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Sample records for distinguishing iron deficiency

  1. Response to parenteral iron therapy distinguish unexplained refractory iron deficiency anemia from iron-refractory iron deficiency anemia.

    PubMed

    Akin, M; Sarbay, H; Guler, S; Balci, Y I; Polat, A

    2016-04-01

    We evaluated that response to parenteral iron therapy could be helpful in distinguishing the types of iron deficiency anemia. This study analyzed responses to IV iron sucrose therapy of 15 children with unexplained refractory iron deficiency anemia (URIDA). We compared the results at diagnosis, 6 weeks and 6 months after the therapy. Results were compared with responses of 11 patients' results with iron-refractory iron deficiency anemia (IRIDA) from our previous study. Six weeks after the start of treatment, ferritin, MCV, MCH and Hb values were in normal range in 10 patients. The increase in Hb, MCH, MCV, and ferritin values ranged 2.6-3.5 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. In five patients, Hb, MCH, and MCV mean (range) values [11.2 g/dL (11-12.2), 24.5 pg (24-25.6), and 67 fL (65-70)] were nearly normal but ferritin mean (range) values [9.8 ng/mL (8-11)] were below normal. Six weeks after the start of treatment, Hb, MCH, MCV and ferritin values of patients with IRIDA were increased. The increase in Hb, MCH, MCV, and ferritin values ranged 0.8-2.7 g/dL, 1.7-4.2 pg, 2-9 fL, and 13-25 ng/mL, respectively. IRIDA is only partially responsive to parenteral iron supplementation. In conclusion, this study demonstrated that the response to intravenous iron therapy for the URIDA cases improved blood parameters more effectively than hereditary IRIDA. Response to parenteral iron therapy would be helpful to distinguish unexplained refractory IDA from hereditary IRIDA for clinicians who do not have access to hepcidin or TMPRS6 mutation analysis. © 2016 John Wiley & Sons Ltd.

  2. Serum transferrin receptor distinguishes the anemia of chronic disease from iron deficiency anemia.

    PubMed

    Ferguson, B J; Skikne, B S; Simpson, K M; Baynes, R D; Cook, J D

    1992-04-01

    Recent studies have shown that the serum transferrin receptor is a sensitive, quantitative measure of tissue iron deficiency. This study was undertaken to determine the serum transferrin receptor's ability to distinguish iron-deficiency anemia from the anemia of chronic inflammation and to identify iron deficiency in patients with liver disease. The mean transferrin receptor level in 17 normal controls was 5.36 +/- 0.82 mg/L compared with 13.91 +/- 4.63 mg/L in 17 patients with iron-deficiency anemia (p less than 0.001). The mean serum receptor level was normal in all 20 patients with acute infection, including five with acute hepatitis, and was also normal in 8 of 10 anemic patients with chronic liver disease. Receptor levels were in the normal range in all but 4 of 41 patients with anemia of chronic disease. We conclude that unlike serum ferritin levels, which are disproportionately elevated in relation to iron stores in patients with inflammation or liver disease, the serum transferrin receptor level is not affected by these disorders and is therefore a reliable laboratory index of iron deficiency anemia.

  3. Critical appraisal of discriminant formulas for distinguishing thalassemia from iron deficiency in patients with microcytic anemia.

    PubMed

    Urrechaga, Eloísa; Hoffmann, Johannes J M L

    2017-08-28

    Many discriminant formulas have been reported for distinguishing thalassemia trait from iron deficiency in patients with microcytic anemia. Independent verification of several discriminant formulas is deficient or even lacking. Therefore, we have retrospectively investigated discriminant formulas in a large, well-characterized patient population. The investigational population consisted of 2664 patients with microcytic anemia: 1259 had iron deficiency, 1196 'pure' thalassemia trait (877 β- and 319 α-thalassemia), 150 had thalassemia trait with concomitant iron deficiency or anemia of chronic disease, and 36 had other diseases. We investigated 25 discriminant formulas that only use hematologic parameters available on all analyzers; formulas with more advanced parameters were disregarded. The diagnostic performance was investigated using ROC analysis. The three best performing formulas were the Jayabose (RDW index), Janel (11T), and Green and King formulas. The differences between them were not statistically significant (p>0.333), but each of them had significantly higher area under the ROC curve than any other formula. The Jayabose and Green and King formulas had the highest sensitivities: 0.917 both. The highest specificity, 0.925, was found for the Janel formula, which is a composite score of 11 other formulas. All investigated formulas performed significantly better in distinguishing β- than α-thalassemia from iron deficiency. In our patient population, the Jayabose RDW index, the Green and King formula and the Janel 11T score are superior to all other formulas examined for distinguishing between thalassemia trait and iron deficiency anemia. We confirmed that all formulas perform much better in β- than in α-thalassemia carriers and also that they incorrectly classify approximately 30% of thalassemia carriers with concomitant other anemia as not having thalassemia. The diagnostic performance of even the best formulas is not high enough for making a final

  4. Distinguishing effects of anemia and muscle iron deficiency on exercise bioenergetics in the rat

    SciTech Connect

    Davies, K.J.A.; Donovan, C.M.; Refino, C.J.; Brooks, G.A.; Packer, L.; Dallman, P.R.

    1984-06-01

    Three weeks of dietary iron deficiency in weanling rats resulted in anemia (Hb, 39 vs 14.2 g/dl in controls) and decreased oxidative capacities of skeletal muscle (as much as 90% below control values). Whole-animal maximal O/sub 2/ consumption V/sub 0/sub 2///sub max//, measured in a brief treadmill run of progressively increasing work load, was approx.50% lower for iron-deficient rats than for controls, and maximal endurance capacity (time to exhaustion in a separate treadmill run at a constant, sub- V/sub 0/sub 2///sub max// work load) was 90% lower from iron-deficient rats than for controls. Exchange transfusion with packed erythrocytes or plasma, was used to adjust Hb to an intermediate concentration of approximately 9.5 g/dl in both iron-deficient and control rats. This procedure corrected the V/sub 0/sub 2///sub max// of iron-deficient rats to within 15% of control values, whereas endurance capacity showed no improvement. Our experimental dissociation of V/sub 0/sub 2///sub max/// and endurance capacity provides further evidence that V/sub 0/sub 2///sub max// is not the sole determinant of endurance. We propose that defects in V/sub 0/sub 2///sub max// during iron deficiency result primarily from diminished O/sub 2/ delivery, whereas decreased endurance capacity reflects impaired muscle mitochondrial function.

  5. The measurement of free erythrocyte porphyrin (FEP) as a simple means of distinguishing iron deficiency from beta-thalassemia trait in subjects with microcytosis.

    PubMed

    Stockman, J A; Weiner, L S; Simon, G E; Stuart, M J; Oski, F A

    1975-01-01

    Assay of free erythrocyte porphyrin (FEP) and measurement of red cell indices were obtained in a group of subjects with iron deficiency and beta-thalassemia trait to determine if these studies cound detect these disorders and discriminate bbetween them. FEP values were increased in 90.2 per cent of subjects with iron deficiency but were within the normal range in 96.6 per cent of subjects with beta-thalassemia trait. Mean FEP values increased sligtly as transferrin saturation fell but became abnormally elevated when the transferrin saturation fell but became abnormally elevated when the transferrin saturation was less than 15 per cent. Unlike subjecs with iron deficiency in whom the mean corpuscular volume varied from 46 to 84, all individuals with beta-thalassermia trait exhibited microcytosis. In most instances, determination of FEP appears to distinguish beta-thalassemia trait from iron deficiency in patients with microcytosis.

  6. Iron deficiency: definition and diagnosis.

    PubMed

    Cook, J D; Skikne, B S

    1989-11-01

    There has been a continuous refinement over the past several decades of methods to detect iron deficiency and assess its magnitude. The optimal combination of measurements differs for clinical and epidemiological assessment. Clinically, the major problem is to distinguish true iron deficiency from other causes of iron-deficient erythropoiesis, such as the anaemia of chronic disease. Epidemiologically, techniques that provide quantified estimates of body iron are preferable. For both purposes, the serum ferritin is the focal point of the laboratory detection of iron deficiency. Serum ferritin measurements provide a reliable index of body iron stores in healthy individuals, a cost-effective method of screening for iron deficiency, and a useful alternative to bone marrow examinations in the evaluation of anaemic patients. Preliminary studies indicate that measurement of the serum transferrin receptor may be the most reliable way to assess deficits in tissue iron supply.

  7. Distinguishing anemia and iron deficiency of heart failure: signal for severity of disease or unmet therapeutic need?

    PubMed

    Beavers, Craig J; Alburikan, Khalid A; Rodgers, Jo E; Dunn, Steven P; Reed, Brent N

    2014-07-01

    Despite advances in the management of heart failure (HF), quality of life and other outcomes remain suboptimal for many patients. Anemia and iron deficiency are comorbidities associated with adverse outcomes, although their pathophysiology in the setting of HF is not entirely understood. Anemia and iron deficiency may exist independently and may be a consequence of the systemic inflammatory state characterized by chronic HF. However, it is unclear whether serum hemoglobin concentrations and other hematologic parameters serve as markers for the severity of disease or represent novel therapeutic targets. Research in this area has focused primarily on therapies known to be effective for these conditions in other chronic disease states with similar pathophysiologic features (e.g., end-stage renal disease). Despite its many practical advantages, minimal evidence exists to support the use of oral iron supplementation in this setting. In contrast, intravenous iron has been the subject of several recent investigations, demonstrating improvements in both surrogate and clinical end points, although benefits seem to be the most substantial in patients with concomitant anemia. Erythropoietin-stimulating agents demonstrated early promise in retrospective analyses and small prospective trials, but their benefit was outweighed by a lack of improvement in clinical outcomes and an excess number of thromboembolic events in the largest trial of patients with anemia and HF to date. For acute symptomatic anemia, blood transfusion may be considered, although few trials have included patients with HF, and caution must be exerted in those who are hemodynamically unstable. Based on the currently available evidence, treatment of iron deficiency appears to confer benefit in patients with HF, whereas strategies aimed at improving hemoglobin alone do not. Included is a review of the pathophysiology of these conditions in the setting of HF, clinical trials evaluating pharmacologic therapy, and

  8. Iron-deficiency anaemia.

    PubMed

    Cook, J D

    1994-12-01

    Iron-deficiency anaemia (IDA) is a common clinical problem throughout the world and an enormous public health problem in developing countries. The cornerstone of the laboratory identification of IDA is a low haemoglobin and serum ferritin concentration although a normal serum ferritin does exclude IDA. When the serum ferritin is normal in an anaemic patient with iron-deficient erythropoiesis, it is common practise to perform a bone marrow examination to diagnose IDA. The recent introduction of serum transferrin receptor measurements is a useful alternative for distinguishing IDA from the anaemia of chronic disease because the serum receptor concentration is usually elevated in patients with IDA but normal in patients with anaemia due to inflammation or neoplasia. It is helpful for the clinican to be aware of the causes of physiological IDA. The most important are increased rate of body growth, excessive menstrual blood loss, pregnancy, regular blood donation, intensive endurance training, chronic aspirin use and a vegetarian diet. Without these, a careful search for unsuspected gastrointestinal blood loss must be made and even when the suspicion of physiological IDA is high, it is prudent to screen for fecal occult blood. In most patients, IDA responds promptly to oral iron therapy. Patients who experience troublesome side-effects with oral iron might benefit from a gastric delivery system for oral iron which eliminates nausea and vomiting and improves iron absorption when given with food.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Discriminant indices for distinguishing thalassemia and iron deficiency in patients with microcytic anemia: a meta-analysis.

    PubMed

    Hoffmann, Johannes J M L; Urrechaga, Eloísa; Aguirre, Urko

    2015-11-01

    More than 40 mathematical indices have been proposed in the hematological literature for discriminating between iron deficiency anemia and thalassemia trait in subjects with microcytic red blood cells (RBCs). None of these discriminant indices is 100% sensitive and specific and also the ranking of the discriminant indices is not consistent. Therefore, we decided to conduct the first meta-analysis of the most frequently used discriminant indices. An extensive literature search yielded 99 articles dealing with 12 indices that were investigated five or more times. For each discriminant index we calculated the diagnostic odds ratio (DOR) and summary ROC analysis was done for comparing the performance of the indices. The ratio of microcytic to hypochromic RBCs (M/H ratio) showed the best performance, DOR=100.8. This was significantly higher than that of all other indices investigated. The RBC index scored second (DOR=47.0), closely followed by the Sirdah index (DOR=46.7) and the Ehsani index (DOR=44.7). Subsequently, there was a group of four indices with intermediate and three with lower DOR. The lowest performance (DOR=6.8) was found for the RDW (Bessman index). Overall, the indices performed better for adults than for children. The M/H ratio outperformed all other discriminant indices for discriminating between iron deficiency anemia and thalassemia trait. Although its sensitivity and specificity are not high enough for making a definitive diagnosis, it is certainly of value for identifying those subjects with microcytic RBC in whom diagnostic tests for confirming thalassemia are indicated.

  10. Iron Deficiency Anemia.

    PubMed

    DeLoughery, Thomas G

    2017-03-01

    Iron deficiency is one of the most common causes of anemia. The 2 main etiologies of iron deficiency are blood loss due to menstrual periods and blood loss due to gastrointestinal bleeding. Beyond anemia, lack of iron has protean manifestations, including fatigue, hair loss, and restless legs. The most efficient test for the diagnosis of iron deficiency is the serum ferritin. Iron replacement can be done orally, or in patients in whom oral iron is not effective or contraindicated, with intravenous iron. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Iron refractory iron deficiency anemia

    PubMed Central

    De Falco, Luigia; Sanchez, Mayka; Silvestri, Laura; Kannengiesser, Caroline; Muckenthaler, Martina U.; Iolascon, Achille; Gouya, Laurent; Camaschella, Clara; Beaumont, Carole

    2013-01-01

    Iron refractory iron deficiency anemia is a hereditary recessive anemia due to a defect in the TMPRSS6 gene encoding Matriptase-2. This protein is a transmembrane serine protease that plays an essential role in down-regulating hepcidin, the key regulator of iron homeostasis. Hallmarks of this disease are microcytic hypochromic anemia, low transferrin saturation and normal/high serum hepcidin values. The anemia appears in the post-natal period, although in some cases it is only diagnosed in adulthood. The disease is refractory to oral iron treatment but shows a slow response to intravenous iron injections and partial correction of the anemia. To date, 40 different Matriptase-2 mutations have been reported, affecting all the functional domains of the large ectodomain of the protein. In vitro experiments on transfected cells suggest that Matriptase-2 cleaves Hemojuvelin, a major regulator of hepcidin expression and that this function is altered in this genetic form of anemia. In contrast to the low/undetectable hepcidin levels observed in acquired iron deficiency, in patients with Matriptase-2 deficiency, serum hepcidin is inappropriately high for the low iron status and accounts for the absent/delayed response to oral iron treatment. A challenge for the clinicians and pediatricians is the recognition of the disorder among iron deficiency and other microcytic anemias commonly found in pediatric patients. The current treatment of iron refractory iron deficiency anemia is based on parenteral iron administration; in the future, manipulation of the hepcidin pathway with the aim of suppressing it might become an alternative therapeutic approach. PMID:23729726

  12. Iron deficiency in Europe.

    PubMed

    Hercberg, S; Preziosi, P; Galan, P

    2001-04-01

    In Europe, iron deficiency is considered to be one of the main nutritional deficiency disorders affecting large fractions of the population, particularly such physiological groups as children, menstruating women and pregnant women. Some factors such as type of contraception in women, blood donation or minor pathological blood loss (haemorrhoids, gynaecological bleeding...) considerably increase the difficulty of covering iron needs. Moreover, women, especially adolescents consuming low-energy diets, vegetarians and vegans are at high risk of iron deficiency. Although there is no evidence that an absence of iron stores has any adverse consequences, it does indicate that iron nutrition is borderline, since any further reduction in body iron is associated with a decrease in the level of functional compounds such as haemoglobin. The prevalence of iron-deficient anaemia has slightly decreased in infants and menstruating women. Some positive factors may have contributed to reducing the prevalence of iron-deficiency anaemia in some groups of population: the use of iron-fortified formulas and iron-fortified cereals; the use of oral contraceptives and increased enrichment of iron in several countries; and the use of iron supplements during pregnancy in some European countries. It is possible to prevent and control iron deficiency by counseling individuals and families about sound iron nutrition during infancy and beyond, and about iron supplementation during pregnancy, by screening persons on the basis of their risk for iron deficiency, and by treating and following up persons with presumptive iron deficiency. This may help to reduce manifestations of iron deficiency and thus improve public health. Evidence linking iron status with risk of cardiovascular disease or cancer is unconvincing and does not justify changes in food fortification or medical practice, particularly because the benefits of assuring adequate iron intake during growth and development are well established

  13. Current issues in iron deficiency.

    PubMed

    Baynes, R D; Cook, J D

    1996-03-01

    This brief review of developments relating to iron deficiency during the past year covers three main areas: iron supplementation, the regulation of iron absorption, and the use of the serum transferrin receptor for the assessment of iron status. The intermittent administration of iron supplement once or twice weekly rather than daily has been advocated by international health agencies in recent years, but radioiron absorption studies in human subjects have failed to demonstrate any absorptive advantage of the intermittent schedule. The value of prophylactic iron supplementation in elderly blood donors was evaluated and shown to offer limited benefit in maintaining donation frequency. A recent model of the regulation of iron absorption involving erythropoietic and store regulators is discussed and a recent article indicating a potential non-hematopoietic effect of hematopoietic growth factors on iron absorption by the gastrointestinal mucosal cell is reviewed. A new measure of functional iron deficiency, namely the serum transferrin receptor, is discussed, with particular reference to its mechanism of production and its great value in distinguishing iron deficiency anemia from the anemia of chronic disease.

  14. Iron deficiency: the global perspective.

    PubMed

    Cook, J D; Skikne, B S; Baynes, R D

    1994-01-01

    The prevelance of IDA in industrialized countries has declined in recent decades, but there has been little change in the worldwide prevalence. IDA is currently estimated to affect more than 500 million people. Recent studies have indicated that anemia per se, the most common manifestation of iron deficiency, is less important from a public health standpoint than liabilities associated with tissue iron deficiency. The most important of the latter are an impairment in psychomotor development and cognitive function in infants and preschoolers, a deficit in work performance in adults, and an increase in the frequency of low birth weight, prematurity, and perinatal mortality in pregnancy. There have been several recent advances in combatting nutritional iron deficiency. One of the major problems has been in distinguishing iron deficiency from other causes of anemia seen epidemiologically such as malaria, HIV infection, chronic inflammation, hemoglobinopathies, and protein energy malnutrition. When combined with serum ferritin and hemoglobin determinations, the serum transferrin receptor assay is a valuable addition in epidemiologic surveys because it provides a quantitative measure of functional iron deficiency and it distinguishes true IDA from the anemia of chronic disease. The most difficult challenge is to develop effective methods of supplying iron to large segments of a population. Supplementation with iron tablets is suitable for only brief periods of need such as during pregnancy. The poor compliance with existing supplementation programs is believed to be due mainly to the gastrointestinal side effects of oral iron which can be eliminated by the use of a gastric delivery system. The most effective long-term strategy is to increase the intake of bioavailable iron in the diet. The customary approach has been to fortify a food staple such as wheat, rice, sugar, or salt, and thereby increase the iron intake of the entire population. However, because of concerns

  15. Iron deficiency anaemia.

    PubMed

    Lopez, Anthony; Cacoub, Patrice; Macdougall, Iain C; Peyrin-Biroulet, Laurent

    2016-02-27

    Anaemia affects roughly a third of the world's population; half the cases are due to iron deficiency. It is a major and global public health problem that affects maternal and child mortality, physical performance, and referral to health-care professionals. Children aged 0-5 years, women of childbearing age, and pregnant women are particularly at risk. Several chronic diseases are frequently associated with iron deficiency anaemia--notably chronic kidney disease, chronic heart failure, cancer, and inflammatory bowel disease. Measurement of serum ferritin, transferrin saturation, serum soluble transferrin receptors, and the serum soluble transferrin receptors-ferritin index are more accurate than classic red cell indices in the diagnosis of iron deficiency anaemia. In addition to the search for and treatment of the cause of iron deficiency, treatment strategies encompass prevention, including food fortification and iron supplementation. Oral iron is usually recommended as first-line therapy, but the most recent intravenous iron formulations, which have been available for nearly a decade, seem to replenish iron stores safely and effectively. Hepcidin has a key role in iron homoeostasis and could be a future diagnostic and therapeutic target. In this Seminar, we discuss the clinical presentation, epidemiology, pathophysiology, diagnosis, and acute management of iron deficiency anaemia, and outstanding research questions for treatment.

  16. Evaluation of the new red cell parameters on Beckman Coulter DxH800 in distinguishing iron deficiency anaemia from thalassaemia trait.

    PubMed

    Ng, E H Y; Leung, J H W; Lau, Y S; Ma, E S K

    2015-04-01

    The new red blood cell (RBC) parameters such as reticulocyte haemoglobin content and percentage of hypochromic red cells or equivalent, although useful in the laboratory assessment of iron deficiency anaemia (IDA), are confounded by thalassaemia trait (TT). We aim to evaluate the new red cell parameters on the Beckman Coulter DxH800 in distinguishing between IDA and TT. A total of 246 normal subjects, 102 patients with IDA and 115 subjects with TT were accrued for the study. The parameters studied were red blood cell size factor (RSF), low haemoglobin density (LHD%), microcytic anaemia factor (MAF), standard deviation of conductivity of the nonreticulocyte population (SD-C-NRET) and unghosted cell (UGC). Comparison between groups was performed by Student's t-test, and the diagnostic performance was determined by receiver operating characteristic (ROC) curve analysis. Both the LHD% and RSF were significantly higher in IDA than TT, whereas MAF and SD-C-NRET were significantly lower. The SD-C-NRET showed the best diagnostic performance as a single parameter. A formula, [(RBC + Hb) × (HCT + SD-C-NRET)]/RDW-SD, was devised to distinguish between IDA and TT. With a cut-off value of 23, the area under the curve (AUC) was 0.995 (95% CI of 0.99-1.00), the sensitivity was 97%, and the specificity was 99.1%. The new RBC parameters on Beckman Coulter DxH800 provide useful information in distinguishing between IDA and TT, which is important for clinical decision-making and for streamlining laboratory testing. A new formula is devised that performs better than other discriminant functions in the literature. © 2014 John Wiley & Sons Ltd.

  17. [Iron deficiency and pica].

    PubMed

    Muñoz, J A; Marcos, J; Risueño, C E; de Cos, C; López, R; Capote, F J; Martín, M V; Gil, J L

    1998-02-01

    To study the relationship between pica and iron-lack anaemia in a series of iron-deficiency patients in order to establish the pathogenesis of such relationship. Four-hundred and thirty-three patients were analysed. Pica was studied by introducing certain diet queries into the clinical history. All patients received oral iron and were periodically controlled with the usual clinico-haematological procedures. Pica was present in 23 patients (5.3%). Eight nourishing (namely, coffee grains, almonds, chocolate, ice, lettuce, carrots, sunflower seeds and bread) and 2 non-nourishing (clay and paper) substances were involved. A second episode of pica appeared in 9 cases upon relapsing of iron deficiency. Both anaemia and pica were cured by etiologic and substitutive therapy in all instances. No clear correlation was found with either socio-economic status or pathogenetic causes of iron deficiency and pica, and no haematological differences were seen between patients with pica and those without this alteration. (1) The pathogenesis of pica is unclear, although it appears unrelated to the degree of iron deficiency. (2) According to the findings in this series, pica seems a consequence of iron deficiency rather than its cause. (3) Adequate therapy can cure both conditions, although pica may reappear upon relapse of iron deficiency.

  18. Prevention of iron deficiency.

    PubMed

    Hallberg, L

    1994-12-01

    This chapter discusses different methods to prevent iron deficiency--to reduce iron losses (e.g. reducing menstrual iron losses by using a contraceptive pill or combating of hookworm infestation) or to increase iron absorption. Iron absorption can be increased (1) by modifying the composition of meals--increasing the content of dietary factors enhancing iron absorption (e.g. meat and ascorbic acid) or reducing the content of factors inhibiting iron absorption such as phytate and iron-binding phenolic compounds, (2) by increasing the iron content of the diet by fortification with iron, or by (3) supplementation with iron tablets. Several factors to consider in the choice of strategy are discussed such as the importance of the bioavailability of the diet for the efficacy of iron fortification, the choice of vehicle for iron fortification that is compatible with the iron compound used, the feasibility to increase the bioavailability of the dietary iron by modification of the composition of the diet and the short time available in pregnancy to ensure a sufficient supply of the extra iron needed limiting the effective measures available to supplementation with iron tablets.

  19. [Prevalence of iron deficiency].

    PubMed

    Dupont, C

    2017-05-01

    Studies of prévalence in iron deficiency separate iron depletion (defined as decreased blood ferritin) and iron deficiency anemia (defined as blood decrease in both ferritin and hemoglobin). In Europe, most studies are outdated. Prevalence of iron depletion varies from 7 to 18 % and 24 to 36% in toddlers and adolescents, respectively. Prevalence of iron deficiency anemia varies from 2 to 8.5% and 7 to 10% in toddlers and adolescents. In French speaking African countries, Demography Health Surveys show that 80% of children aged 0 to 2 years are anemic, severely for 5 to 9% of them. © 2017 Elsevier Masson SAS. Tous droits réservés.

  20. Genetics Home Reference: iron-refractory iron deficiency anemia

    MedlinePlus

    ... Conditions iron-refractory iron deficiency anemia iron-refractory iron deficiency anemia Printable PDF Open All Close All Enable ... view the expand/collapse boxes. Description Iron-refractory iron deficiency anemia is one of many types of anemia , ...

  1. [Iron deficiency and digestive disorders].

    PubMed

    Cozon, G J N

    2014-11-01

    Iron deficiency anemia still remains problematic worldwide. Iron deficiency without anemia is often undiagnosed. We reviewed, in this study, symptoms and syndromes associated with iron deficiency with or without anemia: fatigue, cognitive functions, restless legs syndrome, hair loss, and chronic heart failure. Iron is absorbed through the digestive tract. Hepcidin and ferroportin are the main proteins of iron regulation. Pathogenic micro-organisms or intestinal dysbiosis are suspected to influence iron absorption.

  2. Iron-refractory iron deficiency anemia (IRIDA).

    PubMed

    Heeney, Matthew M; Finberg, Karin E

    2014-08-01

    Iron deficiency anemia is a common global problem whose etiology is typically attributed to acquired inadequate dietary intake and/or chronic blood loss. However, in several kindreds multiple family members are affected with iron deficiency anemia that is unresponsive to oral iron supplementation and only partially responsive to parenteral iron therapy. The discovery that many of these cases harbor mutations in the TMPRSS6 gene led to the recognition that they represent a single clinical entity: iron-refractory iron deficiency anemia (IRIDA). This article reviews clinical features of IRIDA, recent genetic studies, and insights this disorder provides into the regulation of systemic iron homeostasis.

  3. How Is Iron-Deficiency Anemia Treated?

    MedlinePlus

    ... page from the NHLBI on Twitter. How Is Iron-Deficiency Anemia Treated? Treatment for iron-deficiency anemia will ... cases, surgery may be advised. Treatments for Severe Iron-Deficiency Anemia Blood Transfusion If your iron-deficiency anemia ...

  4. Iron deficiency and iron deficiency anemia in women.

    PubMed

    Coad, Jane; Pedley, Kevin

    2014-01-01

    Iron deficiency is one of the most common nutritional problems in the world and disproportionately affects women and children. Stages of iron deficiency can be characterized as mild deficiency where iron stores become depleted, marginal deficiency where the production of many iron-dependent proteins is compromised but hemoglobin levels are normal and iron deficiency anemia where synthesis of hemoglobin is decreased and oxygen transport to the tissues is reduced. Iron deficiency anemia is usually assessed by measuring hemoglobin levels but this approach lacks both specificity and sensitivity. Failure to identify and treat earlier stages of iron deficiency is concerning given the neurocognitive implications of iron deficiency without anemia. Most of the daily iron requirement is derived from recycling of senescent erythrocytes by macrophages; only 5-10 % comes from the diet. Iron absorption is affected by inhibitors and enhancers of iron absorption and by the physiological state. Inflammatory conditions, including obesity, can result in iron being retained in the enterocytes and macrophages causing hypoferremia as a strategic defense mechanism to restrict iron availability to pathogens. Premenopausal women usually have low iron status because of iron loss in menstrual blood. Conditions which further increase iron loss, compromise absorption or increase demand, such as frequent blood donation, gastrointestinal lesions, athletic activity and pregnancy, can exceed the capacity of the gastrointestinal tract to upregulate iron absorption. Women of reproductive age are at particularly high risk of iron deficiency and its consequences however there is a controversial argument that evolutionary pressures have resulted in an iron deficient phenotype which protects against infection.

  5. Iron deficiency anemia in children.

    PubMed

    Subramaniam, Girish; Girish, Meenakshi

    2015-06-01

    Iron deficiency is not just anemia; it can be responsible for a long list of other manifestations. This topic is of great importance, especially in infancy and early childhood, for a variety of reasons. Firstly, iron need is maximum in this period. Secondly, diet in infancy is usually deficient in iron. Thirdly and most importantly, iron deficiency at this age can result in neurodevelopmental and cognitive deficits, which may not be reversible. Hypochromia and microcytosis in a complete blood count (CBC) makes iron deficiency anemia (IDA) most likely diagnosis. Absence of response to iron should make us look for other differential diagnosis like β thalassemia trait and anemia of chronic disease. Celiac disease is the most important cause of true IDA not responding to oral iron therapy. While oral ferrous sulphate is the cheapest and most effective therapy for IDA, simple nonpharmacological and pharmacological measures can go a long way in prevention of iron deficiency.

  6. The Cardiomyopathy of Iron Deficiency

    PubMed Central

    Hegde, Nikita; Rich, Michael W.; Gayomali, Charina

    2006-01-01

    Iron-deficiency anemia can have deleterious effects on the heart. Herein, we describe the effects of iron deficiency on the heart as corroborated with electrocardiography, radiology, echocardiography, and cardiac catheterization. We review the pathophysiology, clinical features, and management of iron-deficiency–induced cardiomyopathy. PMID:17041692

  7. [Iron deficiency and iron deficiency anemia are global health problems].

    PubMed

    Dahlerup, Jens; Lindgren, Stefan; Moum, Björn

    2015-03-10

    Iron deficiency and iron deficiency anemia are global health problems leading to deterioration in patients' quality of life and more serious prognosis in patients with chronic diseases. The cause of iron deficiency and anemia is usually a combination of increased loss and decreased intestinal absorption and delivery from iron stores due to inflammation. Oral iron is first line treatment, but often hampered by intolerance. Intravenous iron is safe, and the preferred treatment in patients with chronic inflammation and bowel diseases. The goal of treatment is normalisation of hemoglobin concentration and recovery of iron stores. It is important to follow up treatment to ensure that these objectives are met and also long-term in patients with chronic iron loss and/or inflammation to avoid recurrence of anemia.

