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

A method is described which enables simple and accurate measurement of the separate steps of iron absorption. A double isotope technique was used with 59Fe as a tracer and 51Cr (as CrCl3) as an inert, not absorbable indicator. With a whole-body counter it was possible not only to measure initial mucosal uptake and retention but also to calculate mucosal transfer of iron. Thus faeces collection for determination of mucosal uptake of iron was no longer necessary. Absorption of a physiological dose of inorganic iron was studied in 25 normal subjects (15 males and 10 females), in 21 patients with uncomplicated iron deficiency and in 8 patients with idiopathic haemosiderosis. A significant difference was demonstrated between normals and patients with iron deficiency and in idiopathic haemosiderosis with respect to the various steps of iron absorption. The method provides a simple tool for the study of the regulation of iron absorption at the luminal and intracellular site of the intestinal mucosal cell.
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PMID:Mucosal uptake, mucosal transfer and retention of iron, measured by whole-body counting. 12 3

Six black infants and young children with high titers of milk precipitins were identified by screening the sera of 160 children with idiopathic chronic lung disease. None of the six had immunoglobulin deficiency, elevation of sweat chlorides, SS hemoglobin, or recurrent aspiration. All six children had typical manifestations of milk-induced pulmonary hemosiderosis: recurrent pulmonary infiltrates (6/6), hemosiderin-laden pulmonary macrophages (5/6), intermittent wheezing (5/6), eosinophilia (4/6), anemia (4/6), iron deficiency (4/4), failure to thrive (4/6), and elevated levels of serum IgE (4/4). Three children also had chronic rhinitis and eventually developed large adenoids, hypercapnia and acidosis during sleep, and right heart failure. Elimination of cow milk from the diet, symptomatic therapy, and adenoidectomy when indicated resulted in improvement of all six patients. Pulmonary hemosiderosis and some cases of upper airway obstruction with pulmonary hypertension appear to be two stages, early and delayed, of the same immunophysiologic process. Early dietary intervention may prevent the cardiovascular complications of this process.
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PMID:Hyperreactivity to cow milk in young children with pulmonary hemosiderosis and cor pulmonale secondary to nasopharyngeal obstruction. 117 19

Iron deficiency anaemia was detected in 23% of cases with homozygous sickle cell disease. The aetiology of iron deficiency was similar to the other population in the community. High serum ferritin level was detected in 15.4% of the cases and was well correlated to the number of transfusions. Tissue haemosiderosis was not detected in any case. Patients with heterozygous sickle cell had either normal or low serum ferritin levels.
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PMID:Iron in sickle cell disease. 146 1

Enlarged spleen, fever, increased susceptibility to infections, and thrombocytosis, are manifestations of iron deficiency which are relatively specific of pediatric patients. Iron deficiency anemia is part of everyday pediatrics. Patients are referred to the hematologist in the following situations: 1) Therapy is ineffective for one of the following reasons: the hypochromic anemia is not caused by iron deficiency (hemoglobinopathies); iron is less efficiently used because of transferrin deficiency or infectious, inflammatory or cancerous disease; iron therapy is inadequate either because of insufficient dosage or of suboptimal duration. 2) A relapse occurs in spite of adequate therapy. Before investigating the digestive tract, abnormal hemostasis. Osler-Weber-Rendu syndrome and pulmonary hemosiderosis should be considered. 3) Iron deficiency anemia is less common in adolescents. This condition, known as chlorosis, results mainly from increased needs, unbalanced diet, and onset of menses. In some cases no explanation is found but iron therapy leads to recovery. 4) Difficult problems arise in patients with complex anemias: iron deficiency with folic acid or vitamin B12 deficiency; hyposideremia complicating one of the hemoglobinopathies.
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PMID:[Iron-deficiency anemia. Hematologist's viewpoint]. 629 49

The most common cause of anaemia in childhood is iron deficiency. Anaemia due to poor dietary iron is seen most often between 9-24 months of age in infants being fed with large amounts of milk during periods of high growth rate. After the age of two years one must look for other causes of iron deficiency, particularly blood loss. In the description of three cases of idiopathic pulmonary haemosiderosis, the problems of severe chronic anaemia in childhood are discussed. Idiopathic pulmonary haemosiderosis is a rare disease in children, characterized by iron deficiency, anaemia and pulmonary symptoms. It has a high mortality, mostly due to acute pulmonary haemorrhage. However, early diagnosis is important, as some therapeutical regimens have succeeded in delaying the pulmonary haemorrhages and a few patients have possibly gained complete remission.
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PMID:[Idiopathic pulmonary hemosiderosis. A cause of severe iron deficiency anemia in childhood]. 783 32

Serum iron concentrations were studied in two groups of Hausa women, one of pregnant subjects attending the antenatal clinics at a health centre and one of lactating subjects attending the centre's postnatal clinics. It was thought possible that the normal diet of the pregnant women had sufficient iron content to meet the women's increased demands for this metal. Of the pregnant women, 17% had serum iron concentrations of < or = 490 micrograms/litre [14% with microcytic hypochromia and a mean cell haemoglobin concentration (239 +/- 2 g/litre) indicative of iron deficiency, plus 3% with normocytic-microcytic hypochromia] and 7% had normocytic-microcytic cells and 525 +/- 25 micrograms iron/litre of serum. The low serum iron in 17% of the pregnant women may be the result of repeated pregnancies without proper child spacing, leading to maternal iron deficiency syndrome, or of infestation by the parasites that are prevalent in rural areas, or to both. None of the lactating mothers was found to be iron deficient and there were apparently no cases of haemosiderosis. Mean (+/- S.D.) blood haemoglobin concentrations (87.5 +/- 1.3 g/litre), packed cell volumes (32 +/- 3.2%), mean cell haemoglobin concentrations (274 +/- 37 g/litre) and serum iron concentrations (735 +/- 261 micrograms/litre) were all significantly lower in the pregnant women (P < 0.001) than in the lactating women (105.7 +/- 12.9 g/litre, 36.8 +/- 3.4%, 288 +/- 32 g/litre and 1154 +/- 277 micrograms/litre, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diet and serum iron status in pregnant and lactating Hausa women in Kano State, Nigeria. 789 83

