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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 is common during the first years of life. Yet, there is a paucity of data on scholar children. Our main objective was to estimate the prevalence of ferropenic anemia in children 3 to 12 years of age living under conditions of poverty. A total of 323 children were included, 171 attended to a day care institution (group A) and 152 were from the same community but not attended in the day care institution (group B). Hemoglobin (Hb), medium corpuscular volume (MCV) and serum ferritin (SF) were measured in all children. In those with Hb < or = 11 g/dl and/or MCV < or = 73 fl and/or SF < or = 15 microg/l, transferrin saturation (TS) and soluble transferrin receptors (sTR) were also measured. Iron deficiency was defined as SF < or = 15 mg/l and ferropenic anemia was defined as Hb < or = 11 g/dl or MCV < or = 73 fl with sTR > or = 38 mmol/l and SF < or = 10 microg/l or TS < or = 10%. There were no differences between the groups regarding age, weight, height, education, gender and housing conditions. Mean hemoglobin level was 12.6 g/dl (group A: 12.4 g/dl vs. group B: 12.7 g/dl; p=0.012), and mean SF was 45 mg/l, without significant differences between groups. Prevalence of iron deficiency anemia was 2.5% (8/323) and iron deficiency was 4.4% (14/317), without significant differences between groups. These results persisted after controlling for confounding variables. In this group of children living under conditions of poverty in Argentina, iron deficiency anemia was uncommon. We attribute this phenomenon to local affordability of some inexpensive cuts of red meat.
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PMID:[Prevalence of iron deficiency anemia in a group of pre-school and school children, living in conditions of poverty]. 1563 23

A randomized, double-blind, placebo-controlled trial was performed to assess the efficacy of different micronutrient supplementation regimes for improving micronutrient status, preventing anemia, and growth faltering of Vietnamese infants. A population-based sample of 306 infants aged 6-12 mo, split in 4 treatment groups, received daily multiple micronutrient (DMM), daily placebo (P), weekly multiple micronutrient (WMM), or daily iron (DI) supplements for 6 mo, 7 d/wk, under supervision. Weight and length were measured monthly, and anemia and plasma levels of ferritin, zinc, riboflavin, retinol, tocopherol, and homocysteine were determined before and after the supplementation. Z-scores for length-for-age and weight-for-age worsened significantly in all groups, but the length-for-age Z-score decreased significantly less in the DMM group (-0.32 +/- 0.05) than in the P and WMM groups (-0.49 +/- 0.05 and -0.51 +/- 0.05, respectively, P = 0.001). Hemoglobin levels increased significantly more in the DMM group [mean (95%CI): 16.4 g/L (12.4-20.4)] than in the P group [8.6 g/L (5.0-12.2), P = 0.04), with intermediate nonsignificant increases in the WMM [15.0 g/L (11.5-18.5)] and the DI [12.9 g/L (8.4-17.3)] groups. Ferritin changes were significantly greater in DMM (12.1 microg/L) and DI (9.5 microg/L) than in P (-14.7 microg/L) and WMM groups (-9.7 microg/L). Of the other micronutrients, only tocopherol showed a significantly greater level in the DMM group compared with P. Anemia still affected a quarter and zinc deficiency affected a third of infants although there was no iron deficiency after 6 mo of supplementation with DMM, suggesting that multiple factors are causing anemia and that the dose of zinc is too small.
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PMID:Multiple micronutrient supplementation improves anemia, micronutrient nutrient status, and growth of Vietnamese infants: double-blind, randomized, placebo-controlled trial. 1573 11

Although alpha0-thalassemia (thal) defects are not very frequent in the Iranian population, Hb H disease does occur in the country. We have analyzed the alpha gene cluster of 13 patients showing the presence of Hb H to establish the molecular background of this disease in southwest Iran (Shiraz and Hormozgan provinces). Using gap-polymerase chain reaction (gap-PCR) and direct DNA sequencing we have found the --MED-I deletion, the polyadenylation signal (poly A) mutations alphaT-Saudi alpha and alphaT-Turkish alpha and Hb Constant Spring (Hb CS) in association with the common -alpha3.7 deletion. This study has revealed that: 1) at least six genotypes are responsible for Hb H disease in the area: .-alpha3.7/ --MED-I; -alpha3.7/alphaT-Saudi alpha; alphaT-Saudi alpha/alphaT-Saudi alpha; alphaCSalpha/--MED-I; --MED-I/alphaT-Turkish alpha; and the atypical forms of Hb H disease -alpha3.7/alphaCSalpha. 2) The molecular background of Hb H disease in the southwest area of Iran is more similar to the Mediterranean type than to the Southeast Asian. 3) Hb Bart's hydrops fetalis syndrome and mild, intermediate or severe postnatal Hb H disease conditions can be expected, but at a relatively low incidence. 4) The diagnostic flowchart for patients with microcytic hypochromic anemia should include iron deficiency, beta-thal, alpha+- and alpha0-thal analyses.
Hemoglobin 2005
PMID:Molecular basis of Hb H disease in southwest Iran. 1576 54