  8. Iron-Refractory Iron Deficiency Anemia

    PubMed Central

    Yılmaz Keskin, Ebru; Yenicesu, İdil

    2015-01-01

    Iron is essential for life because it is indispensable for several biological reactions, such as oxygen transport, DNA synthesis, and cell proliferation. Over the past few years, our understanding of iron metabolism and its regulation has changed dramatically. New disorders of iron metabolism have emerged, and the role of iron as a cofactor in other disorders has begun to be recognized. The study of genetic conditions such as hemochromatosis and iron-refractory iron deficiency anemia (IRIDA) has provided crucial insights into the molecular mechanisms controlling iron homeostasis. In the future, these advances may be exploited to improve treatment of both genetic and acquired iron disorders. IRIDA is caused by mutations in TMPRSS6, the gene encoding matriptase-2, which downregulates hepcidin expression under conditions of iron deficiency. The typical features of this disorder are hypochromic, microcytic anemia with a very low mean corpuscular volume of erythrocytes, low transferrin saturation, no (or inadequate) response to oral iron, and only a partial response to parenteral iron. In contrast to classic iron deficiency anemia, serum ferritin levels are usually low-normal, and serum or urinary hepcidin levels are inappropriately high for the degree of anemia. Although the number of cases reported thus far in the literature does not exceed 100, this disorder is considered the most common of the “atypical” microcytic anemias. The aim of this review is to share the current knowledge on IRIDA and increase awareness in this field. PMID:25805669

  9. Iron-refractory iron deficiency anemia.

    PubMed

    Yılmaz Keskin, Ebru; Yenicesu, İdil

    2015-03-05

    Iron is essential for life because it is indispensable for several biological reactions, such as oxygen transport, DNA synthesis, and cell proliferation. Over the past few years, our understanding of iron metabolism and its regulation has changed dramatically. New disorders of iron metabolism have emerged, and the role of iron as a cofactor in other disorders has begun to be recognized. The study of genetic conditions such as hemochromatosis and iron-refractory iron deficiency anemia (IRIDA) has provided crucial insights into the molecular mechanisms controlling iron homeostasis. In the future, these advances may be exploited to improve treatment of both genetic and acquired iron disorders. IRIDA is caused by mutations in TMPRSS6, the gene encoding matriptase-2, which downregulates hepcidin expression under conditions of iron deficiency. The typical features of this disorder are hypochromic, microcytic anemia with a very low mean corpuscular volume of erythrocytes, low transferrin saturation, no (or inadequate) response to oral iron, and only a partial response to parenteral iron. In contrast to classic iron deficiency anemia, serum ferritin levels are usually low-normal, and serum or urinary hepcidin levels are inappropriately high for the degree of anemia. Although the number of cases reported thus far in the literature does not exceed 100, this disorder is considered the most common of the "atypical" microcytic anemias. The aim of this review is to share the current knowledge on IRIDA and increase awareness in this field.

  10. Perspectives on nutritional iron deficiency.

    PubMed

    Hallberg, L

    2001-01-01

    Nutritional iron deficiency (ID) is caused by an intake of dietary iron insufficient to cover physiological iron requirements. Studies on iron absorption from whole diets have examined relationships between dietary iron bioavailability/absorption, iron losses, and amounts of stored iron. New insights have been obtained into regulation of iron absorption and expected rates of changes of iron stores or hemoglobin iron deficits when bioavailability or iron content of the diet has been modified and when losses of iron occur. Negative effects of ID are probably related to age, up to about 20 years, explaining some of earlier controversies. Difficulties in establishing the prevalence of mild ID are outlined. The degree of underestimation of the prevalence of mild ID when using multiple diagnostic criteria is discussed. It is suggested that current low-energy lifestyles are a common denominator for the current high prevalence not only of ID but also of obesity, diabetes, and osteoporosis.

  11. Iron Deficiency Anemia in Pregnancy.

    PubMed

    Breymann, Christian

    2015-10-01

    Anemia is a common problem in obstetrics and perinatal care. Any hemoglobin below 10.5 g/dL can be regarded as true anemia regardless of gestational age. Reasons for anemia in pregnancy are mainly nutritional deficiencies, parasitic and bacterial diseases, and inborn red blood cell disorders such as thalassemias. The main cause of anemia in obstetrics is iron deficiency, which has a worldwide prevalence between estimated 20%-80% and consists of a primarily female population. Stages of iron deficiency are depletion of iron stores, iron-deficient erythropoiesis without anemia, and iron deficiency anemia, the most pronounced form of iron deficiency. Pregnancy anemia can be aggravated by various conditions such as uterine or placental bleedings, gastrointestinal bleedings, and peripartum blood loss. In addition to the general consequences of anemia, there are specific risks during pregnancy for the mother and the fetus such as intrauterine growth retardation, prematurity, feto-placental miss ratio, and higher risk for peripartum blood transfusion. Besides the importance of prophylaxis of iron deficiency, the main therapy options for the treatment of pregnancy anemia are oral iron and intravenous iron preparations.

  12. Iron deficiency and iron deficiency anaemia in women.

    PubMed

    Percy, Laura; Mansour, Diana; Fraser, Ian

    2017-04-01

    Iron deficiency (ID) is the most common micronutrient deficiency worldwide with >20% of women experiencing it during their reproductive lives. Hepcidin, a peptide hormone mostly produced by the liver, controls the absorption and regulation of iron. Understanding iron metabolism is pivotal in the successful management of ID and iron deficiency anaemia (IDA) using oral preparations, parenteral iron or blood transfusion. Oral preparations vary in their iron content and can result in gastrointestinal side effects. Parenteral iron is indicated when there are compliance/tolerance issues with oral iron, comorbidities which may affect absorption or ongoing iron losses that exceed absorptive capacity. It may also be the preferred option when rapid iron repletion is required to prevent physiological decompensation or given preoperatively for non-deferrable surgery. As gynaecologists, we focus on managing women's heavy menstrual bleeding (HMB) and assume that primary care clinicians are treating the associated ID/IDA. We now need to take the lead in diagnosing, managing and initiating treatment for ID/IDA and treating HMB simultaneously. This dual management will significantly improve their quality of life. In this chapter we will summarise the importance of iron in cellular functioning, describe how to diagnose ID/IDA and help clinicians choose between the available treatment options. Copyright © 2016. Published by Elsevier Ltd.

  13. The Evidence-Based Evaluation of Iron Deficiency Anemia.

    PubMed

    Hempel, Eliana V; Bollard, Edward R

    2016-09-01

    Anemia is a prevalent disease with multiple possible etiologies and resultant complications. Iron deficiency anemia is a common cause of anemia and is typically due to insufficient intake, poor absorption, or overt or occult blood loss. Distinguishing iron deficiency from other causes of anemia is integral to initiating the appropriate treatment. In addition, identifying the underlying cause of iron deficiency is also necessary to help guide management of these patients. We review the key components to an evidence-based, cost-conscious evaluation of suspected iron deficiency anemia. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Iron deficiency and thrombocytosis.

    PubMed

    Holbro, A; Volken, T; Buser, A; Sigle, J P; Halter, J P; Passweg, J R; Tichelli, A; Infanti, L

    2017-01-01

    According to many textbooks, iron deficiency (ID) is associated with reactive thrombocytosis. In this study, we aimed to investigate the correlation between serum ferritin levels and platelet counts in a large cohort of healthy blood donors. We included all whole blood and apheresis donors aged 18 years or older with at least one ferritin measurement and one platelet count performed at the same visit between 1996 and 2014. A total of 130 345 blood counts and ferritin measurements obtained from 22 046 healthy donors were analysed. Overall, no correlation between serum ferritin and platelet count was observed (r = -0.03, ρ = 0.04 for males, and r = 0.01, ρ = -0.02 for females, respectively). Associations remained clinically negligible after adjusting for age, time since previous blood donation, number of donations and restricting the analysis to ferritin deciles. In this large, retrospective single-centre study, correlations between low ferritin and platelet count in a large and homogeneous cohort of healthy donors were negligible. Further studies in patients with more severe anaemia and patients with inflammation are warranted.

  15. Iron deficiency in the tropics.

    PubMed

    Fleming, A F

    1982-06-01

    Iron in food is classified as belonging to the haem pool, the nonhaem pool, and extraneous sources. Haem iron is derived from vegetable and animal sources with varying bioavailability. Hookworm infestation of the intestinal tract affects 450 million people in the tropics. Schistosoma mansoni caused blood loss in 7 Egyptian patients of 7.5- 25.9 ml/day which is equivalent to a daily loss of iron of .6-7.3 mg daily urinary loss of iron in 9 Egyptian patients. Trichuris trichiura infestation by whipworm is widespread in children with blood loss of 5 ml/day/worm. The etiology of anemia in children besides iron deficiency includes malaria, bacterial or viral infections, folate deficiency and sickle-cell disease. Severe infections cause profound iron-deficiency anemia in children in central American and Malaysia. Plasmodium falciparum malaria-induced anaemia in tropical Africa lowers the mean haemoglobin concentration in the population by 2 g/dI, causing profound anaemia in some. The increased risk of premature delivery, low birthweight, fetal abnormalities, and fetal death is directly related to the degree of maternal anemia. Perinatal mortality was reduced from 38 to 4% in treated anemic mothers. Mental performance was significantly lower in anemic school children and improved after they received iron. Supplements of iron, soy-protein, calcium, and vitamins given to villagers with widespread malnutrition, iron deficiency, and hookworm infestation in Colombia reduced enteric infections in children. Severe iron-deficiency anemia was treated in adults in northern Nigeria by daily in Ferastral 10 ml, which is equivalent to 500 mg of iron per day. Choloroquine, folic acid, rephenium hydroxynaphthoate, and tetrachlorethylene treat adults with severe iron deficiency from hookworm infestation in rural tropical Africa. Blood transfusion is indicated if the patient is dying of anaemia or is pregnant with a haemoglobin concentration 6 gm/dl. In South East Asia, mg per day

  16. Iron deficiency and brain development.

    PubMed

    Lozoff, Betsy; Georgieff, Michael K

    2006-09-01

    Iron deficiency (ID) is common in pregnant women and infants worldwide. Rodent models show that ID during gestation/lactation alters neurometabolism, neurotransmitters, myelination, and gene/protein profiles before and after iron repletion at weaning. Human infants with iron deficiency anemia test lower in cognitive, motor, social-emotional, and neurophysiologic development than comparison group infants. Iron therapy does not consistently improve developmental outcome, with long-term differences observed. Poorer outcome has also been shown in human and monkey infants with fetal/neonatal ID. Recent randomized trials of infant iron supplementation show benefits, indicating that adverse effects can be prevented and/or reversed with iron earlier in development or before ID becomes severe or chronic. This body of research emphasizes the importance of protecting the developing brain from ID.

  17. New insights into iron deficiency and iron deficiency anemia.

    PubMed

    Camaschella, Clara

    2017-02-13

    Recent advances in iron metabolism have stimulated new interest in iron deficiency (ID) and its anemia (IDA), common conditions worldwide. Absolute ID/IDA, i.e. the decrease of total body iron, is easily diagnosed based on decreased levels of serum ferritin and transferrin saturation. Relative lack of iron in specific organs/tissues, and IDA in the context of inflammatory disorders, are diagnosed based on arbitrary cut offs of ferritin and transferrin saturation and/or marker combination (as the soluble transferrin receptor/ferritin index) in an appropriate clinical context. Most ID patients are candidate to traditional treatment with oral iron salts, while high hepcidin levels block their absorption in inflammatory disorders. New iron preparations and new treatment modalities are available: high-dose intravenous iron compounds are becoming popular and indications to their use are increasing, although long-term side effects remain to be evaluated.

  18. Management of Iron Deficiency Anemia

    PubMed Central

    Jimenez, Kristine; Kulnigg-Dabsch, Stefanie

    2015-01-01

    Anemia affects one-fourth of the world’s population, and iron deficiency is the predominant cause. Anemia is associated with chronic fatigue, impaired cognitive function, and diminished well-being. Patients with iron deficiency anemia of unknown etiology are frequently referred to a gastroenterologist because in the majority of cases the condition has a gastrointestinal origin. Proper management improves quality of life, alleviates the symptoms of iron deficiency, and reduces the need for blood transfusions. Treatment options include oral and intravenous iron therapy; however, the efficacy of oral iron is limited in certain gastrointestinal conditions, such as inflammatory bowel disease, celiac disease, and autoimmune gastritis. This article provides a critical summary of the diagnosis and treatment of iron deficiency anemia. In addition, it includes a management algorithm that can help the clinician determine which patients are in need of further gastrointestinal evaluation. This facilitates the identification and treatment of the underlying condition and avoids the unnecessary use of invasive methods and their associated risks. PMID:27099596

  19. Iron induced nickel deficiency

    USDA-ARS?s Scientific Manuscript database

    It is increasingly apparent that economic loss due to nickel (Ni) deficiency likely occurs in horticultural and agronomic crops. While most soils contain sufficient Ni to meet crop requirements, situations of Ni deficiency can arise due to antagonistic interactions with other metals. This study asse...

  20. Iron deficiency and new insights into therapy.

    PubMed

    Low, Michael Sy; Grigoriadis, George

    2017-07-17

    Iron deficiency and iron deficiency anaemia remain prevalent in Australia. The groups at highest risk are pre-menopausal women, socially disadvantaged people and those of Indigenous background. Diagnosing iron deficiency using a full blood examination and iron studies can be difficult and can be further complicated by concomitant inflammation. Results of iron studies should always be interpreted as an overall picture rather than focusing on individual parameters. In difficult clinical scenarios, soluble transferrin receptor assays can be useful. Management of iron deficiency involves identification and treatment of the cause of iron deficiency, as well as effective iron replacement. Clinicians should always take a detailed history and perform a comprehensive physical examination of a patient with iron deficiency. Patients should be monitored even if a likely cause of iron deficiency is identified. Patients who fail to respond to iron replacement or maintain iron status should be referred for further investigation, including endoscopy to exclude internal bleeding. Both enteral and parenteral iron are effective at replacing iron. For most adult patients, we recommend trialling daily oral iron (30-100 mg of elemental iron) as the first-line therapy. Safety and efficacy of intravenous iron infusions have improved with the availability of a newer formulation, ferric carboxymaltose. Patients who fail to respond to oral iron replacement can be safely managed with intravenous iron. Blood transfusion for iron deficiency anaemia should be reserved for life-threatening situations and should always be followed by appropriate iron replacement.

  1. Iron-Deficiency Anemia (For Parents)

    MedlinePlus

    ... Habits for TV, Video Games, and the Internet Iron-Deficiency Anemia KidsHealth > For Parents > Iron-Deficiency Anemia Print ... anemia, a common nutritional deficiency in children. About Iron-Deficiency Anemia Every red blood cell in the body ...

  2. Iron Deficiency and Bariatric Surgery

    PubMed Central

    Jáuregui-Lobera, Ignacio

    2013-01-01

    It is estimated that the prevalence of anaemia in patients scheduled for bariatric surgery is higher than in the general population and the prevalence of iron deficiencies (with or without anaemia) may be higher as well. After surgery, iron deficiencies and anaemia may occur in a higher percentage of patients, mainly as a consequence of nutrient deficiencies. In addition, perioperative anaemia has been related with increased postoperative morbidity and mortality and poorer quality of life after bariatric surgery. The treatment of perioperative anaemia and nutrient deficiencies has been shown to improve patients’ outcomes and quality of life. All patients should undergo an appropriate nutritional evaluation, including selective micronutrient measurements (e.g., iron), before any bariatric surgical procedure. In comparison with purely restrictive procedures, more extensive perioperative nutritional evaluations are required for malabsorptive procedures due to their nutritional consequences. The aim of this study was to review the current knowledge of nutritional deficits in obese patients and those that commonly appear after bariatric surgery, specifically iron deficiencies and their consequences. As a result, some recommendations for screening and supplementation are presented. PMID:23676549

  3. Iron deficiency--facts and fallacies.

    PubMed

    Oski, F A

    1985-04-01

    Iron deficiency occurs in all strata of society, is primarily a result of postnatal feeding practices and not due to congenital deficiencies of iron, can be prevented by appropriate dietary guidance, and, when present, produces important nonhematologic manifestations.

  4. Iron deficiency anemia in heart failure.

    PubMed

    Arora, Natasha P; Ghali, Jalal K

    2013-07-01

    Anemia and iron deficiency are quite prevalent in patients with heart failure (HF) and may overlap. Both anemia and iron deficiency are associated with worse symptoms and adverse clinical outcomes. In the past few years, there has been an enormous interest in the subject of iron deficiency and its management in patients with HF. In this review, the etiology and relevance of iron deficiency, iron metabolism in the setting of HF, studies on iron supplementation in patients with HF and potential cardiovascular effects of subclinical iron overload are discussed.

  5. Iron Deficiency in Autism and Asperger Syndrome.

    ERIC Educational Resources Information Center

    Latif, A.; Heinz, P.; Cook, R.

    2002-01-01

    Retrospective analysis of the full blood count and, when available, serum ferritin measurements of 96 children (52 with autism and 44 with Asperger syndrome) found six autistic children had iron deficiency and 12 of the 23 autistic children with serum ferritin measures were iron deficient. Far fewer Asperger children were iron deficient. Results…

  6. Iron Deficiency in Autism and Asperger Syndrome.

    ERIC Educational Resources Information Center

    Latif, A.; Heinz, P.; Cook, R.

    2002-01-01

    Retrospective analysis of the full blood count and, when available, serum ferritin measurements of 96 children (52 with autism and 44 with Asperger syndrome) found six autistic children had iron deficiency and 12 of the 23 autistic children with serum ferritin measures were iron deficient. Far fewer Asperger children were iron deficient. Results…

  7. Iron sensors and signals in response to iron deficiency.

    PubMed

    Kobayashi, Takanori; Nishizawa, Naoko K

    2014-07-01

    The transcription of genes involved in iron acquisition in plants is induced under iron deficiency, but our understanding of iron sensors and signals remains limited. Iron Deficiency-responsive Element-binding Factor 1 (IDEF1) and Hemerythrin motif-containing Really Interesting New Gene- and Zinc-finger proteins (HRZs)/BRUTUS (BTS) have recently emerged as candidate iron sensors because of their functions as potent regulators of iron deficiency responses and their iron-binding properties. IDEF1 is a central transcriptional regulator of graminaceous genes involved in iron uptake and utilization, predominantly during the early stages of iron deficiency. HRZs/BTS are E3 ubiquitin ligases and negative regulators of iron deficiency responses in both graminaceous and non-graminaceous plants. Rice OsHRZ1 and OsHRZ2 are also potent regulators of iron accumulation. Characterizing these putative iron sensors also provides clues to understanding the nature of iron signals, which may involve ionized iron itself, other metals, oxygen, redox status, heme and iron-sulfur clusters, in addition to metabolites affected by iron deficiency. Systemic iron responses may also be regulated by phloem-mobile iron and its chelators such as nicotianamine. Iron sensors and signals will be identified by demonstration of signal transmission by IDEF1, HRZs/BTS, or unknown factors. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  8. Malabsorption of iron in children with iron deficiency.

    PubMed

    Gross, S J; Stuart, M J; Swender, P T; Oski, F A

    1976-05-01

    Inability to absorb oral iron is believed to be an extremely rare cause of therapeutic failure in the treatment of iron deficiency anemia. Six patients who had failed to respond to oral iron therapy were studied by a simple oral absorption test and contrasted with 25 patients with untreated iron deficiency anemia and 10 normal subjects. All six of the patients who were therapeutic failures demonstrated impaired iron absorption in the absence of other clinical evidence of gastrointestinal disease. In the 25 newly diagnosed patients with iron deficiency. 24 demonstrated elevated iron absorptions while 10 ironreplete normal subjects had minimal elevations in their serum iron values following the administration of the test dose of 1 mg of elemental iron per kilogram. When the therapeutic failures were treated with parenteral iron, all had a therapeutic response. In addition, after treatment the impaired absorption of iron improved transiently. All children who absorbed iron readily responded to oral iron therapy.

  9. Iron deficiency in the young athlete.

    PubMed

    Rowland, T W

    1990-10-01

    Although overt anemia is uncommon, depletion of body iron stores is common among adolescent female athletes. Poor dietary iron intake, menstruation, and increased iron losses associated with physical training all appear to be important factors. Whether nonanemic iron deficiency can impair exercise performance is uncertain. Nonetheless, athletes with low ferritin levels are at risk for impaired erythropoiesis and should receive therapeutic iron supplementation.

  10. Targeting Iron Deficiency Anemia in Heart Failure.

    PubMed

    Saraon, Tajinderpal; Katz, Stuart D

    2016-01-01

    Iron deficiency is common in heart failure (HF) patients, and is associated with increased risk of adverse clinical outcomes. Clinical trials of intravenous iron supplementation in iron-deficient HF patients have demonstrated short-term improvement in functional capacity and quality of life. In some trials, the benefits of iron supplementation were independent of the hemoglobin levels. Additional investigations of iron supplementation are needed to characterize the mechanisms contributing to clinical benefit and long-term safety in HF.

  11. [Iron deficiency in the elderly].

    PubMed

    Helsen, Tuur; Joosten, Etienne

    2016-06-01

    Anemia is a common diagnosis in the geriatric population, especially in institutionalized and hospitalized elderly. Most common etiologies for anemia in elderly people admitted to a geriatric ward are iron-deficiency anemia and anemia associated with chronic disease. Determination of serum ferritin is the most used assay in the differential diagnosis, despite low sensitivity and moderate specificity. New insights into iron homeostasis lead to new diagnostic assays such as serum hepcidin, serum transferrin receptor and reticulocyte hemoglobin equivalent.Importance of proper diagnosis and treatment for this population is large since there is a correlation between anemia and morbidity - mortality. Anemia is usually defined as hemoglobin less than 12 g/dl for women and less than 13 g/dl for men. There is no consensus for which hemoglobinvalue an investigation into underlying pathology is obligatory. This needs to be evaluated depending on functional condition of the patient.

  12. Treatment of Iron Deficiency in Women

    PubMed Central

    Breymann, C.; Römer, T.; Dudenhausen, J. W.

    2013-01-01

    Iron deficiency with and without anaemia is a common cause of morbidity, particularly in women. Iron deficiency is generally the result of an imbalance between iron loss and iron absorption. In women with symptoms suspicious for iron deficiency, it is important to confirm or exclude the suspicion using proper tests. The use of serum ferritin levels is considered the gold standard for diagnosis. Although the ideal ferritin levels are not unknown the current consent is that levels < 40 ng/ml indicate iron deficiency, which needs to be treated in symptomatic patients. However, symptoms can already occur at ferritin levels of < 100 ng/ml and treatment must be adapted to the individual patient. Iron supplementation is only indicated in symptomatic patients diagnosed with iron deficiency whose quality of life is affected. It is important to treat iron deficiency together with its causes or risk factors. For example, blood loss from hypermenorrhea should be reduced. Women also need to receive information about the benefits of an iron-rich diet. If oral treatment with iron supplements is ineffective, parenteral iron administration is recommended. PMID:26633902

  13. Duodenal Amyloidosis Masquerading as Iron Deficiency Anemia

    PubMed Central

    Hurairah, Abu

    2016-01-01

    The present study is a unique illustration of duodenal amyloidosis initially manifesting with iron deficiency anemia. It underscores the importance of clinical suspicion of amyloidosis while performing upper gastrointestinal endoscopy with a biopsy to establish the definite diagnosis in patients with unexplained iron deficiency anemia. PMID:27625911

  14. Perinatal iron deficiency and neurocognitive development

    PubMed Central

    Radlowski, Emily C.; Johnson, Rodney W.

    2013-01-01

    Iron deficiency is the most common form of nutrient deficiency worldwide. It is highly prevalent due to the limited availability of high quality food in developing countries and poor dietary habits in industrialized countries. According to the World Health Organization, it affects nearly 2 billion people and up to 50% of women who are pregnant. Maternal anemia during pregnancy is especially burdensome to healthy neurodevelopment in the fetus because iron is needed for proper neurogenesis, development, and myelination. Maternal anemia also increases the risk of low birth weight, either due to premature birth or fetal growth restriction, which is associated with delayed neurocognitive development and even psychiatric illness. As rapid neurodevelopment continues after birth infants that received sufficient iron in utero, but that receive a low iron diet after 6 months of age, also show deficits in neurocognitive development, including impairments in learning and memory. Unfortunately, the neurocognitive complications of iron deficiency during critical pre- and postnatal periods of brain development are difficult to remedy, persisting into adulthood. Thus, preventing iron deficiency in the pre- and postnatal periods is critical as is devising new means to recapture cognitive function in individuals who experienced early iron deficiency. This review will discuss the prevalence of pre- and postnatal iron deficiency, the mechanism, and effects of iron deficiency on brain and cognitive development. PMID:24065908

  15. Psychomotor development in children with iron deficiency and iron-deficiency anemia.

    PubMed

    Pala, Emin; Erguven, Muferet; Guven, Sirin; Erdogan, Makbule; Balta, Tulin

    2010-09-01

    Iron deficiency and iron-deficiency anemia are the most common nutritional deficiencies in children, especially in developing countries. Iron-deficiency anemia in infancy is associated with impaired neurodevelopment. Studies have shown an association between iron deficiency without anemia and adverse effects on psychomotor development. To determine the effects of iron deficiency and iron-deficiency anemia on psychomotor development in childhood. . We evaluated psychomotor development in healthy children with iron deficiency and iron-deficiency anemia with the use of the Denver II Developmental Screening Test (DDST-II). If the child score was more than 90th percentile compared to children in the same age group, the test was scored as "delay" it was scored as a "caution" if the child score was between the 75th and 90th percentiles. The test result was interpreted as "normal," if there was no delay and only one "caution" for any item. If the child had one or more "delays" or more than two "cautions," the result was classified as "abnormal." DDST-II scores were abnormal in 67.3% of subjects with iron-deficiency anemia, 21.6% of those with iron deficiency, and 15.0% of control subjects. The difference from the control group in the percentage of abnormal scores was significant for subjects with iron-deficiency anemia (p < .01) but not for those with iron deficiency (p = 0.203); p > .05. (p-value, post-hoc comparison of 2 groups.) Iron-deficiency anemia impaired psychomotor development during childhood. However, the evidence on the adverse effects of iron deficiency remains controversial. The Denver II Developmental Screening Test is a valuable test to detect early developmental delays, especially in infants with risk factors.

  16. Serum transferrin receptor levels in the evaluation of iron deficiency in the neonate.

    PubMed

    Rusia, U; Flowers, C; Madan, N; Agarwal, N; Sood, S K; Sikka, M

    1996-10-01

    Iron deficiency anemia (IDA) is a major global problem. Early onset of iron deficiency in developing countries makes it imperative to identify iron deficiency in neonates. Most conventional laboratory parameters of iron status fail to distinguish neonates with iron deficient erythropoiesis. Serum transferrin receptor (STFR) levels are a recent sensitive measure of iron deficiency and the present study was carried out to evaluate the usefulness of cord serum transferrin receptors in identifying iron deficient erythropoiesis in neonates. A complete hemogram, red cell indices, iron profile: serum iron (SI), percent transferrin saturation (TS%) and serum ferritin (SF) was carried out in 100 full-term neonates and their mothers at parturition. Cord and maternal STFR levels were estimated using a sensitive enzyme-linked immunosorbent assay (ELISA) technique. Anemic women had a significantly lower SI, their TS% and high STFR levels suggesting that iron deficiency was responsible for the anemia. In the neonates of iron deficient mothers, cord SI, TS% and cord ferritin were not significantly different from those of neonates born to non-anemic mothers. Cord STFR level correlated well with hemoglobin (Hb) and laboratory parameters of iron status, and its level was significantly higher in neonates born to anemic mothers than in those born to non-anemic mothers. It was the only laboratory parameter to differentiate between neonates born to anemic and non-anemic mothers. Therefore, STFR is a sensitive index of iron status in neonates and identifies neonates with iron deficient erythropoiesis.

  17. Iron deficiency and anemia in heart failure.

    PubMed

    Çavuşoğlu, Yüksel; Altay, Hakan; Çetiner, Mustafa; Güvenç, Tolga Sinan; Temizhan, Ahmet; Ural, Dilek; Yeşilbursa, Dilek; Yıldırım, Nesligül; Yılmaz, Mehmet Birhan

    2017-03-01

    Heart failure is an important community health problem. Prevalence and incidence of heart failure have continued to rise over the years. Despite recent advances in heart failure therapy, prognosis is still poor, rehospitalization rate is very high, and quality of life is worse. Co-morbidities in heart failure have negative impact on clinical course of the disease, further impair prognosis, and add difficulties to treatment of clinical picture. Therefore, successful management of co-morbidities is strongly recommended in addition to conventional therapy for heart failure. One of the most common co-morbidities in heart failure is presence of iron deficiency and anemia. Current evidence suggests that iron deficiency and anemia are more prevalent in patients with heart failure and reduced ejection fraction, as well as those with heart failure and preserved ejection fraction. Moreover, iron deficiency and anemia are referred to as independent predictors for poor prognosis in heart failure. There is strong relationship between iron deficiency or anemia and severity of clinical status of heart failure. Over the last two decades, many clinical investigations have been conducted on clinical effectiveness of treatment of iron deficiency or anemia with oral iron, intravenous iron, and erythropoietin therapies. Studies with oral iron and erythropoietin therapies did not provide any clinical benefit and, in fact, these therapies have been shown to be associated with increase in adverse clinical outcomes. However, clinical trials in patients with iron deficiency in the presence or absence of anemia have demonstrated considerable clinical benefits of intravenous iron therapy, and based on these positive outcomes, iron deficiency has become target of therapy in management of heart failure. The present report assesses current approaches to iron deficiency and anemia in heart failure in light of recent evidence.

  18. [Control of iron deficiency in developing countries].

    PubMed

    Berger, Jacques; Dillon, Jean-Claude

    2002-01-01

    Iron deficiency is the most prevalent nutritional disorder worldwide, especially in developing countries. It occurs when iron absorption cannot compensate iron requirements and losses. Requirements are especially high in pregnant women, infants, young children and adolescents who run a higher risk of being iron-deficient. In developing countries, the main cause of iron deficiency is the low iron bioavailability of the diet. The consequences of iron deficiency are many and serious, affecting not only individuals' health but also the development of societies and countries. The prevention and the control of iron deficiency and anemia in all groups of a population with different iron requirements imply to coordinate different interventions. Iron fortification of staple foods or condiments directed to the whole population is a sustainable and low cost-effective approach. However, at some periods of life, especially during pregnancy and in children from the age of 6 months, iron requirements are high. For pregnant women, the current approach favours the daily iron-folate supplementation during pregnancy but the results in terms of public health are disappointing. The preventive weekly iron-folate supplementation of women during their reproductive life, whose efficacy is recognized, offers a promising alternative; its impact in terms of public health is under current evaluation. For infants and young children, iron fortification of complementary food is effective but this food is generally imported and economically inaccessible to populations with limited resources. The production, by small private units from local products, of complementary foods of low viscosity, good nutritional quality, fortified with vitamins and minerals, and of low cost is at hand in several countries. When complementary foods are not available, the preventive iron supplementation from 6 to 18 months of age has to be advised. This approach should be strengthened by the advantages of the weekly

  19. Iron-induced nickel deficiency in pecan

    USDA-ARS?s Scientific Manuscript database

    Economic loss due to nickel (Ni) deficiency can occur in horticultural and agronomic crops. This study assesses impact of excessive iron (Fe) on expression of Ni deficiency in pecan [Carya illinoinensis (Wangenh.) K. Koch]. Field and greenhouse experiments found Ni deficiency to be inducible by ei...

  20. Iron deficiency: from diagnosis to treatment.

    PubMed

    Polin, Vanessa; Coriat, Romain; Perkins, Géraldine; Dhooge, Marion; Abitbol, Vered; Leblanc, Sarah; Prat, Frédéric; Chaussade, Stanislas

    2013-10-01

    Iron deficiency is the most frequent cause of anaemia worldwide. It impairs quality of life, increases asthenia and can lead to clinical worsening of patients. In addition, iron deficiency has a complex mechanism whose pathologic pathway is recently becoming better understood. The discovery of hepcidin has allowed a better clarification of iron metabolism regulation. Furthermore, the ratio of concentration of soluble transferrin receptor to the log of the ferritin level, has been developed as a tool to detect iron deficiency in most situations. The cause of iron deficiency should always be sought because the underlying condition can be serious. This review will summarize the current knowledge regarding diagnostic algorithms for iron deficiency anaemia. The majority of aetiologies occur in the digestive tract, in men and postmenopausal women, and justify morphological examination of the gut. First line investigations are upper gastrointestinal endoscopy and colonoscopy, and when negative, the small bowel should be explored; newer tools such as video capsule endoscopy have also been developed. The treatment of iron deficiency is aetiological if possible and iron supplementation whether in oral or in parenteral form. New parenteral formulations are available and seem to have promising results in terms of efficacy and safety.

