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

As part of a study of anemia associated with oral contraceptive use, serum vitamin B12 levels, unsaturated B12-binding capacity, and B12 binder fractionation were examined in 67 consecutive mildly anemic (hemoglobin levels below 13 gm%) women using oral contraceptives and 59 such women using other means of birth control. Results were correlated with hematologic parameters such as complete blood counts and evaluation of iron status. Hemoglobin levels were significantly lower (p 0.01) in the non-oral-contraceptive group, while serum iron levels were significantly higher (p 0.05) in the oral contraceptive group and fewer oral contraceptive users demonstrated iron-deficiency anemia. While no B12-deficient subjects were found, serum B12 levels were significantly lower among oral contraceptive users (p 0.05), but differences were more striking between iron-deficient and non-iron deficient subjects, regardless of oral contraceptive status (p 0.02). The role of iron status needs further clarification as the finding of higher serum B12 levels in iron-deficient subjects contrasts with previous reports of lower B12 levels in cases of disease-related iron deficiency. Moreover, the relationship between iron status and serum B12 level was significant only in the oral contraceptive group. Among pill users, iron deficiency was most frequent in those taking sequential rather than combination preparations (67 vs. 39%). Among non-oral-contraceptive subjects, iron deficiency incidence was 96% in IUD users. Serum unsaturated B12 binding capacity was unaffected by pill use, but pill users showed significantly higher transcobalamin I levels, correlating best with white blood cell counts. The assumption that this elevation reflects pill effect on protein synthesis is premature, even though a general increase in alpha 1-globulin has been reported in pill users. Transcobalamin II and 3rd binder levels were not affected and did not correlate with white blood counts. The correlation between UBBC levels and white blood cell counts was significant in both oral contraceptive and non-oral-contraceptive groups. In contrast to previous findings, UBBC could not correlated with any iron parameter.
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PMID:Serum vitamin B12 and B12-binding protein levels associated with oral contraceptives. 72 97

Animals with hereditary abnormalities of hematopoiesis are quite useful in the study of regulatory pathways of megakaryocytopoiesis and platelet formation. Seven such animal models are analyzed here. The Wistar Furth rat has been recently discovered to have reduced platelet number, but large mean platelet volume, and is, therefore, a model of hereditary macrothrombocytopenia. Study of the Wistar Furth rat may help to elucidate the process of platelet formation. Two mouse mutants the S1/S1d and W/Wv, have macrocytic anemia with reduced megakaryocyte number, but normal platelet count. In these mice, the platelet count is maintained by increased platelet production per megakaryocyte. These models demonstrate that factors other than platelet level are monitored in the feedback regulation of megakaryocytopoiesis and platelet production, and further study should lead to a better understanding of the regulation of megakaryocyte size. The Belgrade rat has severe microcytic anemia with decreased megakaryocyte number. Megakaryocyte size is increased, but platelet count is moderately reduced and thus the megakaryocyte-platelet picture resembles that of severe iron deficiency anemia. A more in depth examination of this model should delineate the effects of iron deficiency and hypoxia on megakaryocytopoiesis. The grey collie dog has cyclic hematopoiesis with large asynchronous fluctuations in all blood cell counts at approximately 2-week intervals. Megakaryocytes have not been studied. This model should be a tool to define the relationships between hematopoietic growth factors and differentiation of the various hematopoietic cell lineages. The br/br rabbit has a transient disturbance in fetal megakaryocytopoiesis and brachydactyly due to spontaneous amputation. Further study of this model may provide a better understanding of fetal megakaryocyte development and establish whether an association exists between the abnormal megakaryocytes and the limb amputations. The nude mouse with its severe T-lymphocyte deficiency has been studied to ascertain whether T cells play a regulatory role in normal and acute thrombocytopenia-stimulated megakaryocytopoiesis. The question of whether T cells or their products are responsible for reactive thrombocytosis in chronic inflammation could be examined with this model. These animal mutants have provided and should continue to provide important models for understanding the regulation of megakaryocytopoiesis and platelet production.
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PMID:Animal models with inherited hematopoietic abnormalities as tools to study thrombopoiesis. 264 83