Haemodialysis patients with iron overload sometimes develop resistance to erythropoietin therapy due to 'functional iron deficiency'. It is known that this resistance may be overcome by iron supplementation; however, the latter could worsen haemosiderosis. Therefore, we treated four iron-overloaded haemodialysis patients who had developed relative resistance to erythropoietin (among whom three had features of 'functional iron deficiency') with ascorbic acid (500 mg intravenously after haemodialysis, 1-3 times a week). The erythropoietin doses were voluntarily kept unchanged during the study. After a latency of 2-4 weeks, haematocrit and haemoglobin had increased respectively from 26.5 +/- 0.7 to 32.7 +/- 0.4 vol% and from 8.8 +/- 0.3 to 10.8 +/- 0.2 g/dl (means +/- SEM, P < 0.001). While serum ferritin remained unchanged, transferrin saturation increased from 27 +/- 7 to 54 +/- 12% (P < 0.05), suggesting that ascorbic acid supplementation had allowed mobilization of iron from tissue burdens. In one patient, haematocrit declined after withdrawal of vitamin C and increased again after rechallenge. Also, ascorbate supplementation was continued after the study in two patients and allowed the erythropoietin doses to be decreased, 8 and 11 weeks, respectively, after the start of the trial. When a control group of seven patients with normal iron status and without resistance to erythropoietin were challenged in the same manner with ascorbate, no elevation of haematocrit or transferrin saturation was noted. We conclude that ascorbate supplementation may circumvent resistance to erythropoietin that sometimes occurs in iron-overloaded patients, in particular, in the setting of 'functional iron deficiency'.
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PMID:Resistance to erythropoietin in iron-overloaded haemodialysis patients can be overcome by ascorbic acid administration. 852 94

This report describes an 11-year-old boy with idiopathic pulmonary hemosiderosis. His only presenting symptom was severe anemia due to iron deficiency. Idiopathic pulmonary hemosiderosis was diagnosed nine years after the onset of symptoms. During this period many invasive and non-contributory investigations were performed. This report describes the patient's diagnostic problems, clinical features and dramatic improvement with chloroquine (250 mg/day) after failing to respond to megadose methylprednisolone (30 mg/kg). One year later, chloroquine was discontinued. The patient has remained in remission since March 1994. Chloroquine should be used for this life-threatening condition since it is less toxic than other immunosuppressive drugs.
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PMID:Chloroquine in idiopathic pulmonary hemosiderosis. A case report. 1086 2

Idiopathic pulmonary haemosiderosis is an uncommon disorder, which is characterized by iron deficiency, recurrent haemoptysis and diffuse parenchymal infiltration on chest radiograph. We report an 8 year old child who had past history of multiple blood transfusions with diagnosis of iron deficiency anaemia and recurrent chest infection since the age of 21/2 year. At the age of 8 years, the child presented with fever and severe respiratory distress requiring intubation and ventilation. On Chest X-ray, bilateral white out was found and CT scan lung showed diffuse alveolar involvement. Lung biopsy confirmed haemosiderin-laden macrophages. Child was put on steroids and despite severe anaemia (Hb 3.2 g/dl), he showed improvement and survived. To our knowledge, this is the first case of idiopathic pulmonary haemosiderosis reported from Pakistan.
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PMID:Idiopathic pulmonary haemosiderosis presenting as severe iron deficiency anaemia--a case from Pakistan. 2386 64

The routine use of recombinant erythropoiesis-stimulating agents (ESA) over the past three decades has enabled the partial correction of anaemia in most patients with end-stage renal disease (ESRD). Since ESA use frequently leads to iron deficiency, almost all ESA-treated haemodialysis patients worldwide receive intravenous iron (IV) to ensure sufficient available iron during ESA therapy. Patients with inflammatory bowel disease (IBD) are also often treated with IV iron preparations, as anaemia is common in IBD. Over the past few years, liver magnetic resonance imaging (MRI) has become the gold standard method for non-invasive diagnosis and follow-up of iron overload diseases. Studies using MRI to quantify liver iron concentration in ESRD have shown a link between high infused iron dose and risk of haemosiderosis in dialysis patients. In September 2017, the Pharmacovigilance Committee (PRAC) of the European Medicines Agency (EMA) considered convergent publications over the last few years on iatrogenic haemosiderosis in dialysis patients and requested that companies holding marketing authorization for iron products should investigate the risk of iron overload, particularly in patients with end-stage renal disease on dialysis and, by analogy, patients with IBD. We present a narrative review of data supporting the views and decision of the EMA, and then give our expert opinion on this controversial field of anaemia therapeutics.
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PMID:Risk of iron overload with chronic indiscriminate use of intravenous iron products in ESRD and IBD populations. 3133 66


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