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

The prevalence of iron deficiency anemia has decreased in recent years because of improved dietary habits. Yet, iron deficiency anemia is still the most common anemia. Among mature adults, anemia of chronic disease is probably more common. Mean corpuscular volume and red cell distribution width, along with a peripheral smear examination, can often distinguish iron deficiency anemia from other common microcytic anemias, such as thalassemia minor. A normal serum iron level excludes iron deficiency anemia and indicates other causes for microcytic anemia. Often, a low serum iron level and total iron-binding capacity are due to chronic disease, and measurement of serum ferritin or a bone marrow stain for hemosiderin will be necessary to diagnose iron deficiency. Iron therapy to restore the red cell mass should be continued until iron stores are replenished.
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PMID:Iron deficiency anemia. How to diagnose and correct. 240 79

Haematological data on children with mild iron deficiency-anaemia are compared with those of patients with heterozygous beta-thalassemia. The differential diagnosis of beta-thalassemia minor may suspected on the grounds of the blood smear. Confirmation of the diagnosis is based on the MCV, HbA2 and the graphic determination of EVR50 as well as by family survey. With these simple methods beta-thalassemia minor may be diagnosed with reasonable certainty even in the absence of a special laboratory for the determination of the beta-chain deficiency of hemoglobin. The importance of the correct differential diagnosis is stressed because of the danger of unnecessary iron therapy in thalassemia.
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PMID:[Erroneous diagnosis of iron deficiency anemia]. 248 26

Adenosine triphosphate (ATP) and adenosine diphosphate levels are decreased in erythrocytes from individuals with beta-thalassemia minor. Because 5-phosphoribosyl-1-pyrophosphate (PRPP) is an essential precurosr of adenine nucleotides, we tested the hypothesis that impaired PRPP synthesis is a mechanism for the decreased adenine nucleotide content. Erythrocyte PRPP synthetase activity was significantly decreased, and the Michaelis-Menten constant (Km) for ribose-5-phosphate (R5P) was significantly increased in individuals with alpha-thalassemia minor and those with beta-thalassemia minor. Intact erythrocytes from individuals with alpha-thalassemia and those with beta-thalassemia minor also had an impaired rate of PRPP formation. Both the decrease in PRPP synthetase activity and the impaired PRPP formation were also found in erythrocytes with microcytosis resulting from iron deficiency, indicating that these phenomena may not be specific to thalassemia minor. In all individuals examined, the rate of PRPP formation correlated with ATP content, suggesting that either (1) PRPP synthetase activity is a determinant of ATP content or (2) ATP content is a determinant of PRPP synthetase activity. The depletion of ATP from normal erythrocytes did not affect PRPP synthetase activity, suggesting that ATP content is not a determinant of PRPP synthetase activity. However, a decrease in PRPP synthetase activity did cause an impairment in the rate of adenine nucleotide synthesis, suggesting that PRPP synthetase activity is a determinant of ATP content. Taken together, our results suggest that the decrease in PRPP synthetase activity and the resulting impairment in the rate of PRPP formation are mechanisms for the decreased adenine nucleotide content in thalassemic erythrocytes.
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PMID:Decreased erythrocyte phosphoribosylpyrophosphate synthetase activity and impaired formation in thalassemia minor: a mechanism for decreased adenine nucleotide content. 254 52

A Technicon H-1 hematologic analyzer was used to measure the mean leukocyte myeloperoxidase (MPX) in 160 patients seen in a hematology clinic. The normal range was -15 to +10, which included 95% of 300 consecutive hospitalized patients. No abnormalities in the MPX were found in 35 patients with beta-thalassemia minor, 8 with iron deficiency, 14 with myeloproliferative disorders, 17 with autoimmune disorders, and 37 patients with lymphoma in complete remission. On the other hand 36% (10/28) of lymphoma patients with active disease either at diagnosis or relapse had a MPX of greater than 10 compared to only 2.3% (7/300) in hospitalized patients (P less than 0.001). Increased levels of MPX were found primarily in patients with non-Hodgkin's lymphoma (NHL) of intermediate or high grades, or Hodgkin's disease [56% (9/16) compared to only 8.3% (1/12) in those with low grade NHLs, P less than 0.05]. The MPX levels returned to normal after successful treatment. Of the various chemotherapeutic agents used, only hydroxyurea led to a consistent elevation of the MPX. The authors conclude that MPX is commonly increased in patients with lymphoma and in those receiving hydroxyurea. Further studies are required to determine if the MPX is a sensitive test for relapse in patients with lymphomas who had an elevated pretreatment value.
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PMID:The mean leukocyte myeloperoxidase index in hematological patients. 255 19