Increasing multi-ethnicity is likely to make alpha-thalassemia (alpha-thal) more prevalent in Western metropolitan areas. Multiplex polymerase chain reaction (m-PCR) allows rapid and precise identification of most of alpha-thal carriers. With this method, we sought to determine the prevalence of alpha-thal and the corresponding genotype, among all non repetitive consecutive blood samples that had an unexplained microcytosis. These specimens had been sent to the hematology laboratory for a blood count analysis, found to be microcytic, and secondarily tested for ferritin level and hemoglobin (Hb) high performance liquid chromatography (HPLC) profile. Five hundred and sixteen microcytic blood samples were evaluated and 197 samples with normal ferritin and Hb HPLC were studied by m-PCR. Among 196 interpretable PCRs, 48 alpha-thal cases (24.5%) were identified: 28 with a single alpha-globin gene deletion and 20 with two alpha-globin gene deletions. Of these 20 cases, six showed two deletions in cis. None of the erythrocytic parameters studied predicted the presence of alpha-thal deletions. We conclude that a significant proportion (24.5%) of blood counts with microcytosis not explained by an iron deficiency, an inflammatory state or an abnormal Hb on HPLC, are caused by an alpha-globin gene deletion. The pertinence of genetic counseling for alpha-thal based on molecular diagnosis should be evaluated more formally in urban centers where this genetic condition is likely to have an increasing prevalence and clinical relevance.
Hemoglobin 2005
PMID:Prevalence of alpha-globin gene deletions among patients with unexplained microcytosis in a North-American population. 1576 55

An association between Helicobacter pylori infection and iron deficiency anemia has been reported in children, and it has been proposed that H. pylori infection needs to be eradicated to treat absolutely iron deficiency anemia (IDA). We investigated whether there was any correlation between H. pylori infection and iron deficiency (ID) and IDA in children, and whether the eradication of H. pylori infection without iron treatment would lead to the resolution of ID. Hemoglobin and ferritin levels, H. pylori stool antigen test and (14)C urea breath test were measured in 140 children aged 6--16 years (median 9.5 years). Children with H. pylori infection were divided into three groups on the basis of hemoglobin, mean corpuscular volume (MCV), and serum ferritin levels: groups of IDA, ID, and control. All the children received anti-H. pylori combination therapy consisting of amoxicillin, clarithromycin, and lansoprazole. Hemoglobin and MCV values rose significantly compared with baseline values after H. pylori eradication without iron supplementation in children with IDA (p=0.002 and p=0.003, respectively). Ferritin values increased significantly after H. pylori eradication in children with ID (p<0.001). We conclude that complete recovery of ID and IDA can be achieved with H. pylori eradication without iron supplementation in children with H. pylori infection.
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PMID:Is there a relationship between childhood Helicobacter pylori infection and iron deficiency anemia? 1585 6

Anemia due to iron deficiency is the most prevalent form of micronutrient malnutrition in the world, however, the causal relationship between anemia and infection remains unclear. We examined prospectively, the association between anemia and infection among Bedouin infants. We recruited 293 families and newborns from the Bedouin population, which is ongoing major lifestyle changes, during the periods of 1989-1992 and 1994-1997 and followed them to age 18 months. The number of diarrhea and respiratory disease episodes as well as total days of diarrhea were ascertained weekly. Hemoglobin levels were obtained at age 6 months. Additional data on feeding practices, environmental, household and demographic characteristics were obtained throughout the 18 months. Diarrhea before 6 months of age was found to be a risk factor for diarrhea after that age. After controlling for early morbidity < 6 months, anemia (Hb < 11 g/dl) at 6 months was an independent risk factor for diarrhea and respiratory illness from 7 to 18 months of age. This associations remained significant even after controlling, in addition, for environmental and socio-economic factors. In the multivariable models, anemia at age 6 months increased the risk for diarrhea after that age by 2.9-fold (95% confidence interval 1.6 - 5.3; p = 0.001) and that of respiratory disease by 2-fold (1.1 - 3.7; p = 0.03). Our findings suggest that anemia may increase the rates of infections in toddlers. The possibility that reducing anemia in infants may be a preventive measure to lower disease burden from infectious disease in this and other vulnerable populations should be tested in further studies.
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PMID:Anemia as a risk factor for infectious diseases in infants and toddlers: results from a prospective study. 1592 Oct 46