  1. Intravenous Iron Sucrose for Children With Iron Deficiency Anemia.

    PubMed

    Kaneva, Kristiyana; Chow, Erika; Rosenfield, Cathy G; Kelly, Michael J

    2017-07-01

    Iron deficiency anemia (IDA) is the most common nutritional deficiency in children. Most children with IDA are treated with oral iron preparations. However, intravenous (IV) iron is an alternative for children with severe IDA who have difficulty in adhering to or absorbing oral iron. We sought to describe the safety and effectiveness of IV iron sucrose for treatment of IDA in children. Pharmacy records of children who received IV iron sucrose at a children's hospital between 2004 and 2014 were reviewed. Laboratory markers of anemia and iron studies were obtained and preinfusion and postinfusion values were compared. Records were also reviewed for adverse reactions. A total of 142 patients received IV iron sucrose over 10 years. The mean age was 11 years, 9 months. One patient of 142 developed cough and wheezing during the infusion. No other adverse events were found. IV iron sucrose resulted in a statistically significant and clinically meaningful increase in hemoglobin, mean corpuscular volume, serum iron, ferritin, and % iron saturation, with a corresponding decrease in total iron binding capacity. The use of IV iron sucrose in pediatric patients with IDA is safe and leads to a moderate increase in hemoglobin and substantial improvement in iron studies.

  2. Anemia and iron deficiency in heart failure.

    PubMed

    Gil, Victor M; Ferreira, Jorge S

    2014-01-01

    Heart failure is a common problem and a major cause of mortality, morbidity and impaired quality of life. Anemia is a frequent comorbidity in heart failure and further worsens prognosis and disability. Regardless of anemia status, iron deficiency is a common and usually unidentified problem in patients with heart failure. This article reviews the mechanisms, impact on outcomes and treatment of anemia and iron deficiency in patients with heart failure.

  3. Metabolic Remodeling in Iron-deficient Fungi

    PubMed Central

    Philpott, Caroline C.; Leidgens, Sebastien; Frey, Avery G.

    2012-01-01

    Eukaryotic cells contain dozens, perhaps hundreds, of iron-dependent proteins, which perform critical functions in nearly every major cellular process. Nutritional iron is frequently available to cells in only limited amounts; thus, unicellular and higher eukaryotes have evolved mechanisms to cope with iron scarcity. These mechanisms have been studied at the molecular level in the model eukaryotes Saccharomyces cerevisiae and Schizosaccharomyces pombe, as well as in some pathogenic fungi. Each of these fungal species exhibits metabolic adaptations to iron deficiency that serve to reduce the cell’s reliance on iron. However, the regulatory mechanisms that accomplish these adaptations differ greatly between fungal species. PMID:22306284

  4. Iron Deficiency in Adolescents and Young Adults.

    ERIC Educational Resources Information Center

    Risser, William L.; Risser, Jan M. H.

    1990-01-01

    Reviews the prevalence, natural history, causes, impact on performance, diagnosis, and treatment of iron deficiency in adolescent and young adult athletes. All athletes should be screened and treated. The best diagnosis involves determining serum ferritin and hemoglobin levels. Treatment requires therapeutic doses of oral ferrous iron for several…

  5. Iron Deficiency in Adolescents and Young Adults.

    ERIC Educational Resources Information Center

    Risser, William L.; Risser, Jan M. H.

    1990-01-01

    Reviews the prevalence, natural history, causes, impact on performance, diagnosis, and treatment of iron deficiency in adolescent and young adult athletes. All athletes should be screened and treated. The best diagnosis involves determining serum ferritin and hemoglobin levels. Treatment requires therapeutic doses of oral ferrous iron for several…

  6. Coprophagy in iron-deficient rats.

    PubMed

    Neale, R J

    1982-04-01

    An attempt was made to prevent coprophagy in iron-deficient rats using plastic anal cups. Considerable damage to the anal cups occurred as a result of gnawing over periods up to 4 days. Haemoglobin iron determinations in rats with and without cups suggested that the cups had been partially successful in preventing recycling of dietary iron, and that coprophagy may be a significant factor in interpretation of haemoglobin regeneration studies on rodents.

  7. Anaemia, iron deficiency and iron deficiency anaemia among blood donors in Port Harcourt, Nigeria.

    PubMed

    Jeremiah, Zaccheaus Awortu; Koate, Baribefe Banavule

    2010-04-01

    There is paucity of information on the effect of blood donation on iron stores in Port Harcourt, Nigeria. The present study was, therefore, designed to assess, using a combination of haemoglobin and iron status parameters, the development of anaemia and prevalence of iron deficiency anaemia in this area of Nigeria. Three hundred and forty-eight unselected consecutive whole blood donors, comprising 96 regular donors, 156 relatives of patients and 96 voluntary donors, constituted the study population. Three haematological parameters (haemoglobin, packed cell volume, and mean cell haemoglobin concentration) and four biochemical iron parameters (serum ferritin, serum iron, total iron binding capacity and transferrin saturation) were assessed using standard colorimetric and ELISA techniques. The prevalence of anaemia alone (haemoglobin <11.0 g/dL) was 13.7%. The prevalence of isolated iron deficiency (serum ferritin <12 ng/mL) was 20.6% while that of iron-deficiency anaemia (haemoglobin <11.0 g/dL + serum ferritin <12.0 ng/mL) was 12.0%. Among the three categories of the donors, the regular donors were found to be most adversely affected as shown by the reduction in mean values of both haematological and biochemical iron parameters. Interestingly, anaemia, iron deficiency and iron-deficiency anaemia were present almost exclusively among regular blood donors, all of whom were over 35 years old. Anaemia, iron deficiency and iron-deficiency anaemia are highly prevalent among blood donors in Port Harcourt, Nigeria. It will be necessary to review the screening tests for the selection of blood donors and also include serum ferritin measurement for the routine assessment of blood donors, especially among regular blood donors.

  8. Anaemia, iron deficiency and iron deficiency anaemia among blood donors in Port Harcourt, Nigeria

    PubMed Central

    Jeremiah, Zaccheaus Awortu; Koate, Baribefe Banavule

    2010-01-01

    Background There is paucity of information on the effect of blood donation on iron stores in Port Harcourt, Nigeria. The present study was, therefore, designed to assess, using a combination of haemoglobin and iron status parameters, the development of anaemia and prevalence of iron deficiency anaemia in this area of Nigeria. Materials and Methods Three hundred and forty-eight unselected consecutive whole blood donors, comprising 96 regular donors, 156 relatives of patients and 96 voluntary donors, constituted the study population. Three haematological parameters (haemoglobin, packed cell volume, and mean cell haemoglobin concentration) and four biochemical iron parameters (serum ferritin, serum iron, total iron binding capacity and transferrin saturation) were assessed using standard colorimetric and ELISA techniques. Results The prevalence of anaemia alone (haemoglobin <11.0 g/dL) was 13.7%. The prevalence of isolated iron deficiency (serum ferritin <12 ng/mL) was 20.6% while that of iron-deficiency anaemia (haemoglobin <11.0 g/dL + serum ferritin <12.0 ng/mL) was 12.0%. Among the three categories of the donors, the regular donors were found to be most adversely affected as shown by the reduction in mean values of both haematological and biochemical iron parameters. Interestingly, anaemia, iron deficiency and iron-deficiency anaemia were present almost exclusively among regular blood donors, all of whom were over 35 years old. Conclusion Anaemia, iron deficiency and iron-deficiency anaemia are highly prevalent among blood donors in Port Harcourt, Nigeria. It will be necessary to review the screening tests for the selection of blood donors and also include serum ferritin measurement for the routine assessment of blood donors, especially among regular blood donors. PMID:20383305

  9. Iron deficiency anemia in celiac disease.

    PubMed

    Freeman, Hugh James

    2015-08-21

    Iron is an important micronutrient that may be depleted in celiac disease. Iron deficiency and anemia may complicate well-established celiac disease, but may also be the presenting clinical feature in the absence of diarrhea or weight loss. If iron deficiency anemia occurs, it should be thoroughly evaluated, even if celiac disease has been defined since other superimposed causes of iron deficiency anemia may be present. Most often, impaired duodenal mucosal uptake of iron is evident since surface absorptive area in the duodenum is reduced, in large part, because celiac disease is an immune-mediated disorder largely focused in the proximal small intestinal mucosa. Some studies have also suggested that blood loss may occur in celiac disease, sometimes from superimposed small intestinal disorders, including ulceration or neoplastic diseases, particularly lymphoma. In addition, other associated gastric or colonic disorders may be responsible for blood loss. Rarely, an immune-mediated hemolytic disorder with increased urine iron loss may occur that may respond to a gluten-free diet. Reduced expression of different regulatory proteins critical in iron uptake has also been defined in the presence and absence of anemia. Finally, other rare causes of microcytic anemia may occur in celiac disease, including a sideroblastic form of anemia reported to have responded to a gluten-free diet.

  10. Iron deficiency anemia in celiac disease

    PubMed Central

    Freeman, Hugh James

    2015-01-01

    Iron is an important micronutrient that may be depleted in celiac disease. Iron deficiency and anemia may complicate well-established celiac disease, but may also be the presenting clinical feature in the absence of diarrhea or weight loss. If iron deficiency anemia occurs, it should be thoroughly evaluated, even if celiac disease has been defined since other superimposed causes of iron deficiency anemia may be present. Most often, impaired duodenal mucosal uptake of iron is evident since surface absorptive area in the duodenum is reduced, in large part, because celiac disease is an immune-mediated disorder largely focused in the proximal small intestinal mucosa. Some studies have also suggested that blood loss may occur in celiac disease, sometimes from superimposed small intestinal disorders, including ulceration or neoplastic diseases, particularly lymphoma. In addition, other associated gastric or colonic disorders may be responsible for blood loss. Rarely, an immune-mediated hemolytic disorder with increased urine iron loss may occur that may respond to a gluten-free diet. Reduced expression of different regulatory proteins critical in iron uptake has also been defined in the presence and absence of anemia. Finally, other rare causes of microcytic anemia may occur in celiac disease, including a sideroblastic form of anemia reported to have responded to a gluten-free diet. PMID:26309349

  11. Intravenous Iron Sucrose for Children with Iron Deficiency Failing to Respond to Oral Iron Therapy

    PubMed Central

    Crary, Shelley E.; Hall, Katherine; Buchanan, George R.

    2010-01-01

    Background For decades parenteral iron has been used in patients with iron deficiency unresponsive to oral iron therapy and in hemodialysis-dependent patients receiving erythropoietin. Newer intravenous (IV) iron formulations such as iron sucrose have replaced high molecular weight iron dextran in dialysis patients; however, the use of parenteral iron in children without renal disease has not been well defined. Procedure Pharmacy records were reviewed on children (≤ 18 yrs of age) who received IV iron sucrose at Children's Medical Center Dallas between January 1, 2004 and June 30, 2009. Patients who received iron sucrose for chronic renal disease were excluded from analysis. Results Thirty-eight children received iron sucrose for non-renal indications, 13 with iron deficiency refractory to oral iron therapy, 13 with iron malabsorption or dependence on parenteral nutrition, 7 for chronic gastrointestinal blood loss, and 5 for miscellaneous indications. Among these 38 children, who received a total of 510 doses of IV iron sucrose, there were only 6 adverse reactions. Patients in all categories had a good response to the iron sucrose, with a median hemoglobin rise of 1.9 – 3.1 g/dl depending on the indication. Conclusions Parenteral iron is a safe and effective means to treat iron deficiency in children who cannot receive or do not respond to oral iron due to intolerance, poor adherence or iron malabsorption. PMID:21298748

  12. Anaemia, iron deficiency and susceptibility to infections.

    PubMed

    Jonker, Femke A M; Boele van Hensbroek, Michaël

    2014-11-01

    Anaemia, iron deficiency and infections are three major causes of childhood morbidity and mortality throughout the world, although they predominantly occur in resource limited settings. As the three conditions may have the same underlying aetiologies, they often occur simultaneously and may interact. Being an essential component in erythropoiesis, iron is also essential for proper functioning of the host immune system as well as an essential nutrient for growth of various pathogens, including non-typhoid salmonella. This has resulted in a treatment dilemma in which iron is needed to treat the iron deficient anaemia and improve the immune system of the host (child), but the same treatment may also put the child at an increased, potentially fatal, infection risk.

  13. Iron deficiency anemia in inflammatory bowel disease

    PubMed Central

    Kaitha, Sindhu; Bashir, Muhammad; Ali, Tauseef

    2015-01-01

    Anemia is a common extraintestinal manifestation of inflammatory bowel disease (IBD) and is frequently overlooked as a complication. Patients with IBD are commonly found to have iron deficiency anemia (IDA) secondary to chronic blood loss, and impaired iron absorption due to tissue inflammation. Patients with iron deficiency may not always manifest with signs and symptoms; so, hemoglobin levels in patients with IBD must be regularly monitored for earlier detection of anemia. IDA in IBD is associated with poor quality of life, necessitating prompt diagnosis and appropriate treatment. IDA is often associated with inflammation in patients with IBD. Thus, commonly used laboratory parameters are inadequate to diagnose IDA, and newer iron indices, such as reticulocyte hemoglobin content or percentage of hypochromic red cells or zinc protoporphyrin, are required to differentiate IDA from anemia of chronic disease. Oral iron preparations are available and are used in patients with mild disease activity. These preparations are inexpensive and convenient, but can produce gastrointestinal side effects, such as abdominal pain and diarrhea, that limit their use and patient compliance. These preparations are partly absorbed due to inflammation. Non-absorbed iron can be toxic and worsen IBD disease activity. Although cost-effective intravenous iron formulations are widely available and have improved safety profiles, physicians are reluctant to use them. We present a review of the pathophysiologic mechanisms of IDA in IBD, improved diagnostic and therapeutic strategies, efficacy, and safety of iron replacement in IBD. PMID:26301120

  14. Anemia and iron deficiency in heart failure.

    PubMed

    Gunawardena, Shanti; Dunlap, Mark E

    2012-12-01

    Anemia is a common comorbidity in heart failure (HF), and is associated with increased morbidity and mortality. However, it remains unclear whether anemia is merely a marker of poor prognosis or whether anemia itself confers risk. The pathogenesis of anemia in HF is multifactorial. Iron deficiency also confers risk in HF, either with or without associated anemia, and treatment of iron deficiency improves the functional status of patients with HF. An ongoing large clinical trial studying the use of darbepoetin-alfa in patients with anemia and systolic HF is expected to provide information that should improve our understanding of anemia in HF.

  15. Anemia and iron deficiency in heart failure.

    PubMed

    Arora, Natasha P; Ghali, Jalal K

    2014-04-01

    Anemia is a common comorbidity in patients with heart failure (HF) and is associated with poor prognosis. Iron deficiency, with or without anemia, confers increased risk of mortality and morbidity. Along with the altered iron metabolism in HF patients, inflammation creates challenges in the interpretation of laboratory parameters used to diagnose anemia in HF. Since the RED-HF trial failed to demonstrate any benefit from the use of erythropoiesis-stimulating agents (ESAs) on mortality or morbidity in HF patients, ESAs are no longer considered a treatment option, although intravenous iron has potential as therapy for anemic and nonanemic HF patients.

  16. Distinguishing iron-reducing from sulfate-reducing conditions

    USGS Publications Warehouse

    Chapelle, F.H.; Bradley, P.M.; Thomas, M.A.; McMahon, P.B.

    2009-01-01

    Ground water systems dominated by iron- or sulfate-reducing conditions may be distinguished by observing concentrations of dissolved iron (Fe2+) and sulfide (sum of H2S, HS-, and S= species and denoted here as "H2S"). This approach is based on the observation that concentrations of Fe2+ and H2S in ground water systems tend to be inversely related according to a hyperbolic function. That is, when Fe2+ concentrations are high, H2S concentrations tend to be low and vice versa. This relation partly reflects the rapid reaction kinetics of Fe2+ with H2S to produce relatively insoluble ferrous sulfides (FeS). This relation also reflects competition for organic substrates between the iron- and the sulfate-reducing microorganisms that catalyze the production of Fe2+ and H 2S. These solubility and microbial constraints operate in tandem, resulting in the observed hyperbolic relation between Fe2+ and H 2S concentrations. Concentrations of redox indicators, including dissolved hydrogen (H2) measured in a shallow aquifer in Hanahan, South Carolina, suggest that if the Fe2+/H2S mass ratio (units of mg/L) exceeded 10, the screened interval being tapped was consistently iron reducing (H2 ???0.2 to 0.8 nM). Conversely, if the Fe 2+/H2S ratio was less than 0.30, consistent sulfate-reducing (H2 ???1 to 5 nM) conditions were observed over time. Concomitantly high Fe2+ and H2S concentrations were associated with H2 concentrations that varied between 0.2 and 5.0 nM over time, suggesting mixing of water from adjacent iron- and sulfate-reducing zones or concomitant iron and sulfate reduction under nonelectron donor-limited conditions. These observations suggest that Fe2+/H2S mass ratios may provide useful information concerning the occurrence and distribution of iron and sulfate reduction in ground water systems. ?? 2009 National Ground Water Association.

  17. Iron deficiency in Canadian blood donors.

    PubMed

    Goldman, Mindy; Uzicanin, Samra; Scalia, Vito; O'Brien, Sheila F

    2014-03-01

    The adequacy of communication and knowledge of donors and physicians regarding iron needs and the relationship between hemoglobin (Hb) and iron stores require evaluation to address donor iron deficiency. A prospective cohort study was performed on 550 successful donors and 50 donors deferred for low Hb (<125 g/L on repeat fingerstick). Donors participated in an on-clinic interview and had serum ferritin measured. They were mailed their results and recontacted regarding follow-up. Most donors are unaware of possible health impacts of donation and do not discuss donation with their physician. In successful donors, mean ferritin levels were 37 and 131 μg/L in first-time and reactivated (no donation for 2 years) females and males and 19 and 29 μg/L in frequent repeat females and males, respectively (p < 0.0001), with infrequent donors having intermediate results. Mean ferritin was 12 μg/L in donors deferred for low Hb. Twenty of 22 donors failing initial Hb testing and passing on repeat testing had ferritin below 25 μg/L. On follow-up, 63 of 164 donors (38%) with low ferritin were taking iron supplements 2 months postdonation. Iron deficiency is frequent, particularly in female donors and frequent donors. A fail on initial Hb testing followed by a pass on repeat testing is likely to be due to iron deficiency and borderline anemia. Donors and physicians need to be more aware of iron needs associated with blood donation and appropriate treatment for low iron stores. © 2013 American Association of Blood Banks.

  18. Association between iron deficiency and febrile seizures.

    PubMed

    Papageorgiou, Valia; Vargiami, Euthymia; Kontopoulos, Eleutherios; Kardaras, Panagiotis; Economou, Marina; Athanassiou-Mataxa, Miranta; Kirkham, Fenella; Zafeiriou, Dimitrios I

    2015-09-01

    The relationship between iron status and febrile seizures has been examined in various settings, mainly in the Developing World, with conflicting results. The aim of this study was to investigate any association between iron deficiency and febrile seizures (FS) in European children aged 6-60 months. Prospective, case-control study. Greek population in Thessaloniki. 50 patients with febrile seizures (cases) and 50 controls (children presenting with fever, without seizures). None. Haematologic parameters (haemoglobin concentration, haematocrit, mean corpuscular volume, red cell distribution width), plasma iron, total iron-binding capacity, plasma ferritin, transferrin saturation and soluble transferrin receptors were compared in cases and controls. Plasma ferritin was lower (median [range]: 42.8 (3-285.7) vs 58.3 (21.4-195.3 ng/ml; p = 0.02) and Total Iron Binding Capacity (TIBC) higher (mean [Standard Deviation] 267 [58.9] vs 243 [58.45] μg/dl, p = 0.04) in cases than in controls. Results were similar for 12 complex FS cases (ferritin 30 (3-121 vs 89 (41.8-141.5ng/lL; TIBC 292.92 [68.0] vs 232.08 [36.27] μg/dL). Iron deficiency, defined as ferritin <30 ng/ml, was more frequent in cases (24%) than controls (4%; p = 0.004). Ferritin was lower and TIBC higher in 18 with previous seizures than in 32 with a first seizure although haemoglobin and mean cell haemoglobin concentration were higher. European children with febrile seizures have lower Ferritin than those with fever alone, and iron deficiency, but not anaemia, is associated with recurrence. Iron status screening should be considered as routine for children presenting with or at high risk for febrile seizures. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  19. Iron and Folate-Deficiency Anaemias.

    ERIC Educational Resources Information Center

    Hercberg, Serge

    1990-01-01

    Nutritional anemia is believed to be the most widespread nutritional disorder in the world. While it generally affects developing countries, developed countries are also affected to an extent sufficient to justify the implementation of preventive measures at a national level. This report focuses on iron and folate deficiencies, which are by far…

  20. Iron and Folate-Deficiency Anaemias.

    ERIC Educational Resources Information Center

    Hercberg, Serge

    1990-01-01

    Nutritional anemia is believed to be the most widespread nutritional disorder in the world. While it generally affects developing countries, developed countries are also affected to an extent sufficient to justify the implementation of preventive measures at a national level. This report focuses on iron and folate deficiencies, which are by far…

  1. [Iron deficiency in elderly people: clinical presentation and management].

    PubMed

    Chassagne, Philippe; Bahri, Oarda; Roca, Frédéric

    2014-06-01

    Iron deficiency (absolute or functional) is commonly observed (frequently without associated anemia) in up to one third of old people. Iron deficiency is the most cause of anemia in adults. Many non hematological consequences of iron deficiency are described like: cardiac failure, mood or cognitive disorders, chronic fatigue or restless leg syndrome. Iron deficiency can be orally or with intravenous iron replacement treates if necessary. Long term compliance of patients orally treated for iron deficiency is poor mainly because of fair tolerability of drugs. New regimen of intravenous iron replacement are now available when orally iron administration can not be achieved. In functional iron deficiency iron intravenous replacement seems especially relevant. However further controlled studies are necessary to assess their clinical benefits.

  2. Iron deficiency: new insights into diagnosis and treatment.

    PubMed

    Camaschella, Clara

    2015-01-01

    Iron deficiency and iron deficiency anemia are common conditions worldwide affecting especially children and young women. In developing countries, iron deficiency is caused by poor iron intake and/or parasitic infection, whereas vegetarian dietary choices, poor iron absorption, and chronic blood loss are common causes in high-income countries. Erythropoiesis stimulating agents can result in functional iron deficiency for erythropoiesis even when stores are iron-replete. Diagnosis of iron deficiency is straightforward, except when it occurs in the context of inflammatory disorders. Oral iron salts correct absolute iron deficiency in most patients, because low hepcidin levels facilitate iron absorption. Unfortunately frequent side effects limit oral iron efficacy. Intravenous iron is increasingly utilized, because currently available preparations allow rapid normalization of total body iron even with a single infusion and are effective also in functional iron deficiency and in iron deficiency associated with inflammatory disorders. The evidence is accumulating that these preparations are safe and effective. However, long-term safety issues of high doses of iron need to be further explored. © 2015 by The American Society of Hematology. All rights reserved.

  3. Prevention of iron deficiency in infants and toddlers.

    PubMed

    Kazal, Louis A

    2002-10-01

    The prevalence of nutritional iron deficiency anemia in infants and toddlers has declined dramatically since 1960. However, satisfaction with this achievement must be tempered because iron deficiency anemia in infants and toddlers is associated with long-lasting diminished mental, motor, and behavioral functioning. Additionally, the prevalence of iron deficiency anemia in one- to three-year-old children seems to be increasing. The exact relationship between iron deficiency anemia and the developmental effects is not well understood, but these effects do not occur until iron deficiency becomes severe and chronic enough to produce anemia. At that point, treatment with iron can reverse the anemia and restore iron sufficiency, yet the poorer developmental functioning appears to persist. Therefore, intervention should focus on the primary prevention of iron deficiency. In the first year of life, measures to prevent iron deficiency include completely avoiding cow's milk, starting iron supplementation at four to six months of age in breastfed infants, and using iron-fortified formula when not breastfeeding. Low-iron formula should not be used. In the second year of life, iron deficiency can be prevented by use of a diversified diet that is rich in sources of iron and vitamin C, limiting cow's milk consumption to less than 24 oz per day, and providing a daily iron-fortified vitamin. All infants and toddlers who did not receive primary prevention should be screened for iron deficiency. Screening is performed at nine to 12 months, six months later, and at 24 months of age. The hemoglobin/hematocrit level alone detects only patients with enough iron deficiency to be anemic. Screening by erythrocyte protoporphyrin or red-cell distribution width identifies earlier stages of iron deficiency. A positive screening test is an indication for a therapeutic trial of iron, which remains the definitive method of establishing a diagnosis of iron deficiency.

  4. Lead Toxicity and Iron Deficiency in Utah Migrant Children.

    ERIC Educational Resources Information Center

    Ratcliffe, Stephen D.; And Others

    1989-01-01

    Determines the frequency of presumptive iron deficiency and lead toxicity in 198 Utah migrant children, aged 9-72 months. There were no confirmed cases of lead toxicity. Thirteen percent of all children tested, and 30 percent of those aged 9-23 months, were iron deficient. Hematocrit determination is an insensitive screen for iron deficiency.…

  5. Solemnity: A Clinical Risk Index for Iron Deficient Infants.

    ERIC Educational Resources Information Center

    Honig, Alice Sterling; Oski, Frank A.

    1984-01-01

    Studies four groups of infants with iron deficiency but without anemia in an attempt to discover behavioral signs that can be used to index high-risk probability for iron deficiency. Solemnity in well-attached infants is suggested as a clinical sign to indicate the need for biochemical screening for iron deficiency. (AS)

  6. Lead Toxicity and Iron Deficiency in Utah Migrant Children.

    ERIC Educational Resources Information Center

    Ratcliffe, Stephen D.; And Others

    1989-01-01

    Determines the frequency of presumptive iron deficiency and lead toxicity in 198 Utah migrant children, aged 9-72 months. There were no confirmed cases of lead toxicity. Thirteen percent of all children tested, and 30 percent of those aged 9-23 months, were iron deficient. Hematocrit determination is an insensitive screen for iron deficiency.…

  7. Solemnity: A Clinical Risk Index for Iron Deficient Infants.

    ERIC Educational Resources Information Center

    Honig, Alice Sterling; Oski, Frank A.

    1984-01-01

    Studies four groups of infants with iron deficiency but without anemia in an attempt to discover behavioral signs that can be used to index high-risk probability for iron deficiency. Solemnity in well-attached infants is suggested as a clinical sign to indicate the need for biochemical screening for iron deficiency. (AS)

  8. [Prevention of iron deficiency and iron deficiency anemia in tropical areas].

    PubMed

    Dillon, J C

    2000-01-01

    Iron deficiency is the most widespread nutritional disease in the World. It is prevalent in tropical areas especially in pregnant women and children. The main cause in these areas is consumption of foods containing inhibitors of iron absorption resulting in insufficient bioavailability. In advanced stages of iron deficiency, low hemoglobin levels lead to anemia. Functional consequences of anemia depend on age including mental and physical retardation in children and work disability in adults. Although other disorders including parasitic, infectious, genetic, and nutritional diseases may be involved in anemia in tropical areas, iron deficiency is always a factor because of nutritional conditions. The WHO has proposed laboratory criteria for use in establishing the incidence of iron deficiency and related anemia in a given population. Based on several surveys, four preventive strategies have been developed, i.e., dietary diversification, iron supplementation, general public health measures, and food fortification. Each of these strategies has advantages and disadvantages. The prevailing consensus is that coordinated use of these approaches holds forth the only hope of impacting the incidence of iron-deficiency anemia in tropical regions.

  9. [Iron deficiency in elderly patients: use of biomarkers].

    PubMed

    Le Petitcorps, Hélène; Monti, Alexandra; Pautas, Éric

    2015-01-01

    Iron deficiency, due to blood loss or malabsorption, is commonly observed in geriatric practice. In elderly people, association of inflammatory diseases to iron loss makes diagnosis of absolute iron deficiency sometimes difficult. In case of inflammation, the interpretation of usual biomarkers of iron deficiency (serum ferritin, transferrin saturation, serum iron) may be difficult. The recent discovery of the role of hepcidine in the iron homeostasis, in physiological and pathological situation, contributes to better understanding of the iron regulation. The aim of this short paper is to underline some specificities of elderly iron physiology, to explain hepcidine's role in physiological and pathological situations and to propose a diagnostic approach for a better interpretation of usual biomarkers, in order to differentiate absolute iron deficiency and functional iron deficiency.

  10. [A neonate with anaemia of prematurity: zinc protoporphyrin identifies iron deficiency anaemia without iron deficiency].

    PubMed

    van der Feen, Diederik E; van Hillegersberg, Jacqueline L A M; Schippers, Johannes A

    2015-01-01

    Anaemia is a common problem in premature infants and is generally easy to treat with iron supplementation. If the anaemia persists despite appropriate correction of deficiencies, more extensive evaluation is required. We describe a case of a premature male infant with a production-deficient anaemia without metabolic deficiencies, eventually identified as anaemia of prematurity. This type of anaemia is commonly diagnosed but its highly variable and complex aetiology and phenotype are often poorly understood. A probable explanation for the anaemia of prematurity in this case was a transient iron incorporation defect, identifiable by high levels of zinc protoporphyrin.

  11. Have we forgotten the significance of postpartum iron deficiency?

    PubMed

    Bodnar, Lisa M; Cogswell, Mary E; McDonald, Thad

    2005-07-01

    The postpartum period is conventionally thought to be the time of lowest iron deficiency risk because iron status is expected to improve dramatically after delivery. Nonetheless, recent studies have reported a high prevalence of postpartum iron deficiency and anemia among ethnically diverse low-income populations in the United States. In light of the recent emergence of this problem in the medical literature, we discuss updated findings on postpartum iron deficiency, including its prevalence, functional consequences, risk factors, and recommended primary and secondary prevention strategies. The productivity and cognitive gains made possible by improving iron nutriture support intervention. We therefore conclude that postpartum iron deficiency warrants greater attention and higher quality care.

  12. Metabolic Response to Iron Deficiency in Saccharomyces cerevisiae*

    PubMed Central

    Shakoury-Elizeh, Minoo; Protchenko, Olga; Berger, Alvin; Cox, James; Gable, Kenneth; Dunn, Teresa M.; Prinz, William A.; Bard, Martin; Philpott, Caroline C.

