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

Iron deficiency, defined as a serum ferritin level less than or equal to 50 micrograms/l was found in 28 (11%) of 252 consecutive elderly in-patients (mean age 81 years). Sixteen among them were anaemic and only five had a microcytic anaemia. In a separate study, 15 anaemic and 13 non-anaemic iron-deficient elderly in-patients were investigated in order to evaluate the prevalence of gastrointestinal symptoms and lesions in both groups. In nine of the anaemic and seven of the non-anaemic patients a potential cause for the iron deficiency was established. Most anaemic and non-anaemic patients lacked the symptoms described as suggestive of underlying gastrointestinal pathology. Thus, a ferritin level less than or equal to 50 micrograms/l justifies a gastrointestinal investigation if the general condition allows for it as well in anaemic as in non-anaemic elderly hospitalized patients. Therefore, serum ferritin should be part of the routine biochemical investigation of elderly in-patients.
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PMID:Significance of a low serum ferritin level in elderly in-patients. 814 96

Systemic-onset juvenile chronic arthritis (SoJCA) is associated with high levels of circulating interleukin-6 (IL-6) and is frequently complicated by severe microcytic anemia whose pathogenesis is unclear. Therefore, we studied 20 consecutive SoJCA patients with hemoglobin (Hb) levels <12 g/dL, evaluating erythroid progenitor proliferation, endogenous erythropoietin production, body iron status, and iron supply for erythropoiesis. Hb concentrations ranged from 6.5 to 11.9 g/dL. Hb level was directly related to mean corpuscular volume (r = .82, P < .001) and inversely related to circulating transferrin receptor (r = -.81, P < .001) suggesting that the severity of anemia was directly proportional to the degree of iron-deficient erythropoiesis. Serum ferritin ranged from 18 to 1,660 microgram/L and was unrelated to Hb level. Bone marrow iron stores wore markedly reduced in the three children investigated, and they also showed increased serum transferrin receptor and normal-to-high serum ferritin. All 20 patients had elevated IL-6 levels and normal in vitro growth of erythroid progenitors. Endogenous erythropoietin (epo) production was appropriate for the degree of anemia as judged by both the observed to predicted log (serum epo) ratio 10.95 +/- 0.12) and a comparison of the serum epo-Hb regression found in these subjects with that of thalassemia patients. Multiple regression analysis showed that serum transferrin receptor was the parameter most closely related to hemoglobin concentration: variation in circulating transferrin receptor explained 61% of the variation in Hb level (P < .001). In 10 severely anemic patients, amelioration of anemia following intravenous iron administration resulted in normalization of serum transferrin receptor. Defective iron supply to the erythron rather than blunted epo production is the major cause of the microcytic anemia associated with SoJCA. A true body-iron deficiency caused by decreased iron absorption likely complicates long-lasting inflammation in the most anemic children, and this can be recognized by high serum transferrin receptor levels. Although oral iron is of no benefit, intravenous iron saccharate is a safe and effective means for improving iron availability for erythropoiesis and correcting this anemia. Thus, while chronically high endogenous IL-6 levels do not appear to blunt epo production, they are probably responsible for the observed abnormalities in iron metabolism. Anemia of chronic disease encompasses a variety of anemic conditions whose peculiar features may specifically correlate with the type of cytokine(s) predominantly released.
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PMID:Defective iron supply for erythropoiesis and adequate endogenous erythropoietin production in the anemia associated with systemic-onset juvenile chronic arthritis. 863 55

An attempt was made to create an expert system with sufficient accuracy to diagnose classes of anemia and report presumptive diagnoses directly on the hematology form. The system should simulate the processes of human experts who can reliably achieve diagnostic separability by pattern analysis. A hybrid expert system combining rule-based and artificial neural network (ANN) models was constructed to evaluate microcytic anemia in a 3-layered program using hematocrit (HCT), mean corpuscular volume (MCV), and coefficient of variation of cell distribution width (RDWcv) as inputs. These measurements are available as standard output on most hematology analyzers. Three categories of microcytic anemia were considered, iron deficiency (IDA), hemoglobinopathy (HEM), and anemia of chronic disease (ACD). A novel feature of the model is its construction and training using human expert input alone. Model construction is described in detail. The model's performance was evaluated with actual case data. It was successful in correctly classifying 96.5% of 473 documented cases of microcytic anemia and anemia of chronic disease. It thus exhibits sufficient accuracy for it to be considered for use in reporting microcytic anemia diagnoses on hematology forms.
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PMID:An expert system to diagnose anemia and report results directly on hematology forms. 868 71