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

Twenty-six adult patients with histologically confirmed celiac disease on gluten-free diet after apparent disease remission were reexamined at 4-6 months intervals for a mean period of 55.4 months (range 13-137). Eight patients remained clinically well with normal blood tests. Eighteen patients had clinical or biological abnormalities. Eleven patients reported repeated episodes of meteorism and abdominal pain and/or diarrhea which disappeared in 2 after lactose withdrawal. Iron deficiency and macrocytic anemia were sometimes observed in 5 and 4 patients respectively. Altered plasma calcium, phosphorus and alkaline phosphatase and/or bone densitometry findings were detected in 7 patients. Seventeen patients (12 presenting some of the above findings) agreed to a repeat biopsy: 13 of these showed grade II and 4 grade III abnormalities. Although adult celiac patients may show marked improvement during gluten-free diet, minor clinical disturbances and biochemical abnormalities may still be present.
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PMID:Clinical, biochemical and histological abnormalities in adult celiac patients on gluten-free diet. 408 41

Iron-deficiency anemia is one of the major problems encountered in renal transplant recipients. The aim of this retrospective study was to reevaluate the causes of anemia among 100 anemic kidney recipients. Patients with serum creatinine levels greater than 2 mg/dL were excluded from the study. Female patients were considered to be anemic if the hemoglobin was <12 g/dL for males, <13 g/dL. Complete blood count, serum creatinine, serum iron, iron-binding capacity, ferritin, transferrin saturation, erythrocyte folate, and serum vitamin B(12) levels were measured in all patients. Mean hemoglobin value was 10.2 +/- 1.4 g/dL for female and 9.9 +/- 1.3 for male patients, mean corpuscular volume (MCV) 91.3 +/- 4.9 fL. We observed normocytic anemia in 60, macrocytic anemia in 30, and microcytic anemia in 10 patients. A low level of serum folate was observed in 9 (15%) and of vitamin B(12) in 5 (8.8%) of 60 patients with normocytic anemia. Folate deficiency was found in 18 (60%) and vitamin B(12) deficiency in 12 (40%) of 30 patients with macrocytic anemia. All patients with microcytic anemia had iron deficiency. Splenomegaly was seen significantly more often in patients with macrocytic than normocytic anemia (P =.008). Folate and vitamin B(12) deficiency were the major causes of nutritional anemia; oral or parenteral supplementation with these vitamins is likely to cure the anemia in the majority of cases.
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PMID:Causes of anemia in renal transplant recipients. 1501 34

The purpose of this report is to describe 4 cases of Biermer's anemia observed in West Africa over a 7-year period. Severe asthenia was the main clinical manifestation. Laboratory tests consistently demonstrated macrocytic anemia usually with a deep drop in hemoglobin levels ranging from 40 to 84 g/l associated with various degrees of thrombocytopenia or leukopenia. Other consistent findings were bone marrow megaloblastosis, serum vitamin B12 deficiency, and intrinsic factor antibodies. In most cases diagnosis was established on the basis of therapeutic tests with subsequent confirmation. Treatment using vitamin B12 therapy was successful in all cases. The authors recommend iron deficiency testing during the course of the disease and gastric biopsy during fibroscopy of upper digestive tract even if no macroscopic lesions are found.
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PMID:[Four case reports of Biermer's anemia in West Africa]. 1507 22

The aim of the study was to examine the clinical utility of the reticulocyte hemoglobin content (CHr) in relation to the mean cell volume of the erythrocyte (MCV) and ferritin for the differential diagnosis of iron-deficient anemia (IDA). In 96 anemic patients classified according to morphology of erythrocytes, CHr indicated a high statistical difference between the non-anemic control group and microcytic (p < 0.001) and normocytic (p < 0.001) anemic groups, but was limited in patients with macrocytic anemia, for which reason they were excluded from the study. In the inflammatory disorders, ferritin concentration may be normal or increase due to acute phase response, which provides false information on a patient's iron status, but CHr indicated a high statistical difference between the control group and the non-inflammatory (p < 0.001) and inflammatory groups (p < 0.001). Receiver operator characteristic curve analysis demonstrates that CHr has a better overall sensitivity and specificity than MCV and ferritin in the diagnosis of iron deficiency compared to hemoglobin concentration.
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PMID:Reticulocyte hemoglobin content in the diagnosis of iron deficiency anemia. 1533 May 12