Several groups of authors have derived discriminant functions (DFs) based on red cell indices (primarily MCH, MCV, and RDW) that can be used to differentiate iron deficiency from thalassemia minor. The Technicon H*1 analyzer provides a direct MCHC measurement (termed the CHCM), in addition to the conventional computed value (Hgb/PCV). To evaluate the clinical utility of red cell discriminant analysis, chart review was performed in 176 cases for which hemoglobin characterization and quantitation studies had been requested. Six published discriminants were evaluated for cases of clearly defined iron deficiency anemia and thalassemia minor. Overall diagnostic efficiency ranged from 50%-82%, and the diagnostic performance of three of the discriminants failed to achieve statistical significance. Mean values for both MCHC and CHCM were significantly lower in patients with iron deficiency than in patients with other causes of microcytic anemia. It was also observed that MCHC was significantly greater than CHCM in patients with iron deficiency anemia, but not in patients with other causes of microcytic anemia. Both MCHC and the difference between MCHC and CHCM showed potential value as parameters for the differential diagnosis of iron deficiency from other causes of microcytic anemia. It was noted, however, that in 67% of the cases studied, the use of a DF could not have resolved the diagnosis to the extent that hemoglobin characterization and quantitation studies were no longer indicated.
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PMID:The clinical utility of discriminant functions for the differential diagnosis of microcytic anemias. 262 Jan 1

Iron deficiency in pregnant women affected with beta-thalassemia minor and minima shows the need for prompt iron treatment. Some notes on the relationship between pregnancy and thalassemia are reported.
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PMID:[Iron therapy in patients with beta-thalassemia minor and minima in pregnancy]. 273 39

A new classification of anemias, which is based on mean corpuscular volume and quantitative anisocytosis (red blood cell distribution width), was evaluated in 331 pregnant women on initial presentation for prenatal care. Seventy-four of them had severe iron depletion (serum ferritin level less than or equal to 10 ng/dl). Contrary to the above classification, early iron deficiency without anemia was infrequently identified by an increase in distribution width (4 of 25 patients). The distribution width was not consistently increased in the 49 anemic, iron-deficient patients; 34 were normal and would have been considered to have thalassemia minor or anemia of chronic disease according to the new classification. The distribution width was no more sensitive than the mean corpuscular volume in suggesting iron deficiency. This study does not confirm the usefulness of the new classification in the diagnosis of iron deficiency in this patient population.
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PMID:An evaluation of red blood cell heterogeneity (increased red blood cell distribution width) in iron deficiency of pregnancy. 291 16

This report describes the findings of a screening program of 918 obstetric patients for thalassemia minor. Patients with erythrocyte mean corpuscular volume (MCV) less than 80 fL on initial complete blood count were evaluated with serum iron, total iron binding capacity, quantitative hemoglobin electrophoresis, and trial of iron replacement. A diagnosis of thalassemia minor was made when microcytosis persisted after exclusion of iron deficiency or other causes of erythrocyte microcytosis. Twenty-six women (2.8% of those screened) had an initial MCV less than 80 fL. Three cases of previously unsuspected thalassemia minor were detected (one alpha-thalassemia, two beta-thalassemia). Of 17 well-documented cases of iron deficiency, 16 had a hemoglobin level above 11 g/dL on initial complete blood count and would not have been otherwise detected until much later in gestation. A simple screening program can effectively identify pregnant women with unrecognized thalassemia minor and can also detect patients with iron deficiency before they become anemic.
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PMID:Antenatal screening for thalassemia minor. 335 69

The laboratory evaluation of anemia begins with a complete blood count and reticulocyte count. The anemia is then categorized as microcytic, macrocytic or normocytic, with or without reticulocytosis. Examination of the peripheral smear and a small number of specific tests confirm the diagnosis. The serum iron level, total iron-binding capacity, serum ferritin level and hemoglobin electrophoresis generally separate the microcytic anemias. The erythrocyte size-distribution width may be particularly helpful in distinguishing iron deficiency from thalassemia minor. Significant changes have occurred in the laboratory evaluation of macrocytic anemia, and a new syndrome of nitrous oxide-induced megaloblastosis and neurologic dysfunction has been recognized. A suggested approach to the hemolytic anemias includes using the micro-Coombs' test and ektacytometry. Finally, a number of causes have been identified for normocytic anemia without reticulocytosis, including normocytic megaloblastic anemia and the acquired immunodeficiency syndrome.
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PMID:Laboratory evaluation of anemia. 357 35

The authors studied 119 children with microcytic anemia who were selected by lack of response to a month's treatment with oral iron. Family studies and retesting after further treatment with iron were done in all cases to ensure accurate diagnosis. Seventy-five cases of beta-thalassemia minor (BTM) and 40 cases of iron deficiency were identified. In all 75 cases of BTM, at least one parent had a mean cell volume (MCV) less than 79 microns. In 35 of 40 children with iron deficiency, the MCV of both parents was normal. In contrast, Hb A2 was normal in 15% (11 of 75) of children with BTM, until they received additional treatment with oral iron. The authors conclude that in children with microcytic anemia unresponsive to a month's treatment with oral iron, the MCV of the parents is superior to Hb A2 in discriminating between iron deficiency and heterozygous beta-thalassemia. Repeated testing after additional treatment with oral iron may be needed to ensure accurate diagnosis.
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PMID:Discrimination between iron deficiency and heterozygous beta-thalassemia in children. 370 8


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