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

The red cell distribution width (RDW), and another red cell discriminant function incorporating RDW (MCV2 x RDW/Hgb x 100) were determined in a group of 30 patients with iron deficiency anemia, 30 patients with beta thalassemia trait, and 30 normal subjects. Both RDW and (MCV2 x RDW/Hgb x 100) mean values were significantly higher in iron deficiency anemia than in beta thalassemia trait (p < 0.001). Taking RDW equal or above 21.0 percent among microcytic anemia patients, we identified correctly 90.0 percent of patients with iron deficiency anemia. The sensitivity and specificity of the test were 90.0 percent (IC 95 percent: 0.75-0.98) and 77.0 percent (IC 95 percent: 0.60-0.88), respectively. RDW values below 21.0 percent identified correctly 77.0 percent of beta thalassemia trait with a sensitivity and a specificity of 77.0 percent (IC 95 percent: 0.60-0.88) and 90.0 percent (IC 95 percent: 0.75-0.96), respectively. Taking values of (MCV2 x RDW/Hgb x 100) above and below 80.0 percent as indicative of iron deficiency and beta thalassemia trait, respectively, we identified correctly 97.0 percent of those patients in each group. Both sensitivity and specificity were 97.0 percent (IC 95 percent: 0.84-0.99). These results indicated that the red cell discriminant function incorporating volume dispersion (MCV2 x RDW/Hgb x 100) is a highly sensitive and specific method in the initial screening of patients with microcytic anemia and is better than RDW in differentiating iron deficiency anemia from beta thalassemia trait.
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PMID:Comparison of red cell distribution width and a red cell discriminant function incorporating volume dispersion for distinguishing iron deficiency from beta thalassemia trait in patients with microcytosis. 923 26

Castleman's disease is a rare, benign disorder most commonly located in the mediastinum as a solitary mass. It is a lymphoid tissue disorder characterized by lymphoid proliferation. In this paper we describe a case of asymptomatic interlobar fissure tumor, localized Castleman's disease, hyaline vascular type, in a 30-year-old female. The tumor arose from the interlobar fissure between the right middle and lower lobes. Laboratory data revealed hypochromic microcytic anemia, similar to that found in iron deficiency, and an elevated erythrocyte sedimentation rate. She underwent video-assisted thoracic surgery for excision of the tumor. Anemia disappeared two months after surgery. No recurrence of the lung tumor was seen 19 months following surgery and she remains well.
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PMID:Castleman's disease: a case report. 926 Mar 74

Microcytosis is a common hematological finding, usually related to iron deficiency or beta-thalassemia. When both of these conditions are excluded, alpha-thalassemia must be considered in the differential diagnosis. No simple biochemical test is able to diagnose the alpha-thalassemia trait. Using PCR amplification of the breakpoint in deletional forms, and amplification of the alpha 2 gene and restriction enzyme digestion in non-deletional forms, we identified the alpha-thalassemia carrier status in 42 out of 51 (82%) patients with microcytosis or slight microcytic anemia, unrelated to iron deficiency or beta-thalassemia. Our results underline the usefulness of molecular tests in clinical practice.
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PMID:Feasibility of molecular diagnosis of alpha-thalassemia in the evaluation of microcytosis. 940 28

Iron deficiency is the most common cause of anemia, and the most common cause of iron deficiency is bleeding from the gastrointestinal tract, or gynecological bleeding in the case of women. More rarely it may be due to an increased need for, or a reduction in the uptake of, iron. In addition to the usual clinical symptoms of anemia, there may also be symptoms affecting the skin, mucosae, and appendages of the skin. For the establishment of the diagnosis, the various causes of hypochromic, microcytic anemia must be differentiated, and the underlying cause of the iron deficiency clarified. With respect to treatment, the underlying disease is of primary importance. In the absence of absorption disorders or intolerability, oral replacement of iron in a suitable form is the substitution treatment of choice.
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PMID:[Basic principles and clinical significance of iron deficiency]. 948 Feb 50

Iron deficiency is the most common cause of anemia in adolescents and is of continuing concern in Japan. We have conducted screening for anemia in adolescents in the Tokyo area since 1966. Screening for the prevalence of anemia is important both for identifying populations at risk and determining the appropriate treatment for individual patients. The number of junior and senior high school students enrolled in the screening program was 793 in 1966, which increased to more than 70,000 by 1989. A normal hemoglobin (Hb) level was present in 90% of students before 1981, and in 98% of boys and 95% of girls in 1990. The percentage of girls with a normal Hb level has decreased gradually since 1991. The high incidence of mild hypochromic microcytic anemia suggests an increase in the prevalence of iron deficiency. Dieting may be the cause of this undesirable phenomenon in adolescents.
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PMID:Prevalence of anemia in Japanese adolescents: 30 years' experience in screening for anemia. 1007 54

Aluminum, a trivalent cation unable to undergo redox reactions, has been linked to many diseases such as dialysis dementia and microcytic anemia without iron deficiency. It has also been implicated in Alzheimer's disease although this is controversial. Because cell death due to oxidative injury is suspected to be a contributory factor in many neurological diseases and aluminum neurotoxicity, glioma (C-6) and neuroblastoma (NBP2) cells were utilized to assess early changes in oxidative parameters consequent to a 48-h exposure to aluminum sulfate. A 500-microM concentration of this salt produced a significant increase in reactive oxygen species (ROS) production and a significant decrease in glutathione (GSH) content in glioma cells. However, the same concentration of the aluminum salt did not lead to any significant changes in the neuroblastoma cells. Mitochondrial respiratory activity in glioma cells was also found to be significantly higher in the aluminum treated cells. As judged by morin-metal complex formation, aluminum can enter glioma cells much more readily than neuroblastoma cells. Thus, it is possible that the cerebral target following an acute exposure to aluminum may be glial rather than neuronal.
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PMID:Aluminum-induced oxidative events in cell lines: glioma are more responsive than neuroblastoma. 1038 Nov 87


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