalassemias and iron deficiency. Only a red cell distribution width above 17.0 resulted in a specificity for iron deficiency of 0.91. Red cell distribution width is considered to be an unreliable screening test in a population with a low incidence of thalassemias. The high incidence of anemias of chronic disease in the region investigated should lead to more complex diagnostic procedures than offered by blood count values alone.
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PMID:Erythrocyte indices as screening tests for the differentiation of microcytic anemias. 939 91

The concentration of soluble transferrin receptor (sTfR) in serum is reported to be useful in the diagnosis of iron deficiency, especially for patients with concurrent chronic disease, where routine tests of iron status are compromised by the inflammatory condition. A new diagnostic assay for sTfR is calibrated against natural plasma sTfR, thus minimizing calibration discrepancies that result from differences between the analyte and the cellular transferrin receptor used in other assays. Use of the new assay to measure sTfR concentrations in 225 healthy, hematologically normal adults provided a reference interval against which pathological samples could be compared. There was no difference in the reference intervals for men and women and no correlation of [sTfR] with the age of the subject. Black subjects had significantly higher concentrations than nonblacks, and people living at high altitude had higher concentrations than those living closer to sea level. These differences were additive.
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PMID:Measurement of soluble transferrin receptor in serum of healthy adults. 955 May 51

Interest in including screening for hemochromatosis in the routine medical care of adults has grown in recent years. In March 1997, at a meeting on iron overload at the Centers for Disease Control and Prevention, the directors of four hemochromatosis screening programs described the major challenges that they faced and the lessons that they learned in implementing their programs. Seven issues were consistently described as important challenges: 1) changes in case definitions of hemochromatosis, 2) selection of screening threshold values and identification of false-positive cases, 3) variability and lack of standardization in screening test measurements, 4) physician education, 5) informed consent and concerns about medical and genetic discrimination, 6) patient compliance with screening and therapy, and 7) incidental detection of iron deficiency. The two programs that have been completed report a prevalence of iron overload from hemochromatosis of 4.2 to 4.5 per 1000 persons screened; this is consistent with findings in the recent literature. All programs report that screening is feasible and propose that hemochromatosis be defined by repeated elevated serum transferrin saturation values(with or without DNA test results) rather than by the clinical outcome of excessive iron in tissue. The goal of screening programs is to diagnose iron status disorders, particularly hemochromatosis, before they lead to iron overload and chronic disease states. Further research is needed on the ability of genetic and phenotypic tests to predict the clinical expression of hemochromatosis. The experiences outlined in this report highlight practical issues that need to be addressed when iron status screening for hemochromatosis is implemented. It is hoped that this information will facilitate similar efforts in other health care settings.
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PMID:Screening for hemochromatosis in primary care settings. 986 49

In most chronic disease conditions, the systemic inflammatory response and its mediators play an essential pathogenic role. Protein calorie malnutrition, a prominent feature of end-stage renal disease (ESRD), also develops, largely as a consequence of the systemic inflammatory response. ESRD (uremia), dialysis, systemic metabolic acidosis, and infections activate the systemic inflammatory response. Elevations in C-reactive protein and depressions of serum albumin below 4 g/dL are found in more than 50% of ESRD patients undergoing dialysis. In many patients receiving dialysis, the impact of this acute-phase response on measures of iron metabolism limits the ability to diagnose iron deficiency. Furthermore, there are risks to iron administration, although data linking iron overload to risk of infection in dialysis patients is suggestive, not definitive. It seems reasonable to hypothesize that the greatest risk of iron administration is in patents who are already infected, and the greater risk would be to raise the serum iron level and transferrin saturation precipitously. The total-dose infusion method, which provides all iron required to correct deficiency in 1 dose, is more likely to produce side effects and rapidly raise serum iron levels and transferrin saturation. The use of low-dose intravenous iron supplementation (10 to 20 mg per dialysis treatment or 100 mg every second week) avoids iron overtreatment and should reduce adverse events. In ESRD patients receiving dialysis, the importance of the systemic inflammatory response in the development of protein calorie malnutrition, the impact of the acute-phase response on iron nutriture, and the response to erythropoietin therapy must be considered to achieve an understanding of the altered responses to nutritional therapy in this setting.
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PMID:The systemic inflammatory response and its impact on iron nutriture in end-stage renal disease. 1051 74

The frequency and etiology of anemia were investigated in 2,913 children between six and 16 years of age in Sanliurfa, in the southeast region of Turkey. Anemia was found in 142 (7.8%) children in the 6-11 years of age group, and in 16 (1.5%) in the 12-16 years of age group; in total, in 158 (5.4%) children. Causes were iron deficiency in 93 (58.9%) children, beta-thalassemia heterozygosity in 10 (6.3%) children, chronic disease that causes anemia of inflammation in 30 (19.0%) children, and intestinal parasitic infections in 17 (10.8%) children. In eight (5.1%) children, the cause of anemia could not be determined. The study's results showed that iron deficiency anemia and chronic and parasitic disease are important problems in schoolchildren of Sanliurfa, while beta-thalassemia and hemoglobinopathies have less importance.
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PMID:The frequency and etiology of anemia among children 6-16 years of age in the southeast region of Turkey. 1093 71

Anemia should not be accepted as an inevitable consequence of aging. A cause is found in approximately 80 percent of elderly patients. The most common causes of anemia in the elderly are chronic disease and iron deficiency. Vitamin B12 deficiency, folate deficiency, gastrointestinal bleeding and myelodysplastic syndrome are among other causes of anemia in the elderly. Serum ferritin is the most useful test to differentiate iron deficiency anemia from anemia of chronic disease. Not all cases of vitamin B12 deficiency can be identified by low serum levels. The serum methylmalonic acid level may be useful for diagnosis of vitamin B12 deficiency. Vitamin B12 deficiency is effectively treated with oral vitamin B12 supplementation. Folate deficiency is treated with 1 mg of folic acid daily.
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PMID:Anemia in the elderly. 1103 74


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