    2010-01-01

    Iron is an essential cofactor for enzymes involved in numerous cellular processes, yet little is known about the impact of iron deficiency on cellular metabolism or iron proteins. Previous studies have focused on changes in transcript and proteins levels in iron-deficient cells, yet these changes may not reflect changes in transport activity or flux through a metabolic pathway. We analyzed the metabolomes and transcriptomes of yeast grown in iron-rich and iron-poor media to determine which biosynthetic processes are altered when iron availability falls. Iron deficiency led to changes in glucose metabolism, amino acid biosynthesis, and lipid biosynthesis that were due to deficiencies in specific iron-dependent enzymes. Iron-sulfur proteins exhibited loss of iron cofactors, yet amino acid synthesis was maintained. Ergosterol and sphingolipid biosynthetic pathways had blocks at points where heme and diiron enzymes function, whereas Ole1, the essential fatty acid desaturase, was resistant to iron depletion. Iron-deficient cells exhibited depletion of most iron enzyme activities, but loss of activity during iron deficiency did not consistently disrupt metabolism. Amino acid homeostasis was robust, but iron deficiency impaired lipid synthesis, altering the properties and functions of cellular membranes. PMID:20231268

  13. Iron deficiency anemia from diagnosis to treatment in children

    PubMed Central

    Özdemir, Nihal

    2015-01-01

    Iron deficiency is the most common nutritional deficiency worldwide and an important public health problem especially in developing countries. Since the most important indicator of iron deficieny is anemia, the terms “iron deficiency” and “iron deficiency anemia” are often used interchangeably. However, iron deficiency may develop in the absence of anemia and the tissues may be affected from this condition. The most common causes of iron deficiency in children include insufficient intake together with rapid growth, low birth weight and gastrointestinal losses related to excessive intake of cow’s milk. If insufficient intake can be excluded and there is insufficient response to oral iron treatment in patients with iron deficiency especially in older children, blood loss should be considered as the underlying cause. The main principles in management of iron deficiency anemia include investigation and elimination of the cause leading to iron deficiency, replacement of deficiency, improvement of nutrition and education of the patient and family. In this article, the practical approaches in the diagnosis and treatment of iron deficiency and the experience of our center have been reviewed. PMID:26078692

  14. Iron Refractory Iron Deficiency Anemia: Presentation With Hyperferritinemia and Response to Oral Iron Therapy

    PubMed Central

    Khuong-Quang, Dong-Anh; Schwartzentruber, Jeremy; Westerman, Mark; Lepage, Pierre; Finberg, Karin E.; Majewski, Jacek

    2013-01-01

    Iron-refractory iron-deficiency anemia (IRIDA) is an autosomal recessive disorder caused by mutations in TMPRSS6. Patients have hypochromic microcytic anemia refractory to oral iron and are only partially responsive to parenteral iron administration. We report a French-Canadian kindred in which 2 siblings presented in early childhood with severe microcytic anemia, hypoferremia, and hyperferritinemia. Both children have been successfully treated solely with low-dose oral iron since diagnosis. Clinical and biological presentation did not fit any previously described genetic iron-deficiency anemia. Whole exome sequencing identified in both patients compound heterozygous mutations of TMPRSS6 leading to p.G442R and p.E522K, 2 mutations previously reported to cause classic IRIDA, and no additional mutations in known iron-regulatory genes. Thus, the phenotype associated with the unique combination of mutations uncovered in both patients expands the spectrum of disease associated with TMPRSS6 mutations to include iron deficiency anemia that is accompanied by hyperferritinemia at initial presentation and is responsive to continued oral iron therapy. Our results have implications for genetic testing in early childhood iron deficiency anemia. Importantly, they emphasize that whole exome sequencing can be used as a diagnostic tool and greatly facilitate the elucidation of the genetic basis of unusual clinical presentations, including hypomorphic mutations or compound heterozygosity leading to different phenotypes in known Mendelian diseases. PMID:23319530

  15. Iron refractory iron deficiency anemia: presentation with hyperferritinemia and response to oral iron therapy.

    PubMed

    Khuong-Quang, Dong-Anh; Schwartzentruber, Jeremy; Westerman, Mark; Lepage, Pierre; Finberg, Karin E; Majewski, Jacek; Jabado, Nada

    2013-02-01

    Iron-refractory iron-deficiency anemia (IRIDA) is an autosomal recessive disorder caused by mutations in TMPRSS6. Patients have hypochromic microcytic anemia refractory to oral iron and are only partially responsive to parenteral iron administration. We report a French-Canadian kindred in which 2 siblings presented in early childhood with severe microcytic anemia, hypoferremia, and hyperferritinemia. Both children have been successfully treated solely with low-dose oral iron since diagnosis. Clinical and biological presentation did not fit any previously described genetic iron-deficiency anemia. Whole exome sequencing identified in both patients compound heterozygous mutations of TMPRSS6 leading to p.G442R and p.E522K, 2 mutations previously reported to cause classic IRIDA, and no additional mutations in known iron-regulatory genes. Thus, the phenotype associated with the unique combination of mutations uncovered in both patients expands the spectrum of disease associated with TMPRSS6 mutations to include iron deficiency anemia that is accompanied by hyperferritinemia at initial presentation and is responsive to continued oral iron therapy. Our results have implications for genetic testing in early childhood iron deficiency anemia. Importantly, they emphasize that whole exome sequencing can be used as a diagnostic tool and greatly facilitate the elucidation of the genetic basis of unusual clinical presentations, including hypomorphic mutations or compound heterozygosity leading to different phenotypes in known Mendelian diseases.

  16. Deficiencies in the Management of Iron Deficiency Anemia During Childhood.

    PubMed

    Powers, Jacquelyn M; Daniel, Catherine L; McCavit, Timothy L; Buchanan, George R

    2016-04-01

    Limited high-quality evidence supports the management of iron deficiency anemia (IDA). To assess our institutional performance in this area, we retrospectively reviewed IDA treatment practices in 195 consecutive children referred to our center from 2006 to mid-2010. The majority of children were ≤4 years old (64%) and had nutritional IDA (74%). In 11- to 18-year-old patients (31%), the primary etiology was menorrhagia (42%). Many were referred directly to the emergency department and/or prescribed iron doses outside the recommended range. Poor medication adherence and being lost-to-follow-up were common. Substantial improvements are required in the management of IDA. © 2016 Wiley Periodicals, Inc.

  17. Failure of hematocrit to detect iron deficiency in infants.

    PubMed

    Kazal, L A

    1996-03-01

    Infants of low-income families have three times the risk of iron deficiency as those of families above the poverty level. Psychomotor deficits have been associated with iron deficiency once it produces anemia. High-risk infants are usually screened for iron deficiency between 9 and 12 months of age with a hematocrit measurement. This type of screening may miss iron-deficient infants who are not yet anemic. In the well-child clinics for low-income families in Houston, Texas, a hematocrit (Hct) < or = 33% is the standard screening criterion for iron deficiency. Three hundred twenty-one infants between the ages of 9 and 18 months had capillary blood drawn for Hct testing. Serum ferritin levels were simultaneously measured. Six (1.9%) of the 321 infants were anemic, but none because of iron deficiency. Fifty-one infants (15.9%) were iron deficient (ferritin <10 micrograms/L), none of whom were anemic. Hematocrit and ferritin levels did not correlate statistically. The Hct is not an adequate screening test for iron deficiency in this population of infants. Although this population is usually considered high-risk, iron deficiency was mild. Selective screening of high-risk infants in this population may be appropriate, but a more sensitive screening test is required. Further studies are needed to determine the prevalences of iron deficiency in this and other high-risk populations.

  18. Pica in iron deficiency: a case series

    PubMed Central

    2010-01-01

    Introduction Pica is an unusual condition where patients develop cravings for non-nutritive substances that can cause significant health risks. We report three patients with pica, two of them showing evolutionary changes associated with pica and the third demonstrating a peculiar nature of pica, which has yet to be reported. Case presentation We describe three patients who presented with symptoms of pica. The first patient is a 36-year-old Caucasian woman who had dysfunctional uterine bleeding associated with daily ingestion of two super-sized cups of ice as iced tea. The second patient is a 62-year-old Caucasian man who presented with bleeding from colonic polyps associated with drinking partially frozen bottled water. Lastly, the third patient, a 37-year-old Hispanic woman, presented with dysfunctional uterine bleeding and habitually chewed rubber bands. All three patients presented with hematological parameters diagnostic for iron deficiency anemia. Conclusion Pica has been practiced for centuries without a clear etiology. We have noticed that the younger community of academic and community physicians are not aware of the importance of complaints related to pica. None of our patients we describe here, as well as their primary care physicians, were aware of the importance of their pica related symptoms. Pica symptoms abated in one of our patients upon iron supplementation, while the other two are currently under treatment as of this writing. We believe pica is an important sign of iron deficiency that should never be ignored, and the craving for any unusual substance should compel clinicians to search for occult blood loss with secondary iron deficiency. PMID:20226051

  19. Commentary: Iron deficiency and hair loss: problems with measurement of iron.

    PubMed

    Elston, Dirk M

    2010-12-01

    Iron is involved in many critical physiologic processes within the hair follicle, suggesting that iron deficiency could disrupt hair synthesis. However, studies of iron as a cause of hair loss have produced conflicting results. Some of the discrepancies may relate to limitations of assays for iron deficiency. This commentary discusses the sensitivity and specificity of available tests for iron deficiency and presents practical guidelines for testing and supplementation.

  20. Behavior of Infants with Iron-Deficiency Anemia.

    ERIC Educational Resources Information Center

    Lozoff, Betsy; And Others

    1998-01-01

    Compared behavior of 52 Costa Rican 12- to 23-month-olds with iron-deficiency anemia to that of 139 infants with better iron status. Found that iron-deficient infants maintained closer contact with caregivers; showed less pleasure and playfulness; were more wary, hesitant, and easily tired; made fewer attempts at test items; and attended less to…

  1. So you know how to treat iron deficiency anemia.

    PubMed

    Schrier, Stanley L

    2015-10-22

    In this issue of Blood, Moretti et al provide data that challenge the entrenched oral treatment of iron deficiency anemia. The paper shows how the newer understanding of hepcidin and iron metabolism in general can lead to very practical improvements in the management of iron deficiency anemia, a disorder that may affect as many as 1 billion people.

  2. Behavior of Infants with Iron-Deficiency Anemia.

    ERIC Educational Resources Information Center

    Lozoff, Betsy; And Others

    1998-01-01

    Compared behavior of 52 Costa Rican 12- to 23-month-olds with iron-deficiency anemia to that of 139 infants with better iron status. Found that iron-deficient infants maintained closer contact with caregivers; showed less pleasure and playfulness; were more wary, hesitant, and easily tired; made fewer attempts at test items; and attended less to…

  3. [Iron deficiency anemia and anemia of chronic disorders].

    PubMed

    Metzgeroth, G; Hastka, J

    2015-09-01

    Hypochromic-microcytic anemias are characterized by a hemoglobin deficiency of the erythrocytes. The main reason for the insufficient hemoglobin synthesis is, with exception of thalassemia and a few other rare conditions, primarily a disorder of iron metabolism. Differential diagnostic considerations are focused on iron deficiency anemia, with approximately 80% the most common form of anemia worldwide. Iron deficiency anemia shows a particularly high prevalence in developing countries, but is also in industrialized Western countries the most common cause of anemia. Infants, toddlers, premenopausal or pregnant women, and elderly people are at particularly high risk of iron deficiency anemia. The most important differential diagnosis for iron deficiency anemia is the anemia of chronic disorders (ACD). This anemia is caused by a disturbance of iron utilization (functional iron deficiency), in which iron absorption and iron release, as a nonspecific defense mechanism, is blocked to restrict iron availability for the inflammatory process but also withhold iron from the erythropoiesis. ACD is not rare, but plays a significant role in hospitalized patients and in the elderly. The differentiation between ACD and iron deficiency anemia is highly important from a clinical point of view, due to different types of further management. The cause for iron deficiency should be clarified in each case, whereas the etiology for ACD is often obvious. The standard treatment of iron deficiency anemia is oral iron supplementation. Intravenous iron application is reserved for problem patients. The best treatment for ACD is the elimination of the underlying chronic disorder. In case of persistent ACD, red blood cell transfusions, erythropoietin, and intravenous iron are used therapeutically.

  4. Serum transferrin receptor: a quantitative measure of tissue iron deficiency.

    PubMed

    Skikne, B S; Flowers, C H; Cook, J D

    1990-05-01

    This study was undertaken to evaluate the role of serum transferrin receptor measurements in the assessment of iron status. Repeated phlebotomies were performed in 14 normal volunteer subjects to obtain varying degrees of iron deficiency. Serial measurements of serum iron, total iron-binding capacity, mean cell volume (MCV), free erythrocyte protoporphyrin (FEP), red cell mean index, serum ferritin, and serum transferrin receptor were performed throughout the phlebotomy program. There was no change in receptor levels during the phase of storage iron depletion. When the serum ferritin level reached subnormal values there was an increase in serum receptor levels, which continued throughout the phlebotomy program. Functional iron deficiency was defined as a reduction in body iron beyond the point of depleted iron stores. The serum receptor level was a more sensitive and reliable guide to the degree of functional iron deficiency than either the FEP or MCV. Our studies indicate that the serum receptor measurement is of particular value in identifying mild iron deficiency of recent onset. The iron status of a population can be fully assessed by using serum ferritin as a measure of iron stores, serum receptor as a measure of mild tissue iron deficiency, and hemoglobin concentration as a measure of advanced iron deficiency.

  5. [The role of iron as a deficient element].

    PubMed

    Schümann, K

    1989-12-01

    Iron is an essential trace element. In its heme-form as well as in its non heme-form it is a part of enzymes and hemoproteins. For a safe and adequate dietary intake 10-18 mg of iron are recommended daily. Frequently, this quantity is not available: approximately 20% of the world population is iron-deficient. In this state the enteral transfer capacity for toxic metals, e.g., Cd and Pb, is increased and the adaptation to physical strain as well as the immunological responses are depressed. Alterations of body iron-stores are almost exclusively balanced by adequate adaptation of the enteral iron-transfer capacity. The mechanism of this adaptation process can neither be satisfactorily explained by the "mucosal block hypothesis", nor by the "mucosal transferrin hypothesis". When the time-course of iron storage and its relation to intestinal iron transfer was investigated after i.v. iron administration to iron-deficient rats, the results indicated that the process of adaptation is located in the intestinal mucosa. Intestinal iron loading is decreased in iron deficiency, whereas the iron transfer into the organism is increased. Further investigation is necessary to find out by which mechanism the iron manages to bypass existing mucosal storage capacity in this situation. The geographical distribution of iron deficiency is influenced by a variety of local factors. Still, the paramount causes of iron-deficiency are unbalanced iron losses and the lack of bioavailable iron in the diet. The bioavailability of non heme iron is influenced by the composition of the diet. The effect of promotors of iron absorption, such as meat, amino acids, polycarbonic acids and ascorbate is opposed by the influence of inhibitors, such as bran, soya products, vegetables and egg-dishes. Iron losses are mainly due to blood losses. Thus, the wide distribution of hookworm diseases in tropical areas contributes significantly to the endemic iron-deficiency in these regions. A more physiological loss

  6. Iron deficiency and iron excess damage mitochondria and mitochondrial DNA in rats.

    PubMed

    Walter, Patrick B; Knutson, Mitchell D; Paler-Martinez, Andres; Lee, Sonia; Xu, Yu; Viteri, Fernando E; Ames, Bruce N

    2002-02-19

    Approximately two billion people, mainly women and children, are iron deficient. Two studies examined the effects of iron deficiency and supplementation on rats. In study 1, mitochondrial functional parameters and mitochondrial DNA (mtDNA) damage were assayed in iron-deficient (< or =5 microg/day) and iron-normal (800 microg/day) rats and in both groups after daily high-iron supplementation (8,000 microg/day) for 34 days. This dose is equivalent to the daily dose commonly given to iron-deficient humans. Iron-deficient rats had lower liver mitochondrial respiratory control ratios and increased levels of oxidants in polymorphonuclear-leukocytes, as assayed by dichlorofluorescein (P < 0.05). Rhodamine 123 fluorescence of polymorphonuclear-leukocytes also increased (P < 0.05). Lowered respiratory control ratios were found in daily high-iron-supplemented rats regardless of the previous iron status (P < 0.05). mtDNA damage was observed in both iron-deficient rats and rats receiving daily high-iron supplementation, compared with iron-normal rats (P < 0.05). Study 2 compared iron-deficient rats given high doses of iron (8,000 microg) either daily or every third day and found that rats given iron supplements every third day had less mtDNA damage on the second and third day after the last dose compared to daily high iron doses. Both inadequate and excessive iron (10 x nutritional need) cause significant mitochondrial malfunction. Although excess iron has been known to cause oxidative damage, the observation of oxidant-induced damage to mitochondria from iron deficiency has been unrecognized previously. Untreated iron deficiency, as well as excessive-iron supplementation, are deleterious and emphasize the importance of maintaining optimal iron intake.

  7. Iron deficiency in heart failure: a practical guide.

    PubMed

    Ebner, Nicole; von Haehling, Stephan

    2013-09-23

    Iron is an element necessary for cells due to its capacity of transporting oxygen and electrons. One of the important co-morbidities in heart failure is iron deficiency. Iron has relevant biological functions, for example, the formation of haemoglobin, myoglobin and numerous enzymatic groups. The prevalence of iron deficiency increases with the severity of heart failure. For a long time, the influence of iron deficiency was underestimated especially in terms of worsening of cardiovascular diseases and of developing anaemia. In recent years, studies with intravenous iron agents in patients with iron deficiency and cardiovascular diseases indicated new insights in the improvement of therapy. Experimental studies support the understanding of iron metabolism. Many physicians remain doubtful of the use of intravenous iron due to reports of side effects. The aim of this review is to describe iron metabolism in humans, to highlight the influence of iron deficiency on the course and symptoms of heart failure, discuss diagnostic tools of iron deficiency and provide guidance on the use of intravenous iron.

  8. Lead toxicity and iron deficiency in Utah migrant children

    SciTech Connect

    Ratcliffe, S.D.; Lee, J.; Lutz, L.J.; Woolley, F.R.; Baxter, S. ); Civish, F. ); Johnson, M. )

    1989-05-01

    The authors determined the frequency of presumptive iron deficiency and lead toxicity in 198 Utah migrant children, ages 9-72 months, during the summer of 1985. There were no confirmed cases of lead toxicity, 13% of those tested and 30% of the children ages 9-23 months were iron deficient. Hematocrit determinations accurately predicted iron deficiency in only 35% of the children confirmed to have this disorder via erythrocyte protoporphyrin screening.

  9. Lead toxicity and iron deficiency in Utah migrant children.

    PubMed Central

    Ratcliffe, S D; Lee, J; Lutz, L J; Woolley, F R; Baxter, S; Civish, F; Johnson, M

    1989-01-01

    We determined the frequency of presumptive iron deficiency and lead toxicity in 198 Utah migrant children, ages 9-72 months, during the summer of 1985. There were no confirmed cases of lead toxicity. Thirteen per cent of those tested and 30 per cent of the children ages 9-23 months were iron deficient. Hematocrit determinations accurately predicted iron deficiency in only 35 per cent of the children confirmed to have this disorder via erythrocyte protoporphyrin screening. PMID:2650572

  10. A link between premenopausal iron deficiency and breast cancer malignancy

    PubMed Central

    2013-01-01

    Background Young breast cancer (BC) patients less than 45 years old are at higher risk of dying from the disease when compared to their older counterparts. However, specific risk factors leading to this poorer outcome have not been identified. Methods One candidate is iron deficiency, as this is common in young women and a clinical feature of young age. In the present study, we used immuno-competent and immuno-deficient mouse xenograft models as well as hemoglobin as a marker of iron status in young BC patients to demonstrate whether host iron deficiency plays a pro-metastatic role. Results We showed that mice fed an iron-deficient diet had significantly higher tumor volumes and lung metastasis compared to those fed normal iron diets. Iron deficiency mainly altered Notch but not TGF-β and Wnt signaling in the primary tumor, leading to the activation of epithelial mesenchymal transition (EMT). This was revealed by increased expression of Snai1 and decreased expression of E-cadherin. Importantly, correcting iron deficiency by iron therapy reduced primary tumor volume, lung metastasis, and reversed EMT markers in mice. Furthermore, we found that mild iron deficiency was significantly associated with lymph node invasion in young BC patients (p<0.002). Conclusions Together, our finding indicates that host iron deficiency could be a contributor of poor prognosis in young BC patients. PMID:23800380

  11. Iron Deficiency in Heart Failure: Looking Beyond Anaemia.

    PubMed

    Wong, Christopher C Y; Ng, Austin C C; Kritharides, Leonard; Sindone, Andrew P

    2016-03-01

    Iron is an essential micronutrient in many cellular processes. Iron deficiency, with or without anaemia, is common in patients with chronic heart failure. Observational studies have shown iron deficiency to be associated with worse clinical outcomes and mortality. The treatment of iron deficiency in chronic heart failure patients using intravenous iron alone has shown promise in several clinical trials, although further studies which include larger populations and longer follow-up times are needed. Copyright © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  12. Iron deficiency anemia in infants and toddlers

    PubMed Central

    Joo, Eun Young; Kim, Keun Young; Kim, Dong Hyun; Lee, Ji-Eun

    2016-01-01

    Background In Korea, the prevalence of anemia and iron deficiency anemia (IDA) among older infants and young children remains high. To detect IDA early and to reduce its adverse impact, we assessed the characteristics of infants and young children who had IDA or were at risk of developing IDA, or who exhibited characteristics associated with severe anemia. Methods Among the 1,782 IDA-affected children aged 6 months to 18 years who visited the hospital, we retrospectively analyzed the medical records and laboratory data of 1,330 IDA-affected children aged 6–23 months who were diagnosed between 1996 and 2013. We excluded patients with a C-reactive protein level ≥5 mg/dL. Results IDA was predominant in boys (2.14:1) during infancy and early childhood. The peak IDA incidence was noted among infants aged 9–12 months. Only 7% patients exhibited symptoms of IDA, while 23.6% patients with severe IDA demonstrated classic symptoms/signs of IDA. Low birth weight (LBW) infants with IDA demonstrated low adherence to iron supplementation. In a multivariate analysis, prolonged breastfeeding without iron fortification (odds ratio [OR] 5.70), and a LBW (OR 6.49) were identified as risk factors of severe anemia. Conclusion LBW infants need more attention in order to increase their adherence to iron supplementation. For the early detection of IDA, nutritional status of all infants, and iron batteries of high-risk infants (LBW infants, infants with prolonged breastfeeding, picky eaters, and/or infants with the presence of IDA symptoms) should be evaluated at their health screening visits. PMID:28090490

  13. Lactoferrin efficacy versus ferrous sulfate in curing iron deficiency and iron deficiency anemia in pregnant women.

    PubMed

    Paesano, Rosalba; Berlutti, Francesca; Pietropaoli, Miriam; Pantanella, Fabrizio; Pacifici, Enrica; Goolsbee, William; Valenti, Piera

    2010-06-01

    Iron deficiency (ID) and iron deficiency anemia (IDA) are the most common iron disorders throughout the world. ID and IDA, particularly caused by increased iron requirements during pregnancy, represent a high risk for preterm delivery, fetal growth retardation, low birth weight, and inferior neonatal health. Oral administration of ferrous sulfate to cure ID and IDA in pregnancy often fails to increase hematological parameters, causes adverse effects and increases inflammation. Recently, we have demonstrated safety and efficacy of oral administration of 30% iron saturated bovine lactoferrin (bLf) in pregnant women suffering from ID and IDA. Oral administration of bLf significantly increases the number of red blood cells, hemoglobin, total serum iron and serum ferritin already after 30 days of the treatment. The increasing of hematological values by bLf is related to the decrease of serum IL-6 and the increase of serum hepcidin, detected as prohepcidin, whereas ferrous sulfate increases IL-6 and fails to increase hematological parameters and prohepcidin. bLf is a more effective and safer alternative than ferrous sulfate for treating ID and IDA in pregnant women.

  14. Cobalamin deficiency can mask depleted body iron reserves.

    PubMed

    Solmaz, Soner; Özdoğu, Hakan; Boğa, Can

    2015-06-01

    Vitamin B12 deficiency impairs DNA synthesis and causes erythroblast apoptosis, resulting in anaemia from ineffective erythropoiesis. Iron and cobalamin deficiency are found together in patients for various reasons. We have observed that cobalamin deficiency masks iron deficiency in some patients. We hypothesised that iron is not used by erythroblasts because of ineffective erythropoiesis due to cobalamin deficiency. Therefore, we aimed to demonstrate that depleted iron body reserves are masked by cobalamin deficiency. Seventy-five patients who were diagnosed with cobalamin deficiency were enrolled in this study. Complete blood counts and serum levels of iron, unsaturated iron binding capacity (UIBC), ferritin, vitamin B12, and thyroid stimulant hormone were determined at diagnosis and after cobalamin therapy. Patients who had a combined deficiency at diagnosis and after cobalamin therapy were recorded. Before cobalamin therapy, we found increased serum iron levels (126.4 ± 63.4 µg/dL), decreased serum UIBC levels (143.7 ± 70.8 µg/dL), increased serum ferritin levels (192.5 ± 116.4 ng/mL), and increased transferrin saturation values (47.2 ± 23.5 %). After cobalamin therapy, serum iron levels (59.1 ± 30 µg/dL), serum ferritin levels (44.9 ± 38.9 ng/mL) and transferrin saturation values (17.5 ± 9.6 %) decreased, and serum UIBC levels (295.9 ± 80.6 µg/dL) increased. Significant differences were observed in all values (p < 0.0001). Seven patients (9.3 %) had iron deficiency before cobalamin therapy, 37 (49.3 %) had iron deficiency after cobalamin therapy, and a significant difference was detected between the proportions of patients who had iron deficiency (p < 0.0001). This study is important because insufficient data are available on this condition. Our results indicate that iron deficiency is common in patients with cobalamin deficiency, and that cobalamin deficiency can mask iron deficiency. Therefore, we suggest that all

  15. Intravenous ferric carboxymaltose for the treatment of iron deficiency anemia.

    PubMed

    Friedrisch, João Ricardo; Cançado, Rodolfo Delfini

    2015-01-01

    Nutritional iron deficiency anemia is the most common deficiency disorder, affecting more than two billion people worldwide. Oral iron supplementation is usually the first choice for the treatment of iron deficiency anemia, but in many conditions, oral iron is less than ideal mainly because of gastrointestinal adverse events and the long course needed to treat the disease and replenish body iron stores. Intravenous iron compounds consist of an iron oxyhydroxide core, which is surrounded by a carbohydrate shell made of polymers such as dextran, sucrose or gluconate. The first iron product for intravenous use was the high molecular weight iron dextran. However, dextran-containing intravenous iron preparations are associated with an elevated risk of anaphylactic reactions, which made physicians reluctant to use intravenous iron for the treatment of iron deficiency anemia over many years. Intravenous ferric carboxymaltose is a stable complex with the advantage of being non-dextran-containing and a very low immunogenic potential and therefore not predisposed to anaphylactic reactions. Its properties permit the administration of large doses (15mg/kg; maximum of 1000mg/infusion) in a single and rapid session (15-minute infusion) without the requirement of a test dose. The purpose of this review is to discuss some pertinent issues in relation to the history, pharmacology, administration, efficacy, and safety profile of ferric carboxymaltose in the treatment of patients with iron deficiency anemia.

  16. Intravenous ferric carboxymaltose for the treatment of iron deficiency anemia

    PubMed Central

    Friedrisch, João Ricardo; Cançado, Rodolfo Delfini

    2015-01-01

    Nutritional iron deficiency anemia is the most common deficiency disorder, affecting more than two billion people worldwide. Oral iron supplementation is usually the first choice for the treatment of iron deficiency anemia, but in many conditions, oral iron is less than ideal mainly because of gastrointestinal adverse events and the long course needed to treat the disease and replenish body iron stores. Intravenous iron compounds consist of an iron oxyhydroxide core, which is surrounded by a carbohydrate shell made of polymers such as dextran, sucrose or gluconate. The first iron product for intravenous use was the high molecular weight iron dextran. However, dextran-containing intravenous iron preparations are associated with an elevated risk of anaphylactic reactions, which made physicians reluctant to use intravenous iron for the treatment of iron deficiency anemia over many years. Intravenous ferric carboxymaltose is a stable complex with the advantage of being non-dextran-containing and a very low immunogenic potential and therefore not predisposed to anaphylactic reactions. Its properties permit the administration of large doses (15 mg/kg; maximum of 1000 mg/infusion) in a single and rapid session (15-minute infusion) without the requirement of a test dose. The purpose of this review is to discuss some pertinent issues in relation to the history, pharmacology, administration, efficacy, and safety profile of ferric carboxymaltose in the treatment of patients with iron deficiency anemia. PMID:26670403

  17. Responsiveness to parenteral iron therapy in children with oral iron-refractory iron-deficiency anemia.

    PubMed

    Akin, Mehmet; Atay, Enver; Oztekin, Osman; Karadeniz, Cem; Karakus, Yasin Tugrul; Yilmaz, Bilal; Erdogan, Firat

    2014-02-01

    Intravenous (IV) ferric iron (Fe)-carbohydrate complexes are used for treating Fe deficiency in children with iron-refractory iron-deficiency anemia (IRIDA). An optimal treatment has yet to be determined. There are relatively little publications on the responsiveness to IV iron therapy in children with IRIDA. This study analyzed responses to IV iron sucrose therapy given to 11 children, ranging in age from 2 to 13 years (mean 4.8 years), with iron-deficiency anemia who were unresponsive to oral iron therapy. The hemoglobin and ferritin values (mean) of the 11 children with IRIDA were 7.7 g/dL and 4.8 ng/mL at diagnosis. Both hemoglobin and ferritin levels increased to 9.5 g/dL, and 24 ng/mL, respectively, at 6 weeks after the first therapy. Although the level of hemoglobin was steady at 6 months after the first, and 6 weeks after the second therapy, the ferritin levels continued to increase up to 30 ng/mL and 47 ng/mL at 6 months after the first and 6 weeks after the second therapy, respectively. We recommend that IRIDA should be considered in patients presenting with iron-deficiency anemia of unknown cause that is unresponsive to oral iron therapy. Our results suggest that IV iron therapy should be administered only once in cases of IRIDA. Continued administration of IV iron would be of no benefit to increase hemoglobin levels. On the contrary, ferritin levels may continue to increase resulting in untoward effects of hyperferritinemia.

  18. A randomized trial of iron isomaltoside versus iron sucrose in patients with iron deficiency anemia.

    PubMed

    Derman, Richard; Roman, Eloy; Modiano, Manuel R; Achebe, Maureen M; Thomsen, Lars L; Auerbach, Michael

    2017-03-01

    Iron deficiency anemia (IDA) is common in many chronic diseases, and intravenous (IV) iron offers a rapid and efficient iron correction. This trial compared the efficacy and safety of iron isomaltoside and iron sucrose in patients with IDA who were intolerant of, or unresponsive to, oral iron. The trial was an open-label, comparative, multi-center trial. Five hundred and eleven patients with IDA from different causes were randomized 2:1 to iron isomaltoside or iron sucrose and followed for 5 weeks. The cumulative dose of iron isomaltoside was based on body weight and hemoglobin (Hb), administered as either a 1000 mg infusion over more than 15 minutes or 500 mg injection over 2 minutes. The cumulative dose of iron sucrose was calculated according to Ganzoni and administered as repeated 200 mg infusions over 30 minutes. The mean cumulative dose of iron isomaltoside was 1640.2 (standard deviation (SD): 357.6) mg and of iron sucrose 1127.9 (SD: 343.3) mg. The primary endpoint was the proportion of patients with a Hb increase ≥2 g/dL from baseline at any time between weeks 1-5. Both non-inferiority and superiority were confirmed for the primary endpoint, and a shorter time to Hb increase ≥2 g/dL was observed with iron isomaltoside. For all biochemical efficacy parameters, faster and/or greater improvements were found with iron isomaltoside. Both treatments were well tolerated; 0.6% experienced a serious adverse drug reaction. Iron isomaltoside was more effective than iron sucrose in achieving a rapid improvement in Hb. Furthermore, iron isomaltoside has an advantage over iron sucrose in allowing higher cumulative dosing in fewer administrations. Both treatments were well tolerated in a broad population with IDA.