Iron deficiency is a known complication of achlorhydria and may precede the development of pernicious anemia. Among 160 patients with autoimmune gastritis identified by hypergastrinemia and strongly positive antiparietal antibodies, we explored the overlap between 83 subjects presenting with iron deficiency anemia (IDA), 48 with normocytic indices, and 29 with macrocytic anemia. Compared with macrocytic patients, patients with IDA were 21 years younger (41 +/- 15 years versus 62 +/- 15 years) and mostly women. All groups had a high prevalence of thyroid disease (20%) and diabetes (8%) suggestive of the autoimmune polyendocrine syndrome. Stratification by age cohorts from younger than 20 years to older than 60 years showed a regular and progressive increase in mean corpuscular volume (MCV) from 68 +/- 9 to 95 +/- 16 fl, serum ferritin levels from 4 +/- 2 to 37 +/- 41 microg/L, gastrin level from 166 +/- 118 to 382 +/- 299 pM/L (349 +/- 247 to 800 +/- 627 pg/mL), and a decrease in cobalamin level from 392 +/- 179 to 108 +/- 65 pg/mL. The prevalence of Helicobacter pylori infection was 87.5% at age younger than 20 years, 47% at age 20 to 40 years, 37.5% at 41 to 60 years, and 12.5% at age older than 60 years. These findings challenge the common notion that pernicious anemia is a disease of the elderly and imply a disease starting many years before the establishment of clinical cobalamin deficiency, by an autoimmune process likely triggered by H pylori.
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PMID:Variable hematologic presentation of autoimmune gastritis: age-related progression from iron deficiency to cobalamin depletion. 1700 59

Iron deficiency and iron deficiency anemia are common conditions in children, especially in developing countries. It is often difficult for the pediatrician to know which indices should be used in the diagnosis of these conditions in children. Reticulocyte hemoglobin (Hb) content (CHr) has been shown to be an accurate indicator of anemia, however whether its use suits the situation in developing countries or not is unclear. The aim of this study was to evaluate the value and effectiveness of using CHr as a method to diagnose iron deficiency and iron deficiency anemia in Saudi children. The samples for the study were collected from 305 children suspected to have anemia. Complete blood count, transferrin saturation (Tfsat), ferritin, circulating transferrin receptor (TfR) and CHr were measured. Three groups were defined, iron deficiency (Tfsat <20%, Hb >11 g/dL; n=120), iron deficiency anemia (Tfsat <20%, Hb <11 g/dL; (n=73) and controls (Tfsat >20%; n=112). The anemic group had significantly lower macrocytic anemia (MCV), mean corpuscular hemoglobin (MCH) and CHr. All of the variables in the anemia group were significantly lower than those of the control group except for the ferritin level. Compared to the control group, the iron deficiency group also showed significantly lower values except for transferrin receptor and the ferritin levels. CHr levels of <26 pg correlated well with anemic states. CHr together with a complete blood count may provide an alternative to the traditional hematologic or biochemical panel for the diagnosis of iron deficiency and iron deficiency anemia in young children and is cost-effective in developing countries. A CHr cut-off level of 26 pg is considered to be a reasonable indicator of anemic states.
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PMID:Measurement of reticulocyte hemoglobin content to diagnose iron deficiency in Saudi children. 1652 Sep 41

Pernicious anemia (PA) is a macrocytic anemia that is caused by vitamin B(12) deficiency, as a result of intrinsic factor deficiency. PA is associated with atrophic body gastritis (ABG), whose diagnosis is based on histological confirmation of gastric body atrophy. Serological markers that suggest oxyntic mucosa damage are increased fasting gastrin and decreased pepsinogen I. Without performing Schilling's test, intrinsic factor deficiency may not be proven, and intrinsic factor and parietal cell antibodies are useful surrogate markers of PA, with 73% sensitivity and 100% specificity. PA is mainly considered a disease of the elderly, but younger patients represent about 15% of patients. PA patients may seek medical advice due to symptoms related to anemia, such as weakness and asthenia. Less commonly, the disease is suspected to be caused by dyspepsia. PA is frequently associated with autoimmune thyroid disease (40%) and other autoimmune disorders, such as diabetes mellitus (10%), as part of the autoimmune polyendocrine syndrome. PA is the end-stage of ABG. Long-standing Helicobacter pylori infection probably plays a role in many patients with PA, in whom the active infectious process has been gradually replaced by an autoimmune disease that terminates in a burned-out infection and the irreversible destruction of the gastric body mucosa. Human leucocyte antigen-DR genotypes suggest a role for genetic susceptibility in PA. PA patients should be managed by cobalamin replacement treatment and monitoring for onset of iron deficiency. Moreover, they should be advised about possible gastrointestinal long-term consequences, such as gastric cancer and carcinoids.
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PMID:Pernicious anemia: new insights from a gastroenterological point of view. 2127 87


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