Iron deficiency acquired at an early age can lead to significant developmental alterations. To evaluate the need for an interventional trial, we determined the iron reserves of neonates born to a group of women from an urban disadvantaged group. The influence of maternal iron on newborn hemoglobin, birth weight, and height was also analyzed. Hemoglobin and serum ferritin (SF) concentrations were measured at delivery on 201 neonates and their mothers. Neonatal iron stores were considered deficient when the cord SF concentration was <12.0 microg/L, reduced if > or =12.0 but <30 microg/L, and replenished when > or =30 microg/L. The same cut-offs applied to maternal SF values. Cord SF in the study group was 81.2 +/- 63 microg/L. Following the criteria adopted for this study, three groups of neonates were identified. I: 13 (6.5%) were born with deficient iron stores, II: 15 (7.5%) had reduced iron stores, and III: 173 (86%) had normal levels of storage iron. Cord SF concentrations were 7.1 +/- 3.5, 19.9 +/- 4.4 and 92 +/- 60 microg/L, respectively. Cord hemoglobin did not differ among groups. Iron stores at birth were reduced when maternal stores were deficient, reflecting a limited fetal iron-acquisition capacity and the restrictive effect of gestational iron deficiency on the constitution of adequate fetal iron reserves. These findings support the need for an interventional trial on the study population. Hemoglobin, birth weight, and height did not correlate with fetal or maternal iron stores.
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PMID:Sub-optimal fetal iron acquisition under a maternal environment. 1609 45

We evaluated the analytical performance of a new, commercial, fully automated immunoturbidimetric assay for the determination of ferritin [FER-Latex(X2)CN SEIKEN, Denka Seiken, Japan] in serum on the Olympus AU2700 analyzer. The new assay is a latex-enhanced turbidimetric immunoassay with an analysis time of 10 min. The linearity of the assay was confirmed up to 2505 pmol/L (R2=0.999). The detection limit and the functional sensitivity were both 4.5 pmol/L. The intra- and inter-assay imprecision (CV) at 67, 506, 2186 pmol/L was < 1.8% and < 2.5%, respectively. Verification of the traceability to a WHO standard (80/578) showed a recovery of 102.6% (target value 449 pmol/L). No hook effect was observed in samples containing up to 33,705 pmol/L. The assay showed good correlation with the Beckman Immage nephelometric system (r=0.999). Hemoglobin (< or = 9.8 g/L), total bilirubin (< or = 113 micromol/L), conjugated bilirubin (< or = 109 micromol/L) and rheumatoid factor (< or = 5.2x10(5) IU/L) did not interfere with the assay. The reference interval (2.5-97.5 percentile) was 72-521 pmol/L for men and 27-267 pmol/L for women. The reference interval in patients with anemia, malignant tumors and hemochromatosis was 5.6-52, 130-2436 and 1465-2903 pmol/L, respectively. On the basis of the receiver operating characteristic curve, the 90% sensitivity cut-off value to distinguish between patients with and without iron deficiency was 40 pmol/L. The new latex turbidimetric procedure for ferritin assay is an attractive alternative that avoids the need for dedicated instrumentation.
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PMID:Preliminary evaluation of the performance of a new, highly sensitive commercial immunoassay for serum ferritin determination. 1620 2

The preliminary observation of marked erythrocyte microcytosis in patients treated with sirolimus (SRL) and mycophenolate mofetil (MMF) has been evaluated as part of a prospective study comparing SRL and cyclosporin A (CsA) as a primary immunosuppressant. Normal risk de novo kidney recipients were randomized either to SRL or to CsA. Additional immunosuppressants consisted of MMF and prednisone. In patients with erythrocyte microcytosis, iron deficiency was excluded by measuring serum ferritin and transferrin saturation rate. Fifty-nine patients (30 in SRL and 29 in CsA) were included. Mean corpuscular volume (MCV) (fl) on day 7 was 91.7 +/- 4.8 in SRL group versus 91.4 +/- 4.2 in CsA group (P = 0.77), whereas mean MCV on day 183 post-transplant was 78.5 +/- 3.8 in SRL group versus 88.4 +/- 3.4 in CsA group (P < 0.0001). Hemoglobin concentration (g/dl) was not significantly different. Only two patients in SRL group presented decreased transferrin saturation rate. Marked erythrocyte microcytosis without persistent anemia was observed in patients treated with SRL and MMF.
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PMID:Marked erythrocyte microcytosis under primary immunosuppression with sirolimus. 1635 72

Herein we describe the case of a Tunisian girl who presented with 3% Hb Bart's (gamma4) at birth. At the age of 3 years, she showed microcytosis and hypochromia in the absence of iron deficiency. The first step of molecular analysis was to test for the common Mediterranean mutations and the classical -alpha3.7 deletion was found in the heterozygous state. Since this finding could not explain the level of Hb Bart's at birth, or the hypochromia and microcytosis, all the alpha-globin genes were sequenced. This revealed a rare point mutation at codon 119 (CCT-->TCT) in the alpha1-globin gene, identified for the first time in Tunisia, and which has previously been described as an unstable hemoglobin (Hb) variant named Hb Groene Hart [alpha119(H2)Pro-->Ser (alpha1)]. Here the -alpha3.7/alpha(alpha)119(CCT-->TCT) genotype is responsible for the alpha-thalassemia (thal) trait phenotype.
Hemoglobin 2005
PMID:First description in Tunisia of a point mutation at codon 119 (CCT-->TCT) in the alpha1-globin gene: Hb Groene Hart in association with the -alpha3.7 deletion. 1637 Apr 86


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