  19. A randomized trial of iron isomaltoside versus iron sucrose in patients with iron deficiency anemia

    PubMed Central

    Roman, Eloy; Modiano, Manuel R.; Achebe, Maureen M.; Thomsen, Lars L.; Auerbach, Michael

    2017-01-01

    Abstract Iron deficiency anemia (IDA) is common in many chronic diseases, and intravenous (IV) iron offers a rapid and efficient iron correction. This trial compared the efficacy and safety of iron isomaltoside and iron sucrose in patients with IDA who were intolerant of, or unresponsive to, oral iron. The trial was an open‐label, comparative, multi‐center trial. Five hundred and eleven patients with IDA from different causes were randomized 2:1 to iron isomaltoside or iron sucrose and followed for 5 weeks. The cumulative dose of iron isomaltoside was based on body weight and hemoglobin (Hb), administered as either a 1000 mg infusion over more than 15 minutes or 500 mg injection over 2 minutes. The cumulative dose of iron sucrose was calculated according to Ganzoni and administered as repeated 200 mg infusions over 30 minutes. The mean cumulative dose of iron isomaltoside was 1640.2 (standard deviation (SD): 357.6) mg and of iron sucrose 1127.9 (SD: 343.3) mg. The primary endpoint was the proportion of patients with a Hb increase ≥2 g/dL from baseline at any time between weeks 1‐5. Both non‐inferiority and superiority were confirmed for the primary endpoint, and a shorter time to Hb increase ≥2 g/dL was observed with iron isomaltoside. For all biochemical efficacy parameters, faster and/or greater improvements were found with iron isomaltoside. Both treatments were well tolerated; 0.6% experienced a serious adverse drug reaction. Iron isomaltoside was more effective than iron sucrose in achieving a rapid improvement in Hb. Furthermore, iron isomaltoside has an advantage over iron sucrose in allowing higher cumulative dosing in fewer administrations. Both treatments were well tolerated in a broad population with IDA. PMID:28052413

  20. Iron-heme-Bach1 axis is involved in erythroblast adaptation to iron deficiency.

    PubMed

    Kobayashi, Masahiro; Kato, Hiroki; Hada, Hiroshi; Itoh-Nakadai, Ari; Fujiwara, Tohru; Muto, Akihiko; Inoguchi, Yukihiro; Ichiyanagi, Kenji; Hojo, Wataru; Tomosugi, Naohisa; Sasaki, Hiroyuki; Harigae, Hideo; Igarashi, Kazuhiko

    2017-03-01

    Iron plays the central role in oxygen transport by erythrocytes as a constituent of heme and hemoglobin. The importance of iron and heme is also to be found in their regulatory roles during erythroblast maturation. The transcription factor Bach1 may be involved in their regulatory roles since it is deactivated by direct binding of heme. To address whether Bach1 is involved in the responses of erythroblasts to iron status, low iron conditions that induced severe iron deficiency in mice were established. Under iron deficiency, extensive gene expression changes and mitophagy disorder were induced during maturation of erythroblasts. Bach1(-/-) mice showed more severe iron deficiency anemia in the developmental phase of mice and a retarded recovery once iron was replenished when compared with wild-type mice. In the absence of Bach1, the expression of globin genes and Hmox1 (encoding heme oxygenase-1) was de-repressed in erythroblasts under iron deficiency, suggesting that Bach1 represses these genes in erythroblasts under iron deficiency to balance the levels of heme and globin. Moreover, an increase in genome-wide DNA methylation was observed in erythroblasts of Bach1(-/-) mice under iron deficiency. These findings reveal the principle role of iron as a regulator of gene expression in erythroblast maturation and suggest that the iron-heme-Bach1 axis is important for a proper adaptation of erythroblast to iron deficiency to avoid toxic aggregates of non-heme globin. Copyright© Ferrata Storti Foundation.

  1. Iron deficiency in sports - definition, influence on performance and therapy.

    PubMed

    Clénin, German; Cordes, Mareike; Huber, Andreas; Schumacher, Yorck Olaf; Noack, Patrick; Scales, John; Kriemler, Susi

    2015-01-01

    Iron deficiency is frequent among athletes. All types of iron deficiency may affect physical performance and should be treated. The main mechanisms by which sport leads to iron deficiency are increased iron demand, elevated iron loss and blockage of iron absorption due to hepcidin bursts. As a baseline set of blood tests, haemoglobin, haematocrit, mean cellular volume, mean cellular haemoglobin and serum ferritin levels help monitor iron deficiency. In healthy male and female athletes >15 years, ferritin values <15 mcg are equivalent to empty, values from 15 to 30 mcg/l to low iron stores. Therefore a cut-off of 30 mcg/l is appropriate. For children aged from 6-12 years and younger adolescents from 12-15 years, cut-offs of 15 and 20 mcg/l, respectively, are recommended. As an exception in adult elite sports, a ferritin value of 50 mcg/l should be attained in athletes prior to altitude training, as iron demands in these situations are increased. Treatment of iron deficiency consists of nutritional counselling, oral iron supplementation or, in specific cases, by intravenous injection. Athletes with repeatedly low ferritin values benefit from intermittent oral substitution. It is important to follow up the athletes on an individual basis, repeating the baseline blood tests listed above twice a year. A long-term daily oral iron intake or i.v. supplementation in the presence of normal or even high ferritin values does not make sense and may be harmful.

  2. Ferric carboxymaltose: a review of its use in iron deficiency.

    PubMed

    Keating, Gillian M

    2015-01-01

    Ferric carboxymaltose (Ferinject(®), Injectafer(®)) is an intravenous iron preparation approved in numerous countries for the treatment of iron deficiency. A single high dose of ferric carboxymaltose (up to 750 mg of iron in the US and 1,000 mg of iron in the EU) can be infused in a short time frame (15 min). Consequently, fewer doses of ferric carboxymaltose may be needed to replenish iron stores compared with some other intravenous iron preparations (e.g. iron sucrose). Ferric carboxymaltose improved self-reported patient global assessment, New York Heart Association functional class and exercise capacity in patients with chronic heart failure and iron deficiency in two randomized, placebo-controlled trials (FAIR-HF and CONFIRM-HF). In other randomized controlled trials, ferric carboxymaltose replenished iron stores and corrected anaemia in various populations with iron-deficiency anaemia, including patients with chronic kidney disease, inflammatory bowel disease or heavy uterine bleeding, postpartum iron-deficiency anaemia and perioperative anaemia. Intravenous ferric carboxymaltose was generally well tolerated, with a low risk of hypersensitivity reactions. It was generally better tolerated than oral ferrous sulfate, mainly reflecting a lower incidence of gastrointestinal adverse effects. The most common laboratory abnormality seen in ferric carboxymaltose recipients was transient, asymptomatic hypophosphataemia. The higher acquisition cost of ferric carboxymaltose appeared to be offset by lower costs for other items, with the potential for cost savings. In conclusion, ferric carboxymaltose is an important option for the treatment of iron deficiency.

  3. Treatment of iron deficiency anemia with Ferro-Folgamma.

    PubMed

    Ghinea, Mihaela Maria

    2004-01-01

    Iron deficiency anemia is a hypochromic anemia in which hemoglobin poor synthesis is due to a decrease in the amount of iron in the body. The decrease of iron quantity has many causes: insufficient intake of aliments rich in iron (meat, viscera, green vegetables), increased necessities during growth period, pregnancy, erythrocytes hyperregeneration, high-performance sportsmen, increased loss by digestive way, genito-urinary way, respiratory, hemorrhagic syndromes. Clinically, symptoms and signs specific to all types of anemia and those specific to lack of iron occur besides the symptoms and signs of the underlying disease: atrophic glositis, angular stomatitis, sideropenic dysphagia, pica, skin and nails changes. Laboratory investigations useful for diagnosis are: microcytic, hypochromic anemia, decreased serum iron level, total capacity of iron binding increased, medullar iron store absent, good response to iron therapy. Ferro-Folgamma is one of the most indicated medicines in iron deficiency anemia. Due to its components this medicine has many indications: insufficient alimentary intake concerning iron, folic acid, B12 vitamin, vegetarian alimentation, increased needs during growth period, iron deficiency anaemia secondary to chronic hemorrhages, malnutrition, anemias associated with chronic alcohol intake, preventive treatment of iron deficiency anemia and megaloblastic anemia during pregnancy and lactation.

  4. Reducing iron deficiency anemia in Bolivian school children: calcium and iron combined versus iron supplementation alone.

    PubMed

    Miranda, Melissa; Olivares, Manuel; Brito, Alex; Pizarro, Fernando

    2014-01-01

    The aim of this study was to determine the effect of combined calcium and iron versus single iron supplementation on iron status in Bolivian schoolchildren. Children ages 6 to 10 y old (N = 195), were randomly assigned to receive either 700 mg Ca (as calcium carbonate) plus 30 mg Fe (as ferrous sulfate) (Ca + Fe group) or 30 mg Fe (as ferrous sulfate) (Fe group). The doses were administered daily, from Monday to Friday, between meals at school over 3 mo. Iron status was assessed at baseline and after intervention. Additionally, overall nutritional status was assessed by anthropometry and an estimation of dietary intake. At baseline, the prevalence of anemia in the Ca + Fe group and the Fe group were 15% and 21.5%, respectively. After 3 mo follow-up, the prevalence of iron deficiency anemia dropped significantly (P < 0.001) to 3% in both groups (χ(2) = NS). Iron dietary intake was within recommended levels, but calcium intake only covered 39% of the Recommended Daily Intake. Combined calcium and iron supplementation is equally as effective as single iron supplementation in reducing the prevalence of iron deficiency anemia in Bolivian school children. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. [Iron deficiency anemia. Guideline for diagnosis and treatment].

    PubMed

    2009-08-01

    Iron deficiency is the most important cause of anemia. Preschooler children are particularly vulnerable; a recent analysis reported a prevalence rate higher than 35% among children below 2 year of age. Its early detection, right treatment, and suitable prophylaxis is currently a priority in our country. This guideline establishes the definition of anemia in relation to chronological age, gestational age, and habitat, reviews principal aspects of iron metabolism, enumerates main causes of iron deficiency, and set guidelines for diagnosis, detection, differential diagnosis, treatment and prevention of iron deficiency anemia.

  6. Mitochondrial adaptations to chronic muscle use: effect of iron deficiency.

    PubMed

    Hood, D A; Kelton, R; Nishio, M L

    1992-03-01

    1. The effects of chronic muscle use on mitochondrial structure, enzymes and gene expression is reviewed. The role of iron deficiency in modulating this adaptation is discussed. 2. Chronic muscle use and disuse alter mitochondrial composition and affect mitochondrial subpopulations differentially. This has implications for an understanding of organelle assembly. 3. Iron deficiency decreases mitochondrial functional mass within muscle by reducing the level of heme and non-heme iron-containing components. This alters the metabolic response during exercise and results in a reduced endurance performance. 4. Both iron deficiency and chronic muscle use represent contrasting experimental models for the study of mitochondrial function and biogenesis.

  7. Does iron deficiency anemia affect olfactory function?

    PubMed

    Dinc, Mehmet Emre; Dalgic, Abdullah; Ulusoy, Seckin; Dizdar, Denizhan; Develioglu, Omer; Topak, Murat

    2016-07-01

    Conclusion This study found a negative effect of IDA on olfactory function. IDA leads to a reduction in olfactory function, and decreases in hemoglobin levels result in further reduction in olfactory function. Objective This study examined the effects of iron-deficiency anemia (IDA) on olfactory function. Method The study enrolled 50 IDA patients and 50 healthy subjects. Olfactory function was evaluated using the Sniffin' Sticks olfactory test. The diagnosis of IDA was made according to World Health Organization (WHO) criteria. Results Patients with IDA had a significantly lower threshold, discrimination, and identification (TDI) value, and a lower threshold compared with the control group. However, there were no significant differences between the groups in terms of smell selectivity values.

  8. Fluorescence induction characteristics of iron deficient cyanobacteria

    SciTech Connect

    Henry, R.; Guikema, J.A.

    1986-04-01

    The fluorescence induction characteristics of Anacystis nidulans were examined after cultures were stressed with iron deficiency. When these cells were illuminated with 620 nm light to excite phycocyanin, a fluorescence induction transient was observed which was not present in normal cells. The transient had a rise time of approximately 3-4 sec, and was abolished when cells were preilluminated with 620 nm light. One goal of this work was to ascertain the role of electron transfer between PSII and either PSI or the respiratory system in causing the fluorescence transient. The effects of electron transport inhibitors and uncouplers on fluorescence induction were examined. Respiratory inhibitors, such as KCN, had little or no effect on the fluorescence transient. p-Chloromercuribenzoic acid, at concentrations below 0.5 mM, delayed the transient rise time without causing a decrease in the extent. Uncouplers, such as gramicidin and CCCP, caused a decrease in the extent of the transient.

  9. [Current recommendations for the treatment of iron deficiency anemia].

    PubMed

    Schaefer, R M; Huch, R; Krafft, A

    2007-04-04

    Iron deficiency is a frequent complication in chronically ill patients and in pregnant women. Iron status can now be characterised precisely and relatively easily by determining serum ferritin, transferritin saturation and if necessary hypochromic erythrocytes and the haemoglobin content of erythrocytes (CHr). Oral iron replacement is usually restricted by limited absorption and low tolerability. Intravenous iron therapy is possible in such cases and can be combined with rHuEPO (e.g. EPREX/ epoetin alfa) in severe cases. Iron saccharate (VENOFER) is commercially available in Switzerland and this permits high dose iron replacement without any danger of anaphylaxis or acute iron toxicity.

  10. Iron deficiency and heart failure: diagnostic dilemmas and therapeutic perspectives

    PubMed Central

    Jankowska, Ewa A.; von Haehling, Stephan; Anker, Stefan D.; Macdougall, Iain C.; Ponikowski, Piotr

    2013-01-01

    Iron is a micronutrient essential for cellular energy and metabolism, necessary for maintaining body homoeostasis. Iron deficiency is an important co-morbidity in patients with heart failure (HF). A major factor in the pathogenesis of anaemia, it is also a separate condition with serious clinical consequences (e.g. impaired exercise capacity) and poor prognosis in HF patients. Experimental evidence suggests that iron therapy in iron-deficient animals may activate molecular pathways that can be cardio-protective. Clinical studies have demonstrated favourable effects of i.v. iron on the functional status, quality of life, and exercise capacity in HF patients. It is hypothesized that i.v. iron supplementation may become a novel therapy in HF patients with iron deficiency. PMID:23100285

  11. Iron deficiency and heart failure: diagnostic dilemmas and therapeutic perspectives.

    PubMed

    Jankowska, Ewa A; von Haehling, Stephan; Anker, Stefan D; Macdougall, Iain C; Ponikowski, Piotr

    2013-03-01

    Iron is a micronutrient essential for cellular energy and metabolism, necessary for maintaining body homoeostasis. Iron deficiency is an important co-morbidity in patients with heart failure (HF). A major factor in the pathogenesis of anaemia, it is also a separate condition with serious clinical consequences (e.g. impaired exercise capacity) and poor prognosis in HF patients. Experimental evidence suggests that iron therapy in iron-deficient animals may activate molecular pathways that can be cardio-protective. Clinical studies have demonstrated favourable effects of i.v. iron on the functional status, quality of life, and exercise capacity in HF patients. It is hypothesized that i.v. iron supplementation may become a novel therapy in HF patients with iron deficiency.

  12. Nuclear magnetic resonance metabolomics of iron deficiency in soybean leaves

    USDA-ARS?s Scientific Manuscript database

    Iron (Fe) deficiency is an important agricultural concern leading to lower yields and crop quality. A better understanding of the condition, at the metabolome level, could contribute to the design of strategies to ameliorate Fe deficiency problems. Fe-sufficient and Fe-deficient soybean leaf extract...

  13. Individualized treatment for iron deficiency anemia in adults

    PubMed Central

    Alleyne, Michael; Horne, McDonald K.; Miller, Jeffery L.

    2008-01-01

    Iron deficiency is one of the most common disorders affecting mankind, and iron deficiency anemia continues to represent a major public health problem worldwide. It is especially common among women of childbearing age due to pregnancy and menstrual blood loss. Additional patient groups include those with other sources of blood loss, malnutrition or gut malabsorption. Iron deficiency anemia remains quite prevalent despite the widespread ability to diagnose the disease and availability of medicinal iron preparations. Therefore, new approaches are needed to effectively manage these patient populations. In this review, the diagnosis and treatment of iron deficiency anemia are discussed with emphasis placed upon consideration of patient specific features. It is proposed that all patients participate in their own care by helping their physician to identify a tolerable daily iron dose, formulation, and schedule. Dosing cycles are recommended for iron replacement based upon the tolerated daily dose and the total iron deficit. Each cycle consists of 5000mg of oral elemental iron ingested over at least one month with appropriate follow-up. This approach should assist physicians and their patients with the implementation of individualized treatment strategies for patients with iron deficiency anemia. PMID:18954837

  14. Iron deficiency: an emerging therapeutic target in heart failure.

    PubMed

    Cohen-Solal, Alain; Leclercq, Christophe; Deray, Gilbert; Lasocki, Sigismond; Zambrowski, Jean-Jacques; Mebazaa, Alexandre; de Groote, Pascal; Damy, Thibaud; Galinier, Michel

    2014-09-15

    In patients with heart failure, iron deficiency is frequent but overlooked, with a prevalence of 30%-50%. Since it contributes to cardiac and peripheral muscle dysfunction, iron deficiency is associated with poorer clinical outcomes and a greater risk of death, independent of haemoglobin level. Therefore, iron deficiency emerges as a new comorbidity and a therapeutic target of chronic heart failure in addition to chronic renal insufficiency, anaemia and diabetes. In a series of placebo-controlled, randomised studies in patients with heart failure and iron deficiency, intravenous iron had a favourable effect on exercise capacity, functional class, LVEF, renal function and quality of life. These clinical studies were performed in the context of a renewed interest in iron metabolism. During the past 10 years, knowledge about the transport, storage and homeostasis of iron has improved dramatically, and new molecules involved in iron metabolism have been described (eg, hepcidin, ferroportin, divalent metal transporter 1). Recent European guidelines recommend the monitoring of iron parameters (ie, serum ferritin, transferrin saturation) for all patients with heart failure. Ongoing clinical trials will explore the benefits of iron deficiency correction on various heart failure parameters.

  15. Vitamin A deficiency modulates iron metabolism via ineffective erythropoiesis.

    PubMed

    da Cunha, Marcela S B; Siqueira, Egle M A; Trindade, Luciano S; Arruda, Sandra F

    2014-10-01

    Vitamin A modulates inflammatory status, iron metabolism and erythropoiesis. Given that these factors modulate the expression of the hormone hepcidin (Hamp), we investigated the effect of vitamin A deficiency on molecular biomarkers of iron metabolism, the inflammatory response and the erythropoietic system. Five groups of male Wistar rats were treated: control (AIN-93G), the vitamin A-deficient (VAD) diet, the iron-deficient (FeD) diet, the vitamin A- and iron-deficient (VAFeD) diet or the diet with 12 mg atRA/kg diet replacing all-trans-retinyl palmitate by all-trans retinoic acid (atRA). Vitamin A deficiency reduced serum iron and transferrin saturation levels, increased spleen iron concentrations, reduced hepatic Hamp and kidney erythropoietin messenger RNA (mRNA) levels and up-regulated hepatic and spleen heme oxygenase-1 gene expression while reducing the liver HO-1 specific activity compared with the control. The FeD and VAFeD rats exhibited lower levels of serum iron and transferrin saturation, lower iron concentrations in tissues and lower hepatic Hamp mRNA levels compared with the control. The treatment with atRA resulted in lower serum iron and transferrin concentrations, an increased iron concentration in the liver, a decreased iron concentration in the spleen and in the gut, and decreased hepatic Hamp mRNA levels. In summary, these findings suggest that vitamin A deficiency leads to ineffective erythropoiesis by the down-regulation of renal erythropoietin expression in the kidney, resulting in erythrocyte malformation and the consequent accumulation of the heme group in the spleen. Vitamin A deficiency indirectly modulates systemic iron homeostasis by enhancing erythrophagocytosis of undifferentiated erythrocytes. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Relationship between vitamin D deficiency, bone remodelling and iron status in iron-deficient young women consuming an iron-fortified food.

    PubMed

    Blanco-Rojo, Ruth; Pérez-Granados, Ana M; Toxqui, Laura; Zazo, Pilar; de la Piedra, Concepción; Vaquero, M Pilar

    2013-03-01

    Iron and vitamin D deficiencies are two of the most widespread nutritional disorders in the world. Our aim was to know whether the consumption of an iron-fortified fruit juice modifies bone remodelling and the possible influence of baseline vitamin D status on the recovery of iron status in a group of iron-deficient women. Iron biomarkers, 25-hydroxyvitamin D levels and dietary intake were measured in 123 iron-deficient menstruating women. A subgroup (n = 41) participated in a randomised double-blind placebo-controlled study of 16-weeks during winter. They consumed a placebo fruit juice (P) or iron-fortified fruit juice (F). Dietary intake, 25-hydroxyvitamin D, parathormone (PTH), bone alkaline phosphatase (ALP), aminoterminal telopeptide of collagen I (NTX) and iron biomarkers were determined. Ninety-two per cent of the iron-deficient women were vitamin D deficient or insufficient. Transferrin saturation and 25-hydroxyvitamin D were positively correlated. Iron status improved in F, 25-hydroxyvitamin D decreased in F and P, and PTH, ALP and NTX levels were within the normal range and did not vary. Women with 25-hydroxyvitamin D ≥ 50 nmol/L compared with 25-hydroxyvitamin D < 50 nmol/L showed a higher increase in transferrin saturation (a marker of iron supply to tissues) during iron recovery. The prevalence of vitamin D deficiency or insufficiency is very high in iron-deficient women. The recovery of iron status by consuming an iron-fortified food does not affect 25-hydroxyvitamin D levels; however, the increase in iron supply to tissues is lower if the women also present vitamin D deficiency. Although bone health does not seem to be affected in this group of women, correction of iron and vitamin D deficiencies should be promoted in young women to improve present and future health.

  17. Management of Iron-Deficiency Anemia in Inflammatory Bowel Disease

    PubMed Central

    Nielsen, Ole Haagen; Ainsworth, Mark; Coskun, Mehmet; Weiss, Günter

    2015-01-01

    Abstract Anemia is the most frequent complication of inflammatory bowel disease (IBD), but anemia, mostly due to iron deficiency, has long been neglected in these patients. The aim was to briefly present the pathophysiology, followed by a balanced overview of the different forms of iron replacement available, and subsequently, to perform a systematic review of studies performed in the last decade on the treatment of iron-deficiency anemia in IBD. Given that intravenous therapies have been introduced in the last decade, a systematic review performed in PubMed, EMBASE, the Cochrane Library, and the websites of WHO, FDA, and EMA covered prospective trials investigating the management of iron-deficiency anemia in IBD published since 2004. A total of 632 articles were reviewed, and 13 articles (2906 patients) with unique content were included. In general, oral supplementation in iron-deficiency anemia should be administered with a target to restore/replenish the iron stores and the hemoglobin level in a suitable way. However, in patients with IBD flares and inadequate responses to or side effects with oral preparations, intravenous iron supplementation is the therapy of choice. Neither oral nor intravenous therapy seems to exacerbate the clinical course of IBD, and intravenous iron therapy can be administered even in active disease stages and concomitantly with biologics. In conclusion, because many physicians are in doubt as to how to manage anemia and iron deficiency in IBD, there is a clear need for the implementation of evidence-based recommendations on this matter. Based on the data presented, oral iron therapy should be preferred for patients with quiescent disease stages and trivial iron deficiency anemia unless such patients are intolerant or have an inadequate response, whereas intravenous iron supplementation may be of advantage in patients with aggravated anemia or flares of IBD because inflammation hampers intestinal absorption of iron. PMID:26061331

  18. Behavioral consequences of developmental iron deficiency in infant rhesus monkeys

    PubMed Central

    Golub, Mari S.; Hogrefe, Casey E.; Germann, Stacey L.; Capitanio, John P.; Lozoff, Betsy

    2006-01-01

    Human studies have shown that iron deficiency and iron deficiency anemia in infants are associated with behavioral impairment, but the periods of brain development most susceptible to iron deficiency have not been established. In the present study, rhesus monkeys were deprived of iron by dietary iron restriction during prenatal (n = 14, 10 μg Fe/g diet) or early postnatal (n = 12, 1.5 mg Fe/L formula) brain development and compared to controls (n = 12, 100 μg Fe/g diet, 12 mg Fe/L formula) in behavioral evaluations conducted during the first four months of life in the nonhuman primate nursery. Iron deficiency anemia was detected in the pregnant dams in the third trimester and compromised iron status was seen in the prenatally iron-deprived infants at birth, but no iron deficiency was seen in either the prenatally or postnatally iron-deprived infants during the period of behavioral evaluation. Neither prenatal nor postnatal iron deprivation led to significant delays in growth, or gross or fine motor development. Prenatally deprived infants demonstrated a 20% reduced spontaneous activity level, lower inhibitory response to novel environments, and more changes from one behavior to another in weekly observation sessions. Postnatally deprived infants demonstrated poorer performance of an object concept task, and greater emotionality relative to controls. This study indicates that different syndromes of behavioral effects are associated with prenatal and postnatal iron deprivation in rhesus monkey infants and that these effects can occur in the absence of concurrent iron deficiency as reflected in hematological measures. PMID:16343844

  19. Behavioral consequences of developmental iron deficiency in infant rhesus monkeys.

    PubMed

    Golub, Mari S; Hogrefe, Casey E; Germann, Stacey L; Capitanio, John P; Lozoff, Betsy

    2006-01-01

    Human studies have shown that iron deficiency and iron deficiency anemia in infants are associated with behavioral impairment, but the periods of brain development most susceptible to iron deficiency have not been established. In the present study, rhesus monkeys were deprived of iron by dietary iron restriction during prenatal (n=14, 10 microg Fe/g diet) or early postnatal (n=12, 1.5 mg Fe/L formula) brain development and compared to controls (n=12, 100 microg Fe/g diet, 12 mg Fe/L formula) in behavioral evaluations conducted during the first four months of life in the nonhuman primate nursery. Iron deficiency anemia was detected in the pregnant dams in the third trimester and compromised iron status was seen in the prenatally iron-deprived infants at birth, but no iron deficiency was seen in either the prenatally or postnatally iron-deprived infants during the period of behavioral evaluation. Neither prenatal nor postnatal iron deprivation led to significant delays in growth, or gross or fine motor development. Prenatally deprived infants demonstrated a 20% reduced spontaneous activity level, lower inhibitory response to novel environments, and more changes from one behavior to another in weekly observation sessions. Postnatally deprived infants demonstrated poorer performance of an object concept task, and greater emotionality relative to controls. This study indicates that different syndromes of behavioral effects are associated with prenatal and postnatal iron deprivation in rhesus monkey infants and that these effects can occur in the absence of concurrent iron deficiency as reflected in hematological measures.

  20. Obesity and iron deficiency: a quantitative meta-analysis.

    PubMed

    Zhao, L; Zhang, X; Shen, Y; Fang, X; Wang, Y; Wang, F

    2015-12-01

    Hypoferraemia (i.e. iron deficiency) was initially reported among obese individuals several decades ago; however, whether obesity and iron deficiency are correlated remains unclear. Here, we evaluated the putative association between obesity and iron deficiency by assessing the concentration of haematological iron markers and the risks associated with iron deficiency in both obese (including overweight) subjects and non-overweight participants. We performed a systematic search in the databases PubMed and Embase for relevant research articles published through December 2014. A total of 26 cross-sectional and case-control studies were analysed, comprising 13,393 overweight/obese individuals and 26,621 non-overweight participants. Weighted or standardized mean differences of blood iron markers and odds ratio (OR) of iron deficiency were compared between the overweight/obese participants and the non-overweight participants using a random-effects model. Compared with the non-overweight participants, the overweight/obese participants had lower serum iron concentrations (weighted mean difference [WMD]: -8.37 μg dL(-1) ; 95% confidence interval [CI]: -11.38 to -5.36 μg dL(-1) ) and lower transferrin saturation percentages (WMD: 2.34%, 95% CI: -3.29% to -1.40%). Consistent with this finding, the overweight/obese participants had a significantly increased risk of iron deficiency (OR: 1.31; 95% CI: 1.01-1.68). Moreover, subgroup analyses revealed that the method used to diagnose iron deficiency can have a critical effect on the results of the association test; specifically, we found a significant correlation between iron deficiency and obesity in studies without a ferritin-based diagnosis, but not in studies that used a ferritin-based diagnosis. Based upon these findings, we concluded that obesity is significantly associated with iron deficiency, and we recommend early monitoring and treatment of iron deficiency in overweight and obese individuals. Future

  1. Why iron deficiency is important in infant development.

    PubMed

    Beard, John L

    2008-12-01

    Infants who experience iron deficiency during the first 6-12 mo of life are likely to experience persistent effects of the deficiency that alter functioning in adulthood. A lack of sufficient iron intake may significantly delay the development of the central nervous system as a result of alterations in morphology, neurochemistry, and bioenergetics. Depending on the stage of development at the time of iron deficiency, there may be an opportunity to reverse adverse effects, but the success of repletion efforts appear to be time dependent. Publications in the past several years describe the emerging picture of the consequences of iron deficiency in both human and animal studies. The mechanisms for iron accumulation in the brain and perhaps redistribution are being understood. The data in human infants are consistent with altered myelination of white matter, changes in monoamine metabolism in striatum, and functioning of the hippocampus. Rodent studies also show effects of iron deficiency during gestation and lactation that persist into adulthood despite restoration of iron status at weaning. These studies indicate that gestation and early lactation are likely critical periods when iron deficiency will result in long-lasting damage.

  2. Interleukin 2 production in iron-deficient children.

    PubMed

    Galan, P; Thibault, H; Preziosi, P; Hercberg, S

    1992-01-01

    The relationship between iron status and capacity for IL-2 production by lymphocytes was assessed in 81 children from 6 mo to 3 yr of age selected at random from a population with low socioeconomic status, undergoing free systematic examination in four children's health centers in the Paris area. Iron deficiency was defined by the existence of at least two abnormal values among the three indicators of iron status: serum ferritin level less than or equal to 12 micrograms/L, transferrin saturation less than 12%, and erythrocyte protoporphyrin concentration greater than 3 micrograms/g hemoglobin. According to this definition, 53 children were classified as iron deficient and 28 as iron sufficient. No differences were observed between the iron-deficient and iron-sufficient groups in terms of the IL-2 concentration without stimulation by PHA. IL-2 production by lymphocytes stimulated with PHA, as well as the stimulation index (ratio of IL-2 concentration following stimulation by PHA to that of IL-2 concentration without stimulation by PHA) were significantly lower in iron-deficient children. The reduction in IL-2 production by activated lymphocytes observed in our study of iron-deficient children may be responsible for impairments in immunity found by other authors, particularly in cell-mediated immunity.

  3. Factors associated with iron deficiency anemia in Brazilian preschool children.

    PubMed

    Almeida, Carlos A N de; Ricco, Rubens G; Ciampo, Luiz A del; Souza, Ana M; Pinho, Adriana P; Oliveira, José E Dutra de

    2004-01-01

    To examine the determining factors of anemia and iron deficiency in children attending two day care centers in the town of Pontal, southeast of Brazil. Cross-sectional study was conducted in 192 children aged 12 to 72 months. Personal data (age, sex, use of medicinal iron supplements, duration of breast-feeding, type of delivery, prenatal care, weight, and height), and socioeconomic data (number of co-inhabitants, parental schooling, and per capita family income) were obtained and evaluated together with hemoglobin, serum transferrin receptor, ferritin, and iron deficiency anemia. Age was the variable that most affected iron nutritional status, with higher hemoglobin values, lower transferrin receptor concentrations, higher ferritin values and lower iron deficiency anemia being detected with increasing age. The other studied variables did not show any correlation with iron nutritional status. The obtained data suggest that control strategies for this preschool population should be especially directed at younger children.

  4. Iron Deficiency Anemia: A Common and Curable Disease

    PubMed Central

    Miller, Jeffery L.

    2013-01-01

    Iron deficiency anemia arises when the balance of iron intake, iron stores, and the body's loss of iron are insufficient to fully support production of erythrocytes. Iron deficiency anemia rarely causes death, but the impact on human health is significant. In the developed world, this disease is easily identified and treated, but frequently overlooked by physicians. In contrast, it is a health problem that affects major portions of the population in underdeveloped countries. Overall, the prevention and successful treatment for iron deficiency anemia remains woefully insufficient worldwide, especially among underprivileged women and children. Here, clinical and laboratory features of the disease are discussed, and then focus is placed on relevant economic, environmental, infectious, and genetic factors that converge among global populations. PMID:23613366

  5. Laboratory and genetic assessment of iron deficiency in blood donors.

    PubMed

    Kiss, Joseph E

    2015-03-01

    More than 9 million individuals donate blood annually in the United States. Between 200 and 250 mg of iron is removed with each whole blood donation, reflecting losses from the hemoglobin in red blood cells. Replenishment of iron stores takes many months, leading to a high rate of iron depletion. In an effort to better identify and prevent iron deficiency, blood collection centers are now considering various strategies to manage donor iron loss. This article highlights laboratory and genetic tests to assess the iron status of blood donors and their applicability as screening tests for blood donation. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Iron deficiency in frequent and first time female blood donors.

    PubMed

    Boulahriss, M; Benchemsi, N

    2008-12-01

    Blood donation has a marked influence on the body iron stores especially in female blood donors. Iron deficiency anaemia is an important limiting factor for the number of donations in female regular blood donors. This study was conducted to evaluate the frequency of iron deficiency and relevant factors in frequent and first time female blood donors at Casablanca blood transfusion centre, Morocco. Between November 2005 and April 2006, twenty-one female first time and twenty-one frequent female blood donors were selected randomly. In frequent blood donors, only females with at least 10 donations were included. Haemoglobin concentration. serum ferritin, serum iron and total transferrine binding capacity were measured and analysed. The results of haemoglobin concentration, serum ferritin, serum iron were significant lower in frequent female blood donors when compared with the results of same parameters in first time female blood donors. The results show that the frequency of iron deficiency in frequent female blood donors is 43% and in the first time female blood donors is 14%. Iron deficiency is very common in regular female blood donors at Casablanca's transfusion centre. Frequent blood donation has marked influence on the body iron stores in frequent female blood donors. It is therefore recommended that blood transfusion centres focused on maintaining iron balance by measuring serum ferritin and total transferrine binding capacity in frequent female blood donors. They have also to educate the donors about iron supplementation and yearly ferritin checking.

  7. Iron-Responsive Olfactory Uptake of Manganese Improves Motor Function Deficits Associated with Iron Deficiency

    PubMed Central

    Kim, Jonghan; Li, Yuan; Buckett, Peter D.; Böhlke, Mark; Thompson, Khristy J.; Takahashi, Masaya; Maher, Timothy J.; Wessling-Resnick, Marianne

    2012-01-01

    Iron-responsive manganese uptake is increased in iron-deficient rats, suggesting that toxicity related to manganese exposure could be modified by iron status. To explore possible interactions, the distribution of intranasally-instilled manganese in control and iron-deficient rat brain was characterized by quantitative image analysis using T1-weighted magnetic resonance imaging (MRI). Manganese accumulation in the brain of iron-deficient rats was doubled after intranasal administration of MnCl2 for 1- or 3-week. Enhanced manganese level was observed in specific brain regions of iron-deficient rats, including the striatum, hippocampus, and prefrontal cortex. Iron-deficient rats spent reduced time on a standard accelerating rotarod bar before falling and with lower peak speed compared to controls; unexpectedly, these measures of motor function significantly improved in iron-deficient rats intranasally-instilled with MnCl2. Although tissue dopamine concentrations were similar in the striatum, dopamine transporter (DAT) and dopamine receptor D1 (D1R) levels were reduced and dopamine receptor D2 (D2R) levels were increased in manganese-instilled rats, suggesting that manganese-induced changes in post-synaptic dopaminergic signaling contribute to the compensatory effect. Enhanced olfactory manganese uptake during iron deficiency appears to be a programmed “rescue response” with beneficial influence on motor impairment due to low iron status. PMID:22479410

  8. [Iron deficiency: A diagnostic and therapeutic perspective in psychiatry].

    PubMed

    Kassir, A

    2017-02-01

    Iron plays an essential role in balancing the various metabolism in the body. It is also involved in the synthesis of several neurotransmitters. Nutritional iron deficiency is one of the most widespread worldwide; it poses a great health challenge due to the consequences it entails. The aim of this research study is to explore the percentage of psychiatric patients who have a deficiency in iron. In addition, the study investigates the efficacy of iron administered by oral treatment on psychiatric symptomatology among iron deficient patients. The research study utilized the martial biological results, which involved the observation of the level of iron deficiency among the outpatients of a local psychiatrist and assessor from the period of January 2012 until December 2013. Out of 412 patients, 295 were women and 117 men. The age of the participants ranged from 16 to 89years, with an average age of 45years. The only exclusion criterion was a patient's refusal or inability to take the prescribed iron assessment test. We considered a transferrin saturation coefficient (TSC)<30% and/or a serum ferritin level≤50ng/mL to be "indicative" of obvious iron deficiency, and a ferritin level between 51 and 100ng/mL to be "suggestive" of iron deficiency. A plasma ferritin assay was performed at least once on all of the participants prior to any proposed iron treatment. A calculation of the TSC in 138 patients was requested due to suspected iron deficiency despite a blood ferritin level of>100ng/ml. A single method was utilized in the various laboratories to analyse the blood samples to determine whether there was a deficiency in iron. Only those patients with blood ferritin levels ≤100ng/mL and/or a TSC of<30% (335 patients) were subsequently given exclusively an oral iron treatment prescribed on its own or as a supplement or simultaneously with psychotropic treatment. The daily administered dose of elemental iron varied between 50 and 200mg a day. About half of the women

  9. Ferrous versus ferric oral iron formulations for the treatment of iron deficiency: a clinical overview.

    PubMed

    Santiago, Palacios

    2012-01-01

    Iron deficiency anaemia represents a major public health problem, particularly in infants, young children, pregnant women, and females with heavy menses. Oral iron supplementation is a cheap, safe, and effective means of increasing haemoglobin levels and restoring iron stores to prevent and correct iron deficiency. Many preparations are available, varying widely in dosage, formulation (quick or prolonged release), and chemical state (ferrous or ferric form). The debate over the advantages of ferrous versus ferric formulations is ongoing. In this literature review, the tolerability and efficacy of ferrous versus ferric iron formulations are evaluated. We focused on studies comparing ferrous sulphate preparations with ferric iron polymaltose complex preparations, the two predominant forms of iron used. Current data show that slow-release ferrous sulphate preparations remain the established and standard treatment of iron deficiency, irrespective of the indication, given their good bioavailability, efficacy, and acceptable tolerability demonstrated in several large clinical studies.

  10. The frequency of anemia and iron deficiency in the runner.

    PubMed

    Balaban, E P; Cox, J V; Snell, P; Vaughan, R H; Frenkel, E P

    1989-12-01

    The current consensus is that runners commonly experience a mild anemia influenced by iron deficiency. We compared hematologic parameters of 72 (35 males and 37 females) runners with 48 (27 males and 21 females) nonrunners and assessed the impact of iron supplementation. Male runners had lower hemoglobin (Hb) values than male nonrunners (14.8 vs 15.3 g.dl-1) (P less than 0.05) regardless of iron usage. Female runners had higher (P = 0.05) Hb values than female controls (13.5 vs 12.8 g.dl-1). Female runners off iron had Hbs similar to controls off iron (P = 0.30). Iron parameters (total serum iron, TSI; total iron-binding capacity, TIBC; percent saturation of the TIBC, %sat TIBC; and serum ferritin) of runners vs controls, runners vs runners (on or off iron), and nonrunners vs nonrunners (on or off iron) were comparable except 1) male runners off iron had lower (P less than 0.05) %sat TIBC values (26%) than male runners on iron (34%) and 2) female runners taking iron had ferritin values (32 ng.ml-1) similar to those of female nonrunners taking iron (39 ng.ml-1) but higher (P less than 0.05) than their counterparts off iron (15 and 15 ng.ml-1, respectively). This study concludes that running affects Hb in a variable manner and suggests that the runner's iron status is similar to that of the general population.

  11. Serum Iron and Haemoglobin Estimation in Oral Submucous Fibrosis and Iron Deficiency Anaemia: A Diagnostic Approach

    PubMed Central

    Dinkar, Ajit D; Satoskar, Sujata K; Desai, Sapna Raut

    2016-01-01

    Introduction Oral Submucous Fibrosis (OSMF) is a premalignant condition with potential malignant behaviour characterized by juxta-epithelial fibrosis of the oral cavity. In the process of collagen synthesis, iron gets utilized, by the hydroxylation of proline and lysine, leading to decreased serum iron levels. The trace element like iron is receiving much attention in the detection of oral cancer and precancerous condition like OSMF as it was found to be significantly altered in these conditions. Aim The aim of this study was to compare the haemoglobin and serum iron values of OSMF subjects with that of iron deficiency anaemia subjects. Materials and Methods Total of 120 subjects were included, 40 subjects with the OSMF, 40 with the iron deficiency anemia without tobacco chewing habit, 40 healthy control subjects without OSMF and iron deficiency anaemia. A total of 5ml of venous blood was withdrawn from all the subjects and serum iron and haemoglobin levels were estimated for all the subjects. Estimation of iron was done using Ferrozine method and haemoglobin by Sahli’s method. The statistical method applied were Kruskal Wallis, Mann Whitney and Pearson correlation coefficient test. Results There was a statistically significant difference in serum iron and haemoglobin level in all three groups (p<0.05). The serum iron level was lowest in OSMF group and haemoglobin was lowest in iron deficiency anaemia group. A progressive decrease in serum iron and haemoglobin levels from Stage I of OSMF to the Stage IV of OSMF was also observed. The iron deficiency anaemia group was not found to be suffering from OSMF in the absence of areca-nut or tobacco chewing habits, but OSMF patients with chewing habits were found to be suffering from iron deficiency anaemia. Conclusion There is a progressive decrease in serum iron and haemoglobin levels from Stage I of OSMF to the Stage IV of OSMF so it can be used as an auxillary test in assessment of prognosis of the disease. PMID

  12. Obesity as an Emerging Risk Factor for Iron Deficiency

    PubMed Central

    Aigner, Elmar; Feldman, Alexandra; Datz, Christian

    2014-01-01

    Iron homeostasis is affected by obesity and obesity-related insulin resistance in a many-facetted fashion. On one hand, iron deficiency and anemia are frequent findings in subjects with progressed stages of obesity. This phenomenon has been well studied in obese adolescents, women and subjects undergoing bariatric surgery. On the other hand, hyperferritinemia with normal or mildly elevated transferrin saturation is observed in approximately one-third of patients with metabolic syndrome (MetS) or nonalcoholic fatty liver disease (NAFLD). This constellation has been named the “dysmetabolic iron overload syndrome (DIOS)”. Both elevated body iron stores and iron deficiency are detrimental to health and to the course of obesity-related conditions. Iron deficiency and anemia may impair mitochondrial and cellular energy homeostasis and further increase inactivity and fatigue of obese subjects. Obesity-associated inflammation is tightly linked to iron deficiency and involves impaired duodenal iron absorption associated with low expression of duodenal ferroportin (FPN) along with elevated hepcidin concentrations. This review summarizes the current understanding of the dysregulation of iron homeostasis in obesity. PMID:25215659

  13. Effects of iron replenishment on iron, calcium, phosphorus and magnesium metabolism in iron-deficient rats.

    PubMed

    Pallarés, I; López-Aliaga, I; Lisbona, F; Moratalla, A; Gómez-Ayala, A E; Barrionuevo, M; Hartiti, S; Alférez, M J; Campos, M S

    1996-01-01

    We investigated the effect of Fe deficiency on the nutritive utilization of Fe, Ca, P and Mg in rats. Aside from the well known depletion of Fe in liver, femur and sternum with low values of Hb, Fe deficiency impaired Ca, P and Mg metabolism at different degrees. Iron deficiency altered Mg absorption, lowered the concentration of Ca in the liver, femur and sternum, raised the concentration of P and Mg in the liver, and decreased P in the femur. The altered status was not completely rectified by iron supplementation as the animals were still slightly anemic at the end of the study. The second purpose of the study was to evaluate the ability of three iron compounds (ferric citrate, ferrous sulfate and ferrous ascorbate) to correct the undesirable effects of Fe deficiency. Ten days after treatment with these diets, Fe-deficient rats still had reduced Mg absorption, especially those fed ferric citrate. The concentrations of hemoglobin approached normal values in all groups; however, serum Fe remained low, indicating that Fe reserves were still depleted. Hepatic and femoral Fe concentrations were also lower in all Fe-deficient groups regardless of the diet given, compared with their respective controls, whereas Fe concentrations in the sternum increased significantly with all three diets, suggesting an increase in erythropoiesis. The concentration of Ca, P and Mg in liver approached normal values, and appeared to normalize in the femur, except that Ca and P concentrations remained low with the citrate diet. In the sternum, a site assumed to have higher requirements for these minerals, the concentrations of Ca, P and Mg also increased. These findings indicate that Fe is involved in the bone mineralization, and that in physiological terms, Fe interacts favorably with Ca, P and Mg metabolism, since Fe deficiency altered the status of these metals. These findings also suggest that ferrous ascorbate and ferrous sulfate were more effectively absorbed than was ferric citrate.

  14. Effect of chronic iron deficiency on neuropsychological domains in infants.

    PubMed

    Beltrán-Navarro, Beatriz; Matute, Esmeralda; Vásquez-Garibay, Edgar; Zarabozo, Daniel

    2012-03-01

    The aim of this study was to assess the effects of chronic iron deficiency on neuropsychological traits in infants. We established the nutritional iron status and assessed the neuropsychological characteristics of 58 Mexican 14- to 18-month-old infants. The Bayley Scales of Infant Development, preschool language scales and an environmental sound perception task designed expressly for the study, were used. The infants' mothers were asked to fill out 2 questionnaires concerning their child's sociodemographic background. Six different neuropsychological domains were analyzed. Results showed that the chronic iron deficiency group did show significantly lower scores on language, environmental sound perception, and motor measures, when compared with infants with normal nutritional iron status at 6 and 14 to 18 months. Our conclusion is that the development of language and motor skills and environmental sound perception appeared to be sensitive to the effects of chronic iron deficiency in infants.

  15. Increased sensitivity to iron deficiency in Arabidopsis thaliana overaccumulating nicotianamine.

    PubMed

    Cassin, Gaëlle; Mari, Stéphane; Curie, Catherine; Briat, Jean-François; Czernic, Pierre

    2009-01-01

    Nicotianamine (NA) is a non-protein amino acid derivative synthesized from S-adenosyl L-methionine able to bind several metal ions such as iron, copper, manganese, zinc, or nickel. In plants, NA appears to be involved in iron availability and is essential for the plant to complete its biological cycle. In graminaceous plants, NA is also the precursor in the biosynthesis of phytosiderophores. Arabidopsis lines accumulating 4- and 100-fold more NA than wild-type plants were used in order to evaluate the impact of such an NA overaccumulation on iron homeostasis. The expression of iron-regulated genes including the IRT1/FRO2 iron uptake system is highly induced at the transcript level under both iron-sufficient and iron-deficient conditions. Nevertheless, NA overaccumulation does not interfere with the iron uptake mechanisms since the iron levels are similar in the NA-overaccumulating line and wild-type plants in both roots and leaves under both sufficient and deficient conditions. This observation also suggests that the translocation of iron from the root to the shoot is not affected in the NA-overaccumulating line. However, NA overaccumulation triggers an enhanced sensitivity to iron starvation, associated with a decrease in iron availability. This study draws attention to a particular phenotype where NA in excess paradoxically leads to iron deficiency, probably because of an increase of the NA apoplastic pool sequestering iron. This finding strengthens the notion that extracellular NA in the apoplast could be a major checkpoint to control plant iron homeostasis.

  16. Increased sensitivity to iron deficiency in Arabidopsis thaliana overaccumulating nicotianamine

    PubMed Central

    Cassin, Gaëlle; Mari, Stéphane; Curie, Catherine; Briat, Jean-François; Czernic, Pierre

    2009-01-01

    Nicotianamine (NA) is a non-protein amino acid derivative synthesized from S-adenosyl L-methionine able to bind several metal ions such as iron, copper, manganese, zinc, or nickel. In plants, NA appears to be involved in iron availability and is essential for the plant to complete its biological cycle. In graminaceous plants, NA is also the precursor in the biosynthesis of phytosiderophores. Arabidopsis lines accumulating 4- and 100-fold more NA than wild-type plants were used in order to evaluate the impact of such an NA overaccumulation on iron homeostasis. The expression of iron-regulated genes including the IRT1/FRO2 iron uptake system is highly induced at the transcript level under both iron-sufficient and iron-deficient conditions. Nevertheless, NA overaccumulation does not interfere with the iron uptake mechanisms since the iron levels are similar in the NA-overaccumulating line and wild-type plants in both roots and leaves under both sufficient and deficient conditions. This observation also suggests that the translocation of iron from the root to the shoot is not affected in the NA-overaccumulating line. However, NA overaccumulation triggers an enhanced sensitivity to iron starvation, associated with a decrease in iron availability. This study draws attention to a particular phenotype where NA in excess paradoxically leads to iron deficiency, probably because of an increase of the NA apoplastic pool sequestering iron. This finding strengthens the notion that extracellular NA in the apoplast could be a major checkpoint to control plant iron homeostasis. PMID:19188276

  17. Effect of iron therapy on behavior performance in nonanemic, iron-deficient infants.

    PubMed

    Oski, F A; Honig, A S; Helu, B; Howanitz, P

    1983-06-01

    In an effort to determine whether iron deficiency, in the absence of anemia (hemoglobin greater than 11.0 g/dL), might produce alterations in behavioral development, four groups of nonanemic infants, 9 to 12 months of age, with varying degrees of iron deficiency were studied. Infants were classified as iron sufficient, iron depleted, or iron deficient based on measurements of serum ferritin concentration, erythrocyte protoporphyrin values, and the mean cell volume of erythrocytes. Subjects in each group were tested with the Bayley Mental Development Index, treated with parenteral iron, and retested seven days later. The administration of iron produced a significant increase in the Mental Development Index scores (+21.6 points) in the infants with iron deficiency but no significant change in the scores of infants with iron sufficiency (+6.2 points) or only iron depletion (+5.6 points). It is concluded that iron deficiency, even in the absence of anemia, results in biochemical alterations that impair behavior in infants.

  18. The evaluation of iron deficiency and anemia in male blood donors with other related factors

    PubMed Central

    Yousefinejad, Vahid; Darvishi, Nazila; Arabzadeh, Masoumeh; Soori, Masoumeh; Magsudlu, Mahtab; Shafiayan, Madjid

    2010-01-01

    Aims and Background: Iron deficiency is one of the most common nutritional disorders worldwide and blood donation may cause iron depletion. Limited studies with large sample size have been done on male donors. The aim of this study is to determine the prevalence of iron deficiency and iron deficiency anemia among male donors in the Kurdistan Organization of Blood Transfusion in Iran. Materials and Methods: This was a cross-sectional study. Sample size was 1184 blood donors selected by systematic random sampling. Hemoglobin, serum iron, serum ferritin, total iron banding capacity (TIBC) and transferin saturation were measured in donors. Iron depletion, lack of iron stores, iron deficiency, iron deficiency anemia and anemia were evaluated among them. Data was analyzed with SPSS software and X2, one-way ANOVA, and LSD test. Results: Iron deficiency, anemia, iron deficiency anemia, iron depletion and lack of iron resources were seen in 2.3, 4.08, 2.14, 22.76 and 4.66 percent respectively. There was a significant relationship of iron deficiency and iron deficiency anemia with instances of donation and interval from last donation (P < 0.05). A significant relationship was seen between iron deficiency and iron deficiency anemia among blood donors with more than ten times blood donation (P < 0.05). Conclusions: This study showed regular male donors require especial attention. Therefore, serum ferritin is recommended as a more adequate index to use for iron deficiency screening and planning purposes for iron supplementation among them. PMID:20859513

  19. Iron homeostasis and its disruption in mouse lung in iron deficiency and overload.

    PubMed

    Giorgi, Gisela; D'Anna, María Cecilia; Roque, Marta Elena

    2015-10-01

    What is the central question of this study? The aim was to explore the role and hitherto unclear mechanisms of action of iron proteins in protecting the lung against the harmful effects of iron accumulation and the ability of pulmonary cells to mobilize iron in iron deficiency. What is the main finding and its importance? We show that pulmonary hepcidin appears not to modify cellular iron mobilization in the lung. We propose pathways for supplying iron to the lung in iron deficiency and for protecting the lung against iron excess in iron overload, mediated by the co-ordinated action of iron proteins, such as divalent metal transporter 1, ZRT-IRE-like-protein 14, transferrin receptor, ferritin, haemochromatosis-associated protein and ferroportin. Iron dyshomeostasis is associated with several forms of chronic lung disease, but its mechanisms of action remain to be elucidated. The aim of the present study was to determine the role of the lung in whole-animal models with iron deficiency and iron overload, studying the divalent metal transporter 1 (DMT1), ZRT-IRE-like protein 14 (ZIP14), transferrin receptor (TfR), haemochromatosis-associated protein (HFE), hepcidin, ferritin and ferroportin (FPN) expression. In each model, adult CF1 mice were divided into the following groups (six mice per group): (i) iron-overload model, iron saccharate i.p. and control group (iron adequate), 0.9% NaCl i.p.; and (ii) iron-deficiency model, induced by repeated bleeding, and control group (sham operated). Proteins were assessed by immunohistochemistry and Western blot. In control mice, DMT1 was localized in the cytoplasm of airway cells, and in iron deficiency and overload it was in the apical membrane. Divalent metal transporter 1 and TfR increased in iron deficiency, without changes in iron overload. ZRT-IRE-like protein 14 decreased in airway cells in iron deficiency and increased in iron overload. In iron deficiency, HFE and FPN were immunolocalized close to the apical membrane

  20. Anaemia and iron deficiency in children with inflammatory bowel disease.

    PubMed

    Wiskin, Anthony E; Fleming, Ben J; Wootton, Stephen A; Beattie, R Mark

    2012-07-01

    Anaemia and iron deficiency are common in children with Inflammatory Bowel Disease (IBD) however it is not known if the prevalence of anaemia and iron deficiency alters following diagnosis. Laboratory results from diagnosis, and at follow up one and two years later were recorded retrospectively in children with IBD recruited from a tertiary centre. Anaemia was defined using WHO standards and iron deficiency defined using published guidelines. 46 children (16 girls) with Crohn's disease and 34 children (18 girls) with UC were studied. 75% of children with IBD were anaemic at diagnosis, 30% were anaemic at follow up two years later. 90% of children with Crohn's and 95% of children with Ulcerative Colitis (UC) were iron deficient at diagnosis. At follow up two years later 70% of children with Crohn's and 65% of children with UC were iron deficient. Persistent anaemia and iron deficiency are common in childhood IBD, prevalence alters with duration of time from diagnosis. Copyright © 2011. Published by Elsevier B.V.

  1. Iron deficiency anemia and megaloblastic anemia in obese patients.

    PubMed

    Arshad, Mahmoud; Jaberian, Sara; Pazouki, Abdolreza; Riazi, Sajedeh; Rangraz, Maryam Aghababa; Mokhber, Somayyeh

    2017-03-01

    The association between obesity and different types of anemia remained uncertain. The present study aimed to assess the relation between obesity parameters and the occurrence of iron deficiency anemia and also megaloblastic anemia among Iranian population. This cross-sectional study was performed on 1252 patients with morbid obesity that randomly selected from all patients referred to Clinic of obesity at Rasoul-e-Akram Hospital in 2014. The morbid obesity was defined according to the guideline as body mass index (BMI) equal to or higher than 40 kg/m2. Various laboratory parameters including serum levels of hemoglobin, iron, ferritin, folic acid, and vitamin B12 were assessed using the standard laboratory techniques. BMI was adversely associated with serum vitamin B12, but not associated with other hematologic parameters. The overall prevalence of iron deficiency anemia was 9.8%. The prevalence of iron deficiency anemia was independent to patients' age and also to body mass index. The prevalence of vitamin B12 deficiency was totally 20.9%. According to the multivariable logistic regression model, no association was revealed between BMI and the occurrence of iron deficiency anemia adjusting gender and age. A similar regression model showed that higher BMI could predict occurrence of vitamin B12 deficiency in morbid obese patients. Although iron deficiency is a common finding among obese patients, vitamin B12 deficiency is more frequent so about one-fifth of these patients suffer vitamin B12 deficiency. In fact, the exacerbation of obesity can result in exacerbation of vitamin B12 deficiency.

  2. Current misconceptions in diagnosis and management of iron deficiency

    PubMed Central

    Muñoz, Manuel; Gómez-Ramírez, Susana; Besser, Martin; Pavía, José; Gomollón, Fernando; Liumbruno, Giancarlo M.; Bhandari, Sunil; Cladellas, Mercé; Shander, Aryeh; Auerbach, Michael

    2017-01-01

    The prevention and treatment of iron deficiency is a major public health goal. Challenges in the treatment of iron deficiency include finding and addressing the underlying cause and the selection of an iron replacement product which meets the needs of the patient. However, there are a number of non-evidence-based misconceptions regarding the diagnosis and management of iron deficiency, with or without anaemia, as well as inconsistency of terminology and lack of clear guidance on clinical pathways. In particular, the pathogenesis of iron deficiency is still frequently not addressed and iron not replaced, with indiscriminate red cell transfusion used as a default therapy. In our experience, this imprudent practice continues to be endorsed by non-evidence-based misconceptions. The intent of the authors is to provide a consensus that effectively challenges these misconceptions, and to highlight evidence-based alternatives for appropriate management (referred to as key points). We believe that this approach to the management of iron deficiency may be beneficial for both patients and healthcare systems. We stress that this paper solely presents the Authors’ independent opinions. No pharmaceutical company funded or influenced the conception, development or writing of the manuscript. PMID:28880842

  3. Ferritin Mutants of Escherichia coli Are Iron Deficient and Growth Impaired, and fur Mutants are Iron Deficient

    PubMed Central

    Abdul-Tehrani, Hossein; Hudson, Aaron J.; Chang, Yung-Sheng; Timms, Andrew R.; Hawkins, Chris; Williams, John M.; Harrison, Pauline M.; Guest, John R.; Andrews, Simon C.

    1999-01-01

    Escherichia coli contains at least two iron storage proteins, a ferritin (FtnA) and a bacterioferritin (Bfr). To investigate their specific functions, the corresponding genes (ftnA and bfr) were inactivated by replacing the chromosomal ftnA and bfr genes with disrupted derivatives containing antibiotic resistance cassettes in place of internal segments of the corresponding coding regions. Single mutants (ftnA::spc and bfr::kan) and a double mutant (ftnA::spc bfr::kan) were generated and confirmed by Western and Southern blot analyses. The iron contents of the parental strain (W3110) and the bfr mutant increased by 1.5- to 2-fold during the transition from logarithmic to stationary phase in iron-rich media, whereas the iron contents of the ftnA and ftnA bfr mutants remained unchanged. The ftnA and ftnA bfr mutants were growth impaired in iron-deficient media, but this was apparent only after the mutant and parental strains had been precultured in iron-rich media. Surprisingly, ferric iron uptake regulation (fur) mutants also had very low iron contents (2.5-fold less iron than Fur+ strains) despite constitutive expression of the iron acquisition systems. The iron deficiencies of the ftnA and fur mutants were confirmed by Mössbauer spectroscopy, which further showed that the low iron contents of ftnA mutants are due to a lack of magnetically ordered ferric iron clusters likely to correspond to FtnA iron cores. In combination with the fur mutation, ftnA and bfr mutations produced an enhanced sensitivity to hydroperoxides, presumably due to an increase in production of “reactive ferrous iron.” It is concluded that FtnA acts as an iron store accommodating up to 50% of the cellular iron during postexponential growth in iron-rich media and providing a source of iron that partially compensates for iron deficiency during iron-restricted growth. In addition to repressing the iron acquisition systems, Fur appears to regulate the demand for iron, probably by controlling

  4. Ferritin in the Serum of Normal Subjects and Patients with Iron Deficiency and Iron Overload

    PubMed Central

    Jacobs, A.; Miller, F.; Worwood, M.; Beamish, M. R.; Wardrop, C. A.

    1972-01-01

    The concentration of ferritin in serum gives a quantitative measure of the amount of storage iron in normal subjects and those with iron deficiency or overload. The mean level in normal men is 69 ng/ml, compared with 35 ng/ml in normal women. A concentration below 10 ng/ml is associated with a low transferrin saturation and iron-deficient erythropoiesis. PMID:5082548

  5. Reversing Sports-Related Iron and Zinc Deficiencies.

    ERIC Educational Resources Information Center

    Loosli, Alvin R.

    1993-01-01

    Many active athletes do not consume enough zinc or iron, which are important for oxygen activation, electron transport, and injury healing. Subclinical deficiencies may impair performance and impair healing times. People who exercise regularly need counseling about the importance of adequate dietary intake of iron and zinc. (SM)

  6. Reversing Sports-Related Iron and Zinc Deficiencies.

    ERIC Educational Resources Information Center

    Loosli, Alvin R.

    1993-01-01

    Many active athletes do not consume enough zinc or iron, which are important for oxygen activation, electron transport, and injury healing. Subclinical deficiencies may impair performance and impair healing times. People who exercise regularly need counseling about the importance of adequate dietary intake of iron and zinc. (SM)

  7. Iron deficiency anemia in newly diagnosed celiac disease in children.

    PubMed

    Sanseviero, Maria T; Mazza, Giuseppe A; Pullano, Maria N; Oliveiro, Antonella C; Altomare, Federica; Pedrelli, Luca; Dattilo, Bruno; Miniero, Roberto; Meloni, Gianfranco; Giancotti, Laura; Talarico, Valentina

    2016-02-01

    Celiac disease (CD) in children may occur with a wide spectrum of clinical manifestations: anemia is the most frequent extraintestinal manifestation, iron deficiency anemia (IDA) is the common presentation. In our study we aimed to assess IDA condition in a large cohort of pediatric patients with newly diagnosed CD. Our study includes a cohort of 518 children (340 females and 178 males), 6 months-18 years old, joined between January 1990 and January 2013. We have analyzed hematological parameters and iron balance: serum iron, serum ferritin and serum transferrin levels. The diagnosis of IDA was considered on the basis of hemoglobin levels below -2SD, associated with serum iron and ferritin reduction, serum transferrin increase; all compared with the normal reference values for age. Of all patients, 156 patients (30.1%) had anemia, including 103 females (19.8%) and 53 males (10.2%); of these, 112 (21.62%) had IDA (in 18 cases associated with α- or β-thalassemia trait), 22 were thalassemic trait without iron deficiency and the remaining 19 suffered from other forms of anemia. One hundred fifteen patients (22.20%) with low ferritin levels but normal hemoglobin levels were considered as preanemic iron deficient patients. Our data confirm that iron depletion and IDA represent a frequent finding at the diagnosis of CD. This significant relation existing between CD and iron deficiency should be considered by pediatricians at the diagnosis of CD in order to treat the patients.

  8. Serum transferrin receptors in detection of iron deficiency in pregnancy.

    PubMed

    Rusia, U; Flowers, C; Madan, N; Agarwal, N; Sood, S K; Sikka, M

    1999-08-01

    A prospective hospital-based study was conducted to evaluate the efficacy of serum transferrin receptors in the detection of iron deficiency in pregnant women. The iron status of 100 pregnant women with single uncomplicated term pregnancies in the first stage of labor was established using standard laboratory measures. These included complete hemogram, red cell indices, serum iron, percent transferrin saturation, and serum ferritin. In addition, serum transferrin receptor (STFR) was estimated. The results of 81 women with complete laboratory profiles were analyzed. Thirty-five (43.2%) women were anemic (hemoglobin <11 g/dl). Hemoglobin (Hb) showed a significant correlation with MCH, MCHC, serum iron, and percent transferrin saturation, suggesting that the anemia was likely to be due to iron deficiency. The mean STFR level was 18.05+/-9.9 mg/l in the anemic women and was significantly raised (p<0.001) compared with that of the nonanemic women. STFR correlated significantly with Hb (p<0.001), MCH (p<0.05), MCHC (p<0.01), serum iron (p<0.01), and percent transferrin saturation (p<0.01) and also showed a highly significant correlation with the degree of anemia. Serum ferritin in these women did not correlate with Hb, and only 54.4% of the women had levels <12 ng/ml, which does not reflect the true prevalence of iron deficiency. Serum transferrin receptor estimation is thus a useful measure for detecting iron deficiency in pregnancy.

  9. Idiopathic Pulmonary Hemosiderosis Mimicking Iron Deficiency Anemia: A Delayed Diagnosis?

    PubMed Central

    Koker, Sultan Aydin; Gözmen, Salih; Oymak, Yeşim; Karapinar, Tuba Hilkay; Can, Demet; Genç, Sinan; Vergin, Raziye Canan

    2017-01-01

    Idiopathic pulmonary hemosiderosis (IPH) is an uncommon chronic disorder in children. It is characterized by recurrent pulmonary hemorrhage and may result in hemoptysis and pulmonary insufficiency. The most common hematologic manifestation of IPH is iron deficiency anemia. The etiology of IPH is not known and its diagnosis may be difficult due to the variable clinical courses. The most helpful signs for identifying IPH are iron deficiency anemia and recurrent or chronic cough, hemoptysis, dyspnea, wheezing. We report here 5 pediatric cases of IPH presenting with iron deficiency anemia and without pulmonary symptoms. Mean corpuscular volume was low in all patients; iron was low in 4 out of 5 cases; total iron binding capacity was high in all of them; ferritin was low in 3 patients. At follow up, none of them had responded successfully to the iron therapy. Although they didn’t present with pulmonary symptoms, chest radiographs incidentally revealed diffuse reticulonoduler shadows in all of them. Computed tomography revealed diffuse ground-glass opacities, consolidation, increased density. The diagnosis was confirmed by the detection of hemosiderin-laden macrophages in bronchoalveolar lavage fluid and gastric aspirate. If patients with iron deficiency anemia don’t respond to iron therapy, they should be examined for IPH. Chest radiographs should be taken even in absence of pulmonary symptoms. Early diagnosis is important for a timely management of IPH. PMID:28670434

  10. Efficacy and safety of intravenous iron sucrose in treating adults with iron deficiency anemia

    PubMed Central

    Cançado, Rodolfo Delfini; de Figueiredo, Pedro Otavio Novis; Olivato, Maria Cristina Albe; Chiattone, Carlos Sérgio

    2011-01-01

    Background Iron deficiency is the most common disorder in the world, affecting approximately 25% of the world`s population and the most common cause of anemia. Objective To evaluate the efficacy and safety of intravenous iron sucrose (IS) in the treatment of adults with iron deficiency anemia Methods Eighty-six adult patients with iron deficiency anemia, who had intolerance or showed no effect with oral iron therapy, received a weekly dose of 200 mg of intravenous iron sucrose until the hemoglobin level was corrected or until receiving the total dose of intravenous iron calculated for each patient Results The mean hemoglobin and serum ferritin levels were 8.54 g/dL and 7.63 ng/mL (pre-treatment) and 12.1 g/dL and 99.0 ng/mL (post-treatment) (p-value < 0.0001), respectively. The average increases in hemoglobin levels were 3.29 g/dL for women and 4.58 g/dL for men; 94% of male and 84% of female patients responded (hemoglobin increased by at least 2 g/dL) to intravenous iron therapy. Correction of anemia was obtained in 47 of 69 (68.1%) female patients and in 12 of 17 male (70.6%) patients. A total of 515 intravenous infusions of iron sucrose were administered and iron sucrose was generally well tolerated with no moderate or serious adverse drug reactions recorded by the investigators. Conclusions Our data confirm that the use of intravenous iron sucrose is a safe and effective option in the treatment of adult patients with iron deficiency anemia who lack satisfactory response to oral iron therapy. Intravenous iron sucrose is well tolerated and with a clinically manageable safety profile when using appropriate dosing and monitoring. The availability of intravenous iron sucrose would potentially improve compliance and thereby reduce morbidities from iron deficiency. PMID:23049360

  11. The iron status at birth of neonates with risk factors for developing iron deficiency: a pilot study

    PubMed Central

    MacQueen, BC; Christensen, RD; Ward, DM; Bennett, ST; O’Brien, EA; Sheffield, MJ; Baer, VL; Snow, GL; Lewis, KA Weaver; Fleming, RE; Kaplan, J

    2016-01-01

    OBJECTIVE Small-for-gestational-age (SGA) neonates, infants of diabetic mothers (IDM) and very-low-birth weight premature neonates (VLBW) are reported to have increased risk for developing iron deficiency and possibly associated neurocognitive delays. STUDY DESIGN We conducted a pilot study to assess iron status at birth in at-risk neonates by measuring iron parameters in umbilical cord blood from SGA, IDM, VLBW and comparison neonates. RESULTS Six of the 50 infants studied had biochemical evidence of iron deficiency at birth. Laboratory findings consistent with iron deficiency were found in one SGA, one IDM, three VLBW, and one comparison infant. None of the infants had evidence of iron deficiency anemia. CONCLUSIONS Evidence of biochemical iron deficiency at birth was found in 17% of screened neonates. Studies are needed to determine whether these infants are at risk for developing iron-limited erythropoiesis, iron deficiency anemia or iron-deficient neurocognitive delay. PMID:27977019

  12. Rethinking Iron Regulation and Assessment in Iron Deficiency, Anemia of Chronic Disease, and Obesity: Introducing Hepcidin

    PubMed Central

    Tussing-Humphreys, Lisa; Pustacioglu, Cenk; Nemeth, Elizabeta; Braunschweig, Carol

    2012-01-01

    Adequate iron availability is essential to human development and overall health. Iron is a key component of oxygen-carrying proteins, has a pivotal role in cellular metabolism, and is essential to cell growth and differentiation. Inadequate dietary iron intake, chronic and acute inflammatory conditions, and obesity are each associated with alterations in iron homeostasis. Tight regulation of iron is necessary because iron is highly toxic and human beings can only excrete small amounts through sweat, skin and enterocyte sloughing, and fecal and menstrual blood loss. Hepcidin, a small peptide hormone produced mainly by the liver, acts as the key regulator of systemic iron homeostasis. Hepcidin controls movement of iron into plasma by regulating the activity of the sole known iron exporter ferroportin-1. Downregulation of the ferroportin-1 exporter results in sequestration of iron within intestinal enterocytes, hepatocytes, and iron-storing macrophages reducing iron bioavailability. Hepcidin expression is increased by higher body iron levels and inflammation and decreased by anemia and hypoxia. Importantly, existing data illustrate that hepcidin may play a significant role in the development of several iron-related disorders, including the anemia of chronic disease and the iron dysregulation observed in obesity. Therefore, the purpose of this article is to discuss iron regulation, with specific emphasis on systemic regulation by hepcidin, and examine the role of hepcidin within several disease states, including iron deficiency, anemia of chronic disease, and obesity. The relationship between obesity and iron depletion and the clinical assessment of iron status will also be reviewed. PMID:22717199

  13. Effect of Iron Overload and Iron Deficiency on Liver Hemojuvelin Protein

    PubMed Central

    Krijt, Jan; Frýdlová, Jana; Kukačková, Lenka; Fujikura, Yuzo; Přikryl, Petr; Vokurka, Martin; Nečas, Emanuel

    2012-01-01

    Introduction Hemojuvelin (Hjv) is a key component of the signaling cascade that regulates liver hepcidin (Hamp) expression. The purpose of this study was to determine Hjv protein levels in mice and rats subjected to iron overload and iron deficiency. Methods C57BL/6 mice were injected with iron (200 mg/kg); iron deficiency was induced by feeding of an iron-deficient diet, or by repeated phlebotomies. Erythropoietin (EPO)-treated mice were administered recombinant EPO at 50 U/mouse. Wistar rats were injected with iron (1200 mg/kg), or fed an iron-deficient diet. Hjv protein was determined by immunoblotting, liver samples from Hjv−/− mice were used as negative controls. Mouse plasma Hjv content was determined by a commercial ELISA kit. Results Liver crude membrane fraction from both mice and rats displayed a major Hjv-specific band at 35 kDa, and a weaker band of 20 kDa. In mice, the intensity of these bands was not changed following iron injection, repeated bleeding, low iron diet or EPO administration. No change in liver crude membrane Hjv protein was observed in iron-treated or iron-deficient rats. ELISA assay for mouse plasma Hjv did not show significant difference between Hjv+/+ and Hjv−/− mice. Liver Hamp mRNA, Bmp6 mRNA and Id1 mRNA displayed the expected response to iron overload and iron deficiency. EPO treatment decreased Id1 mRNA, suggesting possible participation of the bone morphogenetic protein pathway in EPO-mediated downregulation of Hamp mRNA. Discussion Since no differences between Hjv protein levels were found following various experimental manipulations of body iron status, the results indicate that, in vivo, substantial changes in Hamp mRNA can occur without noticeable changes of membrane hemojuvelin content. Therefore, modulation of hemojuvelin protein content apparently does not represent the limiting step in the control of Hamp gene expression. PMID:22629388

  14. Iron deficiency state in resistant oral aphthosis of Behcet's disease.

    PubMed

    Dormohammadi Toosi, Taraneh; Shahram, Farhad; Ghodsi, S Zahra; Nadji, Abdolhadi; Tehrani Banihashemi, Arash; Larimi, Seyyedeh Roghieh; Davatchi, Fereydoun

    2014-05-01

    This study was designed to evaluate iron deficiency as a predisposing factor for resistant oral aphthosis in patients with Behcet's disease (BD). In a case control study 220 consecutive BD patients with oral aphthosis were enrolled. All patients had been treated for at least 3 months. They were divided into two groups according to their treatment response (75 patients in the Case and 145 in the Control group). Demographic and clinical characteristics of the disease, serum iron, total iron binding capacity and serum ferritin were determined in each patient. We used independent t-test and Mann-Whitney U-test to compare the quantitative variables and chi-square test for qualitative variables. Odds ratio (OR) and confidence interval at 95% (95% CI) were calculated for each item. There was no significant difference between the two groups in demographics or clinical characteristics of the disease. We found iron deficiency in 72 patients (32.7%, 95% CI: 6.2), higher in the Case group than Control (39.2% vs. 30.1%; P = 0.17). Despite the higher frequency of iron deficiency in men (26.8% vs. 14.5%), the difference was not statistically significant (P = 0.09). Multivariate logistic regression analysis showed that none of the iron deficiency or sex variables could predict the development of resistant oral aphthosis. The OR for iron deficiency was 1.52 (95% CI: 0.81-2.86) and for male sex was 1.04 (95% CI: 0.56-1.91). Despite the higher frequency of iron deficiency in BD patients with resistant oral aphthosis, we were not able to attribute this resistance to this deficiency. © 2013 The Authors International Journal of Rheumatic Diseases © 2013 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  15. [Prevalence of iron deficiency and iron deficiency anemia in pregnant adolescents from northwest Mexico, 2007-2008].

    PubMed

    Méndez Estrada, Rosa Olivia; Pacheco, Bertha; Noriega Verdugo, Hypathia; Quihui, Luis; Morales, Guadalupe; Valencia, Mauro E

    2009-06-01

    Iron deficiency anemia (IDA) remains a word public health problem, particularly in children and child-bearing-age women. Iron demands need to be covered by adolescent women due to the increased physical growing, menstruation, pregnancy and fetal growing tissues at this life stage. This study was proposed to investigate the prevalence of iron deficiency and IDA in pregnant adolescent women from Northwestern Mexico. Participated 186 women under 19 years old during the first or second trimester of pregnancy who attended the local health institutions in Hermosillo Sonora. Questionnaires and 24 hr recalls were administered to collect socioeconomic and dietary information respectively. Hemoglobin (Hb), hematocrit, ferritin and eritrocytic protoporphyrin were measured. Hb and ferritin values were used to categorize the recruited women into normal (37.4%), iron deficient (55.5%) and IDA (7.1%) groups. Six and seven women showed moderated and light anemia status in the IDA group. Fe and fiber intake and weeks of pregnancy were associated with the biochemical indicators of iron at least in two women groups. The high percentage of iron deficient women in this study is demanding the identification and attention of maternal factors and food habits that are risk of iron deficiency in pregnant women.

  16. Malabsorption of iron as a cause of iron deficiency anemia in postmenopausal women

    PubMed Central

    Qamar, Khansa; Saboor, Muhammad; Qudsia, Fatima; Khosa, Shafi Muhammad; Moinuddin; Usman, Muhammad

    2015-01-01

    Objective: Malabsorption is one of the causes of iron deficiency anemia in postmenopausal women. The main objective of this study was to access the frequency of malabsorption in iron deficient anemic postmenopausal women. Methods: A total of 123 postmenopausal women were enrolled in the study. Of these 123 women, 50 were included as ‘control group’ and 73 patients with comparable severity of anemia were the ‘patient group’. Two tablets of ferrous sulfate (200 mg/tablet) along with one tablet of vitamin C (500 mg) were given to all participants. Serum iron levels were determined on samples collected from all participants before and after the administration of ferrous sulfate. Difference between before and after serum iron levels of normal and patients were compared. Results: No change in serum iron between sample one and sample two represented malabsorption. Out of 73, 5 postmenopausal anemic patients showed no change in their serum iron level after the administration of ferrous sulfate. This study shows that frequency of malabsorption of iron in postmenopausal women is 6.8%. Conclusion: Malabsorption should be considered as a prevalent cause of iron deficiency anemia in postmenopausal women. It should be properly diagnosed and iron response should be monitored properly in postmenopausal women with IDA after oral iron therapy. If a postmenopausal woman does not show any response to oral iron therapy, she should be evaluated for iron loss (blood loss and/or malabsorption). Intravenous route should be used for the administration of iron in these patients. PMID:26101480

  17. Developing a service for children with iron deficiency anaemia.

    PubMed

    Bartle, Catherine

    The IDEAS (Iron Deficiency Early Anaemia Services) project is a programme aimed at detecting and offering a system of care for children with iron deficiency anaemia. It is designed and run by health visitors and nurses in an inner-city area of Bradford. Children with low haemoglobin are referred by the health visitor to the specialist nurse-led clinic. Dietary advice consistent with tradition and culture is given and appropriate referrals made to the GP for iron supplementation, and to the consultant paediatrician or haemoglobinopathy adviser when appropriate. An important development has been the identification of a previously undiagnosed abnormal haemoglobin trait.

  18. Iron and immunity: immunological consequences of iron deficiency and overload

    PubMed Central

    Cherayil, Bobby J.

    2011-01-01

    The influence of iron on immune function has been long appreciated. However, the molecular basis for this interaction is less well understood. Recently, there have been several important advances that have shed light on the mechanisms that regulate mammalian iron metabolism. The new insights provide a conceptual framework for understanding and manipulating the cross-talk between iron homeostasis and the immune system. This article will review what is currently known about how disturbances of iron metabolism can affect immunity and how activation of the immune system can lead to alterations in iron balance. PMID:20878249

  19. Treatment of iron deficiency anemia: are monomeric iron compounds suitable for parenteral administration?

    PubMed

    Gupta, A; Crumbliss, A L

    2000-11-01

    Iron deficiency is the most common nutritional problem worldwide, especially in the developing countries. Oral iron supplementation programs have failed because of noncompliance and gastrointestinal toxicity, thereby necessitating parenteral administration of iron. For parenteral administration, only iron-carbohydrate complexes are currently used, because monomeric iron salts release free iron, thereby causing oxidant injury. However, iron-carbohydrate complexes also have significant toxicity, and they are expensive. We have proposed the hypothesis that monomeric iron salts can be safely administered by the parenteral route if iron is tightly complexed to the ligand, thereby causing clinically insignificant release of free iron, and the kinetic properties of the compound allow rapid transfer of iron to plasma transferrin. A detailed analysis of the physicochemical and kinetic properties reveals that ferric iron complexed to pyrophosphate or acetohydroxamate anions may be suitable for parenteral administration. We have demonstrated that infusion of ferric pyrophosphate into the circulation via the dialysate is safe and effective in maintaining iron balance in patients undergoing maintenance hemodialysis. Parenteral administration of monomeric iron compounds is a promising approach to the treatment of iron deficiency in the general population and merits further investigation.

  20. [Iron deficiency and pernicious anemia: a rare association?].

    PubMed

    Zulfiqar, Abrar-Ahmad; Dramé, Moustapha; Pennaforte, Jean-Loup; Novella, Jean-Luc; Vogel, Thomas; Andres, Emmanuel

    2015-01-01

    The aim of this study was to determine the prevalence of iron deficiency among patients with pernicious anemia. We realized a retrospective study from 2000 to 2010 including 55 patients suffering from pernicious anemia who were followed in Reims and Strasbourg university hospitals. Inclusion criteria were histological diagnosis of immune atrophic fundic gastritis and criteria of gastric autoimmuninty, and for which ferritin was measured. Iron deficiency is defined as serum ferritin level <20 μg/L in women and <30 μg/L in men. 45 (81.8%) patients were female. The mean age was 61 ± 17 years (range: 25/98).There was anemia in 32 patients (58.2%). Macrocytosis was noted, with or without anemia, in 30 patients (54.5%); microcytosis, with or without anemia, was noted in 8 (14.5%) patients. 17 patients (30.9%) had normal mean corpuscular volume. Vitamin B12 deficiency was objectived in 42 patients (76.4%) in our series. 16 patients (29%) had iron deficiency. 14 patients were female. They were significantly younger than female subjects without iron deficiency (p =0.004). In conclusion, iron deficiency is not rare in patients with pernicious anemia. It could be a complication of achlorhydria. We suggest a dosage of serum ferritin for all patients with pernicious anemia.

  1. Laboratory and Genetic Assessment of Iron Deficiency in Blood Donors

    PubMed Central

    Kiss, Joseph E.

    2015-01-01

    Synopsis Over 9 million individuals donate blood annually in the US. Between 200 to 250 mg of iron is removed with each whole blood donation, reflecting losses from the hemoglobin in red blood cells. This amount represents approximately 25% of the average iron stores in men and almost 75% of the iron stores in women. Replenishment of iron stores takes many months, leading to a high rate of iron depletion, especially in frequent blood donors (e. g., more than 2 times per year). In large epidemiologic studies, donation frequency, female gender, and younger age (reflecting menstrual status), are particularly associated with iron depletion. Currently, a minimum capillary hemoglobin of 12.5 gm/dl is the sole requirement for donor qualification in the US as far as iron levels are concerned, yet it is known that hemoglobin level is a poor surrogate for low iron. In an effort to better identify and prevent iron deficiency, blood collection centers are now considering various strategies to manage donor iron loss, including changes in acceptable hemoglobin level, donation interval, donation frequency, testing of iron status, and iron supplementation. This chapter highlights laboratory and genetic tests to assess the iron status of blood donors and their applicability as screening tests for blood donation. PMID:25676373

  2. Iron deficiency in young Bradford children from different ethnic groups.

    PubMed Central

    Ehrhardt, P

    1986-01-01

    Haematological parameters and iron state were studied in children admitted to hospital consecutively during a six month period. A total of 147 of 598 children (24.6%) were anaemic, with haemoglobin values below the third centile of the reference range, and 131 of 400 children (32.8%) were iron deficient, with serum ferritin concentrations less than 10 micrograms/l. Both findings were more common in children from the Asian ethnic minority. The "routine" full blood count is a useful tool for the presumptive identification of iron deficiency in childhood. Iron deficiency is deleterious to the health of young children. In view of its extent and degree--not exclusively among the Asian ethnic minority--a community based preventive programme on the lines of the Stop Rickets Campaign is recommended. PMID:3080103

  3. Sleep alterations and iron deficiency anemia in infancy

    PubMed Central

    Peirano, Patricio D.; Algarín, Cecilia R.; Chamorro, Rodrigo A.; Reyes, Sussanne C.; Durán, Samuel A.; Garrido, Marcelo I.; Lozoff, Betsy

    2013-01-01

    Iron-deficiency anemia (IDA) continues to be the most common single nutrient deficiency in the world. An estimated 20-25% of the world’s infants have IDA, with at least as many having iron deficiency without anemia. Infants are at particular risk due to rapid growth and limited dietary sources of iron. We found that infants with IDA showed different motor activity patterning in all sleep-waking states and several differences in sleep states organization. Sleep alterations were still apparent years after correction of anemia with iron treatment in the absence of subsequent IDA. We suggest that altered sleep patterns may represent an underlying mechanism that interferes with optimal brain functioning during sleep and wakefulness in former IDA children. PMID:20620103

  4. Iron deficiency in adolescent female dancers.

    PubMed Central

    Mahlamäki, E; Mahlamäki, S

    1988-01-01

    The iron balance of 25 adolescent dancers and 23 control females of the same age were studied. The concentrations of fasting blood haemoglobin, serum iron, serum transferrin and serum ferritin were determined. Iron supplementation (ferrous sulphate corresponding to 100 mg of elemental iron per day) was instigated if body iron stores were low (serum ferritin less than 30 micrograms.l-1). Blood samples were drawn again after ten weeks. Low haemoglobin concentration (blood haemoglobin less than 125 g.l-1) was more prevalent among dancers than among control subjects. Reduced iron stores as well as completely absent iron stores (serum ferritin concentration less than 12 micrograms.l-1) were equally common in both groups (25% of the subjects). Iron supplementation reduced the number of anaemic girls from 16 to 4 and the highly significant difference in haemoglobin level between the treated and untreated groups disappeared. Ten weeks of iron therapy was not, however, long enough to increase iron stores. PMID:3167502

  5. Are children on jejunal feeds at risk of iron deficiency?

    PubMed

    Tan, Li-Zsa; Adams, Susan E; Kennedy, Alison; Kepreotes, Helen; Ooi, Chee Y

    2015-05-14

    Children on exclusive jejunal feeding may be at risk of iron deficiency due to the feeds bypassing the duodenum, which is the primary site for iron absorption. We describe the biochemical and hematological features of six children on exclusive jejunal feeding who did not receive iron supplementation. At a mean (standard deviation) period of 11 (6.5) mo after commencing jejunal feeds, there was a significant reduction in both serum iron (18.5 g/L vs 9.8 g/L, P = 0.01) and transferrin saturation levels (23.1% vs 13.7%, P = 0.02), suggesting iron deficiency. However, there was no significant change in ferritin, hemoglobin and mean corpuscular volume levels post-commencement of jejunal feeds. This may be the result of small bowel adaptation in response to early iron deficiency. Larger and longer term prospective studies are required to investigate if children on jejunal feeds are at risk of developing iron deficiency.

  6. Iron deficiency anemia and increased urinary norepinephrine excretion.

    PubMed

    Voorhess, M L; Stuart, M J; Stockman, J A; Oski, F A

    1975-04-01

    Chronic iron deficiency in rats resulted in decreased MAO activity both in vitro and in vivo. Since MAO is an important enzyme in inactivation of catecholamines, urinary excretion of DA, NE, E, MN-NMN, and VMA was measured in 24-hour samples from 11 iron-deficient children before and after treatment with intramuscular iron. Pretreatment NE excretion was abnormally high and returned to normal (P=0.001) within one week of therapy. VMA excretion also was higher before than after treatment (P greater than 0.05), but most values were within the normal range for healthy children of comparable size. There was no significant difference between DA, E, and MN-NMN excretion before and after iron therapy. Anemic, non-iron-deficient children had normal urinary NE, E, and VMA excretion before and after transfusion. These findings suggest that the irritability, lack of attentiveness, and low performance scores of iron-deficient children may be related to alterations in catecholamine metabolic pathways secondary to dependence of MAO on adequate iron stores.

  7. Iron Deficiency and Obesity: The Contribution of Inflammation and Diminished Iron Absorption

    DTIC Science & Technology

    2008-01-01

    and iron absorption may be mediated by hepcidin , although further studies will be required to confinn this potential physiological explanation for...the increased prevalence of iron deficiency in the obese. 15. SUBJECT TERMS Hepcidin , inflammation, iron, obesity LIMITATION OF 18. NUMBER16. SECURITY...inflammation and iron absorption may be mediated by hepcidin , although further studies will be required to confirm this potential physiological

  8. Paraoxonase and arylesterase activities in children with iron deficiency anemia and vitamin B12 deficiency anemia.

    PubMed

    Koc, Ahmet; Cengiz, Murad; Ozdemir, Zeynep Canan; Celik, Hakim

    2012-05-01

    Paraoxonase-1 is an esterase enzyme and it has 3 types of activity, namely paraoxonase, arylesterase, and diazoxonase. It has been reported that paraoxonase-1 deficiency is related to increased susceptibility to development of atherosclerosis and cardiovascular disease. The aim of this study was to investigate serum paraoxonase and arylesterase activities in children with iron deficiency anemia and vitamin B(12) deficiency anemia. Thirty children with iron deficiency anemia, 30 children with vitamin B(12) deficiency anemia, and 40 healthy children aged 6 months to 6 years were enrolled in this study. Serum paraoxonase and arylesterase activities were measured with a spectrophotometer by using commercially available kits. Mean paraoxonase and arylesterase activities in vitamin B(12) deficiency anemia group (103 ± 73 and 102 ± 41 U/L, respectively) were significantly lower than mean activities of control group (188 ± 100 and 147 ± 34 U/L, respectively; P < .001 for both) and iron deficiency anemia group (165 ± 103 and 138 ± 39 U/L, respectively; P < .05, P < .001), whereas there were no significant differences between iron deficiency anemia and control groups (P > .05). Paraoxonase and arylesterase activities significantly increased after treatment with vitamin B(12) in vitamin B(12) deficiency anemia; however, there were no significant changes in the activities of these enzymes after iron treatment in iron deficiency anemia group. Important correlations were found between vitamin B(12) levels and both paraoxonase and arylesterase activities (r = .367, P < .001; r = .445, P < .001). Our results suggest that vitamin B(12) deficiency anemia causes important reductions in paraoxonase and arylesterase activities, and after vitamin B(12) therapy the activities of these enzymes returned to near-normal levels.

  9. Identifying factors predicting iron deficiency in United States adolescent females using the ferritin and the body iron models

    PubMed Central

    Sekhar, Deepa L.; Murray-Kolb, Laura E.; Kunselman, Allen R.; Paul, Ian M.

    2015-01-01

    Background & Aims Iron deficiency is the most prevalent nutritional deficiency in the United States affecting 9–16% of female adolescents. With the primary purpose of detecting iron deficiency, primary care screening consists of a hemoglobin or hematocrit laboratory test. This method is simple and inexpensive, but tests for anemia, and is neither sensitive nor specific for iron deficiency. Alternate methods for diagnosing iron deficiency using the ferritin and body iron models are not widely utilized. The study objective was to compare iron deficiency risk factors among adolescent females defined by the ferritin and body iron models to better characterize those who may benefit from iron deficiency testing as opposed to the current anemia-based screen. Methods This cross-sectional study of female adolescents aged 12–21 years utilized National Health and Nutrition Examination Survey 2003–2006 data. Anemia was defined by standard hemoglobin cutoffs. The ferritin model defines iron deficiency through transferrin saturation, ferritin and erythrocyte protoporphyrin laboratory testing. Body iron calculates iron status with a formula involving transferrin receptor and ferritin. Bivariate and multivariable analyses examined associations between questionnaire responses and iron deficiency defined by each model. Results Among 1765 participants, 2.7% were anemic. Iron deficiency prevalence was 13.1% and 9.1% by the ferritin and body iron models, respectively. Based on the model, anemia-based screening had a sensitivity of 15.6–18.8% for iron deficiency. Multivariable associations for ferritin model iron deficiency included age, race/ethnicity, activity level and medroxyprogresterone acetate injection. Age and food insecurity were significant using the body iron model. Conclusions Universal anemia-based screening misses the majority of iron-deficient adolescent females. The common risk factor identified here, adolescent age, may both inform preventive care guidelines on

  10. A pilot iron substitution programme in female blood donors with iron deficiency without anaemia.

    PubMed

    Pittori, C; Buser, A; Gasser, U E; Sigle, J; Job, S; Rüesch, M; Tichelli, A; Infanti, L

    2011-04-01

    Blood donation can contribute to iron deficiency. The possibly resulting anaemia importantly affects donor return rate. The determination of serum ferritin levels revealed iron deficiency in many non-anaemic premenopausal female blood donors at our Institution. We started an iron substitution programme targeting this donor group to prevent anaemia and enhance donor retain. Women aged≤50 with haemoglobin levels adequate for donation and serum ferritin≤10 ng/ml were offered iron supplementation. Substitution lasted 16 weeks and the donation interval was extended. History collection including iron deficiency-related symptoms, whole blood count and serum ferritin determination was performed at baseline and after 2 and 6 months. Data were recorded prospectively and compared with those of 108 female controls with iron deficiency not receiving iron substitution (retrospective data). Of the 116 participating subjects, 60% completed the programme. Significant results were serum ferritin increase (from a mean value of 7.12 to 25.2 ng/ml), resolution of prostration, fatigue, sleep disturbances, tension in the neck, hair loss and nail breakage. No case of anaemia occurred. Sixty per cent of the women completed the programme and donated blood again. Targeted iron substitution prevents the development of anaemia and enhances donation return in premenopausal female blood donors with iron deficiency. © 2010 The Author(s). Vox Sanguinis © 2010 International Society of Blood Transfusion.

  11. Iron-refractory iron deficiency anemia (IRIDA) cases with 2 novel TMPRSS6 mutations.

    PubMed

    Sal, Ertan; Keskin, Ebru Yılmaz; Yenicesu, Idil; Bruno, Mariasole; De Falco, Luigia

    2016-04-01

    Iron-refractory iron deficiency anemia (IRIDA) is a rarely diagnosed autosomal recessive disorder that presents with hypochromic, microcytic anemia due to mutations in TMPRSS6, which encodes matriptase-2. Contrary to classical iron deficiency anemia, serum hepcidin levels are found to be elevated in this disorder. Here, we report 5 cases from 4 unrelated families with inadequate response to iron therapy, who were consequently diagnosed as IRIDA. The mean age of the cases at diagnosis was 5.0 years (range: 0.7-11.3 years). All cases were either homozygous or compound heterozygous for missense or frameshift mutations in the TMPRSS6 gene, 2 of the mutations being novel (Cys410Ser and Leu689Pro). IRIDA should be considered in patients with findings of iron deficiency anemia unresponsive to oral iron therapy, whose serum ferritin levels are found normal or elevated.

  12. Estrous cycle and cold stress in iron-deficient rats

    SciTech Connect

    Smith, S.M.; Bucher, D.R.; Lukaski, H.C. )

    1991-03-11

    Female iron-deficient (ID) rats have plasma triiodothyronine (T{sub 3}) concentrations similar to iron sufficient controls (CN) at 24C. Whether the apparently euthyroid ID female can thermoregulate when exposed to cold was studied to assess the interactive effects of iron deficiency and the female reproductive cycle. Rats were assigned to either ID (n = 60) or CN (n = 60) diets for a period of five weeks. The two groups were then subdivided into five groups, four based on stage of the estrous cycle and the fifth group was ovariectomized one week prior to sacrifice. Animals were exposed to 4C for 6 h. Following sacrifice, tissues were collected for analysis of thyroid hormone and iron status indices. There was an interactive effect of iron status and the estrous cycle on core temperature response to the cold. Plasma thyrozine (T{sup 4}) concentrations were unaffected by iron status or the estrous cycle, and plasma T{sub 3} concentrations were significantly lower in ID than CN rats. Thyroxine 5{prime} - deiodinase activity in the liver was significantly lower in ID animals than CN; this conforms with the plasma T{sub 3} findings. Brown adipose tissue deiodinase was not affected by either iron status or the estrous cycle. In conclusion, iron deficiency impairs thermoregulation in rats, and this effect is related to the ovarian cycle. However, brown adipose tissue does not appear specifically involved in this defect.

  13. Monitoring recovery from iron deficiency using total hemoglobin mass.

    PubMed

    Wachsmuth, Nadine B; Aigner, Thomas; Völzke, Christian; Zapf, Jürgen; Schmidt, Walter F

    2015-02-01

    Using hemoglobin concentration ([Hb]) to diagnose borderline iron deficiency and monitor the progress of its treatment is difficult because of the confounding effects of plasma volume. Because hemoglobin mass (Hbmass) is not affected by plasma volume, it may be a more sensitive parameter. The aim of this study was to monitor Hbmass, iron storage, and maximal oxygen consumption (V˙O2max) during and after oral iron therapy in subjects with severe and moderate iron deficiency. Three groups of female recreational athletes were monitored for at least 22 wk, as follows: 1) severe iron deficiency group (SID) (n = 8; ferritin, ≤12 ng·mL), 2) moderate iron deficiency group (MID) (n = 14; ferritin, ≤25 ng·mL), and 3) control group (n = 8; ferritin, >25 ng·mL). Hbmass and iron status were determined before, during, and up to 12 wk after at least 10 wk of oral iron supplementation. In total, five V˙O2max tests were performed before, during, and after the supplementation period. Hbmass increased markedly in the SID group (15.6% ± 11.0%, P < 0.001) and slightly in the MID group (2.2% ± 3.7%, P < 0.05) by the end of the supplementation period and remained at this level for the following 12 wk. [Hb] and Hbmass were similarly affected, but Hbmass was more closely related to mean corpuscular volume and mean corpuscular hemoglobin than [Hb]. The SID group incorporated 534 ± 127 mg of iron into ferritin and hemoglobin, whereas the MID group incorporated 282 ± 68 mg of iron. V˙O2max increased only in the SID group by 0.20 ± 0.18 L·min (P < 0.05) and was closely related to Hbmass (P < 0.01). Hbmass is a sensitive tool for monitoring recovery from iron deficiency anemia and assessing the effectiveness of iron supplementation in individuals with severe or moderate iron deficiency.

  14. Prediction of iron deficiency in chronic inflammatory rheumatic disease anaemia.

    PubMed

    Baumann Kurer, S; Seifert, B; Michel, B; Ruegg, R; Fehr, J

    1995-12-01

    We prospectively studied 45 anaemic patients (37 women, 8 men) with chronic inflammatory rheumatic diseases. The combination of serum ferritin and CRP (as well as ESR) in its predictive capacity for bone marrow iron stores was examined. The relationship between other iron-related measurements (transferrin, transferrin saturation, soluble transferrin receptor, erythrocyte porphyrins and percentage of hypochromic/microcytic erythrocytes) and bone marrow iron stores was also investigated. Stainable bone marrow iron was taken as the most suitable standard to separate iron-deficient from iron-replete patients. 14 patients (31%) were lacking bone marrow iron. Regression analysis showed a good correlation between ferritin and bone marrow iron (adjusted R2 = 0.721, P < 0.0001). The combination of ferritin and CRP (ESR) did not improve the predictive power for bone marrow iron (adjusted R2 = 0.715) in this cohort of patients with low systemic inflammatory activity. With respect to the bone marrow iron content the best predictive cut-off value of ferritin was 30 micrograms/l (86% sensitivity, 90% specificity). The other iron-related parameters both individually and when combined were less powerful in predicting bone marrow iron than ferritin alone. Only zinc bound erythrocyte protoporphyrin in combination with ferritin slightly improved prediction (adjusted R2 = 0.731). A cut-off point of 11% hypochromic erythrocytes reached a high specificity (90%), but was less sensitive (77%).

  15. Iron deficiency in outdoor pig production.

    PubMed

    Szabo, P; Bilkei, G

    2002-09-01

    It has been claimed that outdoor-reared suckling piglets do not need iron supplementation. According to practical experience, outdoor-reared and non-iron-supplemented piglets show a lower performance in comparison with their iron-supplemented counterparts. The purpose of the present study was to determine the effect of iron supplementation on outdoor-reared suckling piglets. In a large Hungarian outdoor pig production unit, 4691 piglets were assigned to one of two treatment groups. Piglets in group 1 (n = 2344): received no iron supplementation, whereas piglets in group 2 (n = 2347) were intramuscularly injected in the neck on day 3 post-partum with 1.5 ml of Ferriphor 10% solution (TAD Pharmaceutical GmbH, Bremerhaven, Germany). Animal weights, morbidity, haemoglobin concentration and mortality were recorded and analysed. At weaning the iron-injected piglets were significantly (P < 0.05) heavier. The iron-supplemented piglets also revealed significantly (P < 0.01) less pre-weaning morbidity and mortality and higher (P < 0.01) blood haemoglobin concentration compared with the non-injected ones. This study suggests that in order to prevent pre-weaning losses and support piglet health and weight performance, iron supplementation should be administered to piglets in outdoor pig production units.

  16. Cellular growth in iron-deficient rats: effect of pre- and postweaning iron repletion.

    PubMed

    Kochanowski, B A; Sherman, A R

    1985-02-01

    Effects of iron deficiency and repletion pre- and postweaning on cell growth in young rats were studied. Pregnant dams were fed 6 or 250 ppm iron. On d 2 of lactation, half of the dams in each group were fed the opposite diet. On d 17, cell growth in the crossed-over groups was similar to controls showing that cellular development is impaired only when the iron deficiency is present during gestation and lactation. In a second experiment pup littermates of dams fed 6 (D), 12 (M) and 250 (C) ppm iron were weaned to either the same diet as fed to their dams DD, MM or CC; repleted with iron DC, MC; or fed the deficient diet CD until 42 d of age. After dietary iron repletion, cell numbers in thymus (DC and MC) and liver (DC) were greater than those of deficient littermates, but were less than those of controls (CC). Iron repletion postweaning reduced the cardiac hypertrophy (DC vs. DD and MC vs. MM) and increased splenic cell number compared to unrepleted deficient littermates (DC vs. DD). Thus, the severity and reversibility of impaired cellular growth is dependent on the timing and severity of the deficiency and the organ affected.

  17. Iron supplementation as a strategy for the control of iron deficiency and ferropenic anemia.

    PubMed

    Viteri, F E

    1999-09-01

    Iron supplementation is a public health strategy designed for the prevention of iron deficiency and its consecutive anemia. It should be targeted, safe, flexible, long term and ideally, community based under the supervision of the health sector. It must be differentiated from iron therapy, even though, in the intermediate and long term it corrects mild-moderate deficiency of iron and ferropenic anemia. It should complement other measures for the control of iron deficiency. A summary of results comparing daily and intermittent iron supplementation (every 3-days in rats, and weekly in humans) is presented, including studies in an animal model, human supplementary-iron absorption studies, clinical research and field studies. It is concluded that intermittent iron supplementation is efficacious and, that in the long term it achieves an increase in iron reserves while avoiding sustained oxidative stress caused by current practices of excess daily iron supplementation, particularly in the developing world. The stage is set for long-term weekly iron supplementation programs in large population groups to determine its sustainability and effectiveness.

  18. Oily fish increases iron bioavailability of a phytate rich meal in young iron deficient women.

    PubMed

    Navas-Carretero, Santiago; Pérez-Granados, Ana M; Sarriá, Beatriz; Carbajal, Angeles; Pedrosa, Mercedes M; Roe, Mark A; Fairweather-Tait, Susan J; Vaquero, M Pilar

    2008-02-01

    Iron deficiency is a major health problem worldwide, and is associated with diets of low iron bioavailability. Non-heme iron absorption is modulated by dietary constituents, one of which is the so-called "meat factor", present in meat, fish (oily and lean) and poultry, which is an important enhancer of iron absorption in humans. Food processing also affects iron bioavailability. To evaluate the effect of consuming sous vide cooked salmon fish on non-heme iron bioavailability from a bean meal, rich in phytate, in iron-deficient women. Randomized crossover trial in 21 young women with low iron stores (ferritin < 30 microg/L). Two test meals were extrinsically labelled with stable isotopes of iron (Fe-57 or Fe-58). Iron bioavailability was measured as the incorporation of stable isotopes into erythrocytes 14 d after meals consumption. The addition of fish to the bean meal significantly increased (p < 0.001) iron absorption. Serum ferritin concentration and iron absorption were inversely correlated for both the bean meal (R(2) = 0.294, p = 0.011) and the fish and bean meal (R(2) = 0.401, p = 0.002). Sous vide cooked salmon fish increases iron absorption from a high phytate bean meal in humans.

  19. Iron refractory iron deficiency anemia: a heterogeneous disease that is not always iron refractory.

    PubMed

    Donker, Albertine E; Schaap, Charlotte C M; Novotny, Vera M J; Smeets, Roel; Peters, Tessa M A; van den Heuvel, Bert L P; Raphael, Martine F; Rijneveld, Anita W; Appel, Inge M; Vlot, Andre J; Versluijs, A Birgitta; van Gelder, Michel; Granzen, Bernd; Janssen, Mirian C H; Rennings, Alexander J M; van de Veerdonk, Frank L; Brons, Paul P T; Bakkeren, Dirk L; Nijziel, Marten R; Vlasveld, L Thom; Swinkels, Dorine W

    2016-12-01

    TMPRSS6 variants that affect protein function result in impaired matriptase-2 function and consequently uninhibited hepcidin production, leading to iron refractory iron deficiency anemia (IRIDA). This disease is characterized by microcytic, hypochromic anemia and serum hepcidin values that are inappropriately high for body iron levels. Much is still unknown about its pathophysiology, genotype-phenotype correlation, and optimal clinical management. We describe 14 different TMPRSS6 variants, of which 9 are novel, in 21 phenotypically affected IRIDA patients from 20 families living in the Netherlands; 16 out of 21 patients were female. In 7 out of 21 cases DNA sequencing and multiplex ligation dependent probe amplification demonstrated only heterozygous TMPRSS6 variants. The age at presentation, disease severity, and response to iron supplementation were highly variable, even for patients and relatives with similar TMPRSS6 genotypes. Mono-allelic IRIDA patients had a milder phenotype with respect to hemoglobin and MCV and presented significantly later in life with anemia than bi-allelic patients. Transferrin saturation (TSAT)/hepcidin ratios were lower in IRIDA probands than in healthy relatives. Most patients required parenteral iron. Genotype alone was not predictive for the response to oral iron. We conclude that IRIDA is a genotypically and phenotypically heterogeneous disease. The high proportion of female patients and the discrepancy between phenotypes of probands and relatives with the same genotype, suggest a complex interplay between genetic and acquired factors in the pathogenesis of IRIDA. In the absence of inflammation, the TSAT/hepcidin ratio is a promising diagnostic tool, even after iron supplementation has been given. Am. J. Hematol. 91:E482-E490, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  20. [Physiologic and pathologic role of iron in the human body. Iron deficiency anemia in newborn babies].

    PubMed

    Lakatos, Béla; Szentmihályi, Klára; Vinkler, Péter; Balla, György; Balla, József

    2004-09-05

    Iron is one of the most important essential metal ions of which significance is well known for ages. This element is a key moiety of several enzymes in iron containing heme or nonheme form and transfer and storage protein, hemoglobin and myoglobin. Several membrane carriers of iron have already been identified. The redox state of iron is determined by xanthine oxidase, cytochromes and Hp or ceruloplasmin and ferroxidase activity of apo-ferritin, respectively. Some vitamins (C, B2-, B3-, B6-, B12) play also a role in the metabolism of iron. The iron content of cells of the organs is well regulated by the iron homeostasis. Iron has a significant role in the immune system by producing oxygen containing free radicals. Anaemia induced by iron deficiency may cause a challenge concerns for pregnant women, babies and adolescent, primarily.

  1. Effects of a Tripeptide Iron on Iron-Deficiency Anemia in Rats.

    PubMed

    Xiao, Chen; Lei, Xingen; Wang, Qingyu; Du, Zhongyao; Jiang, Lu; Chen, Silu; Zhang, Mingjie; Zhang, Hao; Ren, Fazheng

    2016-02-01

    This study aims to investigate the effects of a tripeptide iron (REE-Fe) on iron-deficiency anemia rats. Sprague-Dawley rats were randomly divided into seven groups: a normal control group, an iron-deficiency control group, and iron-deficiency groups treated with ferrous sulfate (FeSO4), ferrous glycinate (Fe-Gly), or REE-Fe at low-, medium-, or high-dose groups. The rats in the iron-deficiency groups were fed on an iron-deficient diet to establish iron-deficiency anemia (IDA) model. After the model established, different iron supplements were given to the rats once a day by intragastric administration for 21 days. The results showed that REE-Fe had effective restorative action returning body weight, organ coefficients, and hematological parameters in IDA rats to normal level. In addition, comparing with FeSO4 or Fe-Gly, high-dose REE-Fe was more effective on improving the levels of renal coefficient, total iron-binding capacity, and transferrin. Furthermore, the liver hepcidin messenger RNA (mRNA) expression in the high-dose group was significantly higher (p < 0.05) than that in the FeSO4 or Fe-Gly group and showed no significant difference (p > 0.05) with the normal control group. The findings suggest that REE-Fe is an effective source of iron supplement for IDA rats and might be exploited as a new iron fortifier.

  2. Anemia and iron deficiency in gastrointestinal and liver conditions

    PubMed Central

    Stein, Jürgen; Connor, Susan; Virgin, Garth; Ong, David Eng Hui; Pereyra, Lisandro

    2016-01-01

    Iron deficiency anemia (IDA) is associated with a number of pathological gastrointestinal conditions other than inflammatory bowel disease, and also with liver disorders. Different factors such as chronic bleeding, malabsorption and inflammation may contribute to IDA. Although patients with symptoms of anemia are frequently referred to gastroenterologists, the approach to diagnosis and selection of treatment as well as follow-up measures is not standardized and suboptimal. Iron deficiency, even without anemia, can substantially impact physical and cognitive function and reduce quality of life. Therefore, regular iron status assessment and awareness of the clinical consequences of impaired iron status are critical. While the range of options for treatment of IDA is increasing due to the availability of effective and well-tolerated parenteral iron preparations, a comprehensive overview of IDA and its therapy in patients with gastrointestinal conditions is currently lacking. Furthermore, definitions and assessment of iron status lack harmonization and there is a paucity of expert guidelines on this topic. This review summarizes current thinking concerning IDA as a common co-morbidity in specific gastrointestinal and liver disorders, and thus encourages a more unified treatment approach to anemia and iron deficiency, while offering gastroenterologists guidance on treatment options for IDA in everyday clinical practice. PMID:27672287

  3. Anemia and iron deficiency in gastrointestinal and liver conditions.

    PubMed

    Stein, Jürgen; Connor, Susan; Virgin, Garth; Ong, David Eng Hui; Pereyra, Lisandro

    2016-09-21

    Iron deficiency anemia (IDA) is associated with a number of pathological gastrointestinal conditions other than inflammatory bowel disease, and also with liver disorders. Different factors such as chronic bleeding, malabsorption and inflammation may contribute to IDA. Although patients with symptoms of anemia are frequently referred to gastroenterologists, the approach to diagnosis and selection of treatment as well as follow-up measures is not standardized and suboptimal. Iron deficiency, even without anemia, can substantially impact physical and cognitive function and reduce quality of life. Therefore, regular iron status assessment and awareness of the clinical consequences of impaired iron status are critical. While the range of options for treatment of IDA is increasing due to the availability of effective and well-tolerated parenteral iron preparations, a comprehensive overview of IDA and its therapy in patients with gastrointestinal conditions is currently lacking. Furthermore, definitions and assessment of iron status lack harmonization and there is a paucity of expert guidelines on this topic. This review summarizes current thinking concerning IDA as a common co-morbidity in specific gastrointestinal and liver disorders, and thus encourages a more unified treatment approach to anemia and iron deficiency, while offering gastroenterologists guidance on treatment options for IDA in everyday clinical practice.

  4. Iron overload diminishes atherosclerosis in apoE-deficient mice

    PubMed Central

    Kirk, Elizabeth A.; Heinecke, Jay W.; LeBoeuf, Renée C.

    2001-01-01

    It has been proposed that elevated levels of tissue iron increase the risk for atherosclerosis, perhaps by favoring the formation of pro-atherogenic oxidized LDL. Working with apoE-deficient (apoE–/–) mice, which do not require a high-fat diet to develop atherosclerosis, we compared the effects of standard diet (0.02% iron) or a 2% carbonyl iron diet. After 24 weeks, mice fed the 2% carbonyl iron diet had twice as much iron in their plasma, a ninefold increase in bleomycin-detectable free iron in their plasma, and ten times as much iron in their livers as control mice. Dietary iron overload caused a modest (30%) rise in plasma triglyceride and cholesterol. Nevertheless, this regimen did not exacerbate, but rather reduced the severity of atherosclerosis by 50%, and it failed to elevate hepatic levels of heme oxygenase mRNA, which is induced by many different oxidative insults in vitro. Moreover, hepatic levels of protein-bound dityrosine and ortho-tyrosine, two markers of metal-catalyzed oxidative damage in vitro, failed to rise in iron-overloaded animals. Our observations suggest that elevated serum and tissue levels of iron are not atherogenic in apoE–/– mice. Moreover, they call into question the hypothesis that elevated levels of tissue iron promote LDL oxidation and oxidative stress in vivo. PMID:11413162

  5. Implications of Malaria On Iron Deficiency Control Strategies123

    PubMed Central

    Spottiswoode, Natasha; Fried, Michal; Drakesmith, Hal

    2012-01-01

    The populations in greatest need of iron supplementation are also those at greatest risk of malaria: pregnant women and young children. Iron supplementation has been shown to increase malaria risk in these groups in numerous studies, although this effect is likely diminished by factors such as host immunity, host iron status, and effective malaria surveillance and control. Conversely, the risk of anemia is increased by malaria infections and preventive measures against malaria decrease anemia prevalence in susceptible populations without iron supplementation. Studies have shown that subjects with malaria experience diminished absorption of orally administered iron, so that as a consequence, iron supplementation may have generally reduced efficacy in malarious populations. A possible mechanistic link between malaria, poor absorption of iron, and anemia is provided by recent research on hepcidin, the human iron control hormone. Our improved understanding of iron metabolism may contribute to the control of malaria and the treatment of anemia. Malaria surveillance and control are necessary components of programs to control iron deficiency and may enhance the efficacy of iron supplementation. PMID:22797994

  6. Evaluation of Ferric and Ferrous Iron Therapies in Women with Iron Deficiency Anaemia

    PubMed Central

    Berber, Ilhami; Erkurt, Mehmet Ali; Aydogdu, Ismet; Kuku, Irfan

    2014-01-01

    Introduction. Different ferric and ferrous iron preparations can be used as oral iron supplements. Our aim was to compare the effects of oral ferric and ferrous iron therapies in women with iron deficiency anaemia. Methods. The present study included 104 women diagnosed with iron deficiency anaemia after evaluation. In the evaluations performed to detect the aetiology underlying the iron deficiency anaemia, it was found and treated. After the detection of the iron deficiency anaemia aetiology and treatment of the underlying aetiology, the ferric group consisted of 30 patients treated with oral ferric protein succinylate tablets (2 × 40 mg elemental iron/day), and the second group consisted of 34 patients treated with oral ferrous glycine sulphate tablets (2 × 40 mg elemental iron/day) for three months. In all patients, the following laboratory evaluations were performed before beginning treatment and after treatment. Results. The mean haemoglobin and haematocrit increases were 0.95 g/dL and 2.62% in the ferric group, while they were 2.25 g/dL and 5.91% in the ferrous group, respectively. A significant difference was found between the groups regarding the increase in haemoglobin and haematocrit values (P < 0.05). Conclusion. Data are submitted on the good tolerability, higher efficacy, and lower cost of the ferrous preparation used in our study. PMID:25006339

  7. Iron homeostasis and pulmonary hypertension: iron deficiency leads to pulmonary vascular remodeling in the rat.

    PubMed

    Cotroneo, Emanuele; Ashek, Ali; Wang, Lei; Wharton, John; Dubois, Olivier; Bozorgi, Sophie; Busbridge, Mark; Alavian, Kambiz N; Wilkins, Martin R; Zhao, Lan

    2015-05-08

    Iron deficiency without anemia is prevalent in patients with idiopathic pulmonary arterial hypertension and associated with reduced exercise capacity and survival. We hypothesized that iron deficiency is involved in the pathogenesis of pulmonary hypertension and iron replacement is a possible therapeutic strategy. Rats were fed an iron-deficient diet (IDD, 7 mg/kg) and investigated for 4 weeks. Iron deficiency was evident from depleted iron stores (decreased liver, serum iron, and ferritin), reduced erythropoiesis, and significantly decreased transferrin saturation and lung iron stores after 2 weeks IDD. IDD rats exhibited profound pulmonary vascular remodeling with prominent muscularization, medial hypertrophy, and perivascular inflammatory cell infiltration, associated with raised pulmonary artery pressure and right ventricular hypertrophy. IDD rat lungs demonstrated increased expression of hypoxia-induced factor-1α and hypoxia-induced factor-2α, nuclear factor of activated T cells and survivin, and signal transducers and activators of transcription-3 activation, which promote vascular cell proliferation and resistance to apoptosis. Biochemical examination showed reduced mitochondrial complex I activity and mitochondrial membrane hyperpolarization in mitochondria from IDD rat pulmonary arteries. Along with upregulation of the glucose transporter, glucose transporter 1, and glycolytic genes, hk1 and pdk1, lung fluorine-18-labeled 2-fluoro-2-deoxyglucose ligand uptake was significantly increased in IDD rats. The hemodynamic and pulmonary vascular remodeling were reversed by iron replacement (ferric carboxymaltose, 75 mg/kg) and attenuated in the presence of iron deficiency by dichloroacetate and imatinib, 2 putative treatments explored for pulmonary arterial hypertension that target aerobic glycolysis and proliferation, respectively. These data suggest a major role for iron in pulmonary vascular homeostasis and support the clinical evaluation of iron replacement

  8. Pathogenic Mechanisms Underlying Iron Deficiency and Iron Overload: New Insights for Clinical Application

    PubMed Central

    van Velden, DP; van Rensburg, SJ; Erasmus, R

    2009-01-01

    Iron uptake, utilisation, release and storage occur at the gene level. Individuals with variant forms of genes involved in iron metabolism may have different requirements for iron and are likely to respond differently to the same amount of iron in the diet, a concept termed nutrigenetics. Iron deficiency, iron overload and the anemia of inflammation are the commonest iron-related disorders. While at least four types of hereditary iron overload have been identified to date, our knowledge of the genetic basis and consequences of inherited iron deficiency remain limited. The importance of genetic risk factors in relation to iron overload was highlighted with the identification of the HFE gene in 1996. Deleterious mutations in this gene account for 80-90% of inherited iron overload and are associated with loss of iron homeostasis, alterations in inflammatory responses, oxidative stress and in its most severe form, the disorder hereditary haemochromatosis (HH). Elucidation of the genetic basis of HH has led to rapid clinical benefit through drastic reduction in liver biopsies performed as part of the diagnostic work-up of affected patients. Today, detection of a genetic predisposition in the presence of high serum ferritin and transferrin saturation levels is usually sufficient to diagnose HH, thereby addressing the potential danger of inherited iron overload which starts with the same symptoms as iron deficiency, namely chronic fatigue. This review provides the scientific back-up for application of pathology supported genetic testing, a new test concept that is well placed for optimizing clinical benefit to patients with regard to iron status. PMID:27683335

  9. Pathogenic Mechanisms Underlying Iron Deficiency and Iron Overload: New Insights for Clinical Application.

    PubMed

    Kotze, M J; van Velden, D P; van Rensburg, S J; Erasmus, R

    2009-08-01

    Iron uptake, utilisation, release and storage occur at the gene level. Individuals with variant forms of genes involved in iron metabolism may have different requirements for iron and are likely to respond differently to the same amount of iron in the diet, a concept termed nutrigenetics. Iron deficiency, iron overload and the anemia of inflammation are the commonest iron-related disorders. While at least four types of hereditary iron overload have been identified to date, our knowledge of the genetic basis and consequences of inherited iron deficiency remain limited. The importance of genetic risk factors in relation to iron overload was highlighted with the identification of the HFE gene in 1996. Deleterious mutations in this gene account for 80-90% of inherited iron overload and are associated with loss of iron homeostasis, alterations in inflammatory responses, oxidative stress and in its most severe form, the disorder hereditary haemochromatosis (HH). Elucidation of the genetic basis of HH has led to rapid clinical benefit through drastic reduction in liver biopsies performed as part of the diagnostic work-up of affected patients. Today, detection of a genetic predisposition in the presence of high serum ferritin and transferrin saturation levels is usually sufficient to diagnose HH, thereby addressing the potential danger of inherited iron overload which starts with the same symptoms as iron deficiency, namely chronic fatigue. This review provides the scientific back-up for application of pathology supported genetic testing, a new test concept that is well placed for optimizing clinical benefit to patients with regard to iron status.

  10. Iron therapy for the treatment of iron deficiency in chronic heart failure: intravenous or oral?

    PubMed Central

    McDonagh, Theresa; Macdougall, Iain C

    2015-01-01

    This article considers the use and modality of iron therapy to treat iron deficiency in patients with heart failure, an aspect of care which has received relatively little attention compared with the wider topic of anaemia management. Iron deficiency affects up to 50% of heart failure patients, and is associated with poor quality of life, impaired exercise tolerance, and mortality independent of haematopoietic effects in this patient population. The European Society of Cardiology Guidelines for heart failure 2012 recommend a diagnostic work-up for iron deficiency in patients with suspected heart failure. Iron absorption from oral iron preparations is generally poor, with slow and often inefficient iron repletion; moreover, up to 60% of patients experience gastrointestinal side effects. These problems may be exacerbated in heart failure due to decreased gastrointestinal absorption and poor compliance due to pill burden. Evidence for clinical benefits using oral iron is lacking. I.v. iron sucrose has consistently been shown to improve exercise capacity, cardiac function, symptom severity, and quality of life. Similar findings were observed recently for i.v. ferric carboxymaltose in patients with systolic heart failure and impaired LVEF in the double-blind, placebo-controlled FAIR-HF and CONFIRM-HF trials. I.v. iron therapy may be better tolerated than oral iron, although confirmation in longer clinical trials is awaited. Routine diagnosis and management of iron deficiency in patients with symptomatic heart failure regardless of anaemia status is advisable, and, based on current evidence, prompt intervention using i.v. iron therapy should now be considered. PMID:25639592

  11. Iron therapy for the treatment of iron deficiency in chronic heart failure: intravenous or oral?

    PubMed

    McDonagh, Theresa; Macdougall, Iain C

    2015-03-01

    This article considers the use and modality of iron therapy to treat iron deficiency in patients with heart failure, an aspect of care which has received relatively little attention compared with the wider topic of anaemia management. Iron deficiency affects up to 50% of heart failure patients, and is associated with poor quality of life, impaired exercise tolerance, and mortality independent of haematopoietic effects in this patient population. The European Society of Cardiology Guidelines for heart failure 2012 recommend a diagnostic work-up for iron deficiency in patients with suspected heart failure. Iron absorption from oral iron preparations is generally poor, with slow and often inefficient iron repletion; moreover, up to 60% of patients experience gastrointestinal side effects. These problems may be exacerbated in heart failure due to decreased gastrointestinal absorption and poor compliance due to pill burden. Evidence for clinical benefits using oral iron is lacking. I.v. iron sucrose has consistently been shown to improve exercise capacity, cardiac function, symptom severity, and quality of life. Similar findings were observed recently for i.v. ferric carboxymaltose in patients with systolic heart failure and impaired LVEF in the double-blind, placebo-controlled FAIR-HF and CONFIRM-HF trials. I.v. iron therapy may be better tolerated than oral iron, although confirmation in longer clinical trials is awaited. Routine diagnosis and management of iron deficiency in patients with symptomatic heart failure regardless of anaemia status is advisable, and, based on current evidence, prompt intervention using i.v. iron therapy should now be considered.

  12. Identification, Prevention and Treatment of Iron Deficiency during the First 1000 Days

    PubMed Central

    Burke, Rachel M.; Leon, Juan S.; Suchdev, Parminder S.

    2014-01-01

    Iron deficiency is a global problem across the life course, but infants and their mothers are especially vulnerable to both the development and the consequences of iron deficiency. Maternal iron deficiency during pregnancy can predispose offspring to the development of iron deficiency during infancy, with potentially lifelong sequelae. This review explores iron status throughout these “first 1000 days” from pregnancy through two years of age, covering the role of iron and the epidemiology of iron deficiency, as well as its consequences, identification, interventions and remaining research gaps. PMID:25310252

  13. ANEMIA—Differentiating Between Thalassemia Minor and Iron Deficiency

    PubMed Central

    Wallerstein, Ralph O.; Aggeler, Paul M.

    1956-01-01

    Many of the conditions noted in examination of the blood of patients with thalassemia minor are much like those observed in patients with iron deficiency anemia. A study was made of similarities and contrasts between blood and bone marrow features in both conditions for purposes of differential diagnosis. A salient distinction is that bone marrow hemosiderin is present in normal amount in patients with thalassemia minor, but not in those with iron deficiency anemia. If therapy with iron does not restore hemoglobin values to normal, thalassemia minor is strongly suspect. Even in the latter disease, however, there may be small fluctuations in hemoglobin values, particularly in pregnancy. One must be alert to this possibility lest a slight, fleeting increase in hemoglobin be mistakenly ascribed to iron therapy. PMID:13304673

  14. Treatment of iron deficiency anemia in children: a comparative study of ferrous ascorbate and colloidal iron.

    PubMed

    Yewale, Vijay N; Dewan, Bhupesh

    2013-05-01

    To compare the efficacy of ferrous ascorbate and colloidal iron in the treatment of iron deficiency anemia in children. Eighty one children, aged 6 mo to 12 y, were screened for iron deficiency anemia (IDA) and those diagnosed with IDA were randomized to receive ferrous ascorbate or colloidal iron for a period of 12 wk, such that each child received elemental iron 3 mg/kg body weight/d. Increase in hemoglobin (Hb) level was the primary outcome measure. Assessment was performed at baseline, wk 4, wk 8 and wk 12. Of 81 children screened, 73 were included in the study. The mean rise in Hb at the end of the 12 wk was significantly higher in ferrous ascorbate group than the colloidal iron group [3.59 ± 1.67 g/dl vs. 2.43 ± 1.73 g/dl; P < 0.01]. Significantly higher proportion of children receiving ferrous ascorbate (64.86 % vs. 31.03 %; P < 0.01) became non-anemic in comparison to colloidal iron. Ferrous ascorbate provides a significantly higher rise in hemoglobin levels in comparison to colloidal iron. The study supports the use of ferrous ascorbate in the pediatric age group, providing evidence for its role as an efficient oral iron supplement in the treatment of iron deficiency anemia.

  15. Iron deficiency anaemia and blood lead concentrations in Brazilian children.

    PubMed

    Rondó, Patricia Helen Carvalho; Conde, Andréia; Souza, Miriam Coelho; Sakuma, Alice

    2011-09-01

    This study investigated the relationship between iron deficiency/iron deficiency anaemia, assessed by several parameters, and blood lead concentration in children. This cross-sectional study involved 384 Brazilian children, aged 2-11 years, who lived near a lead-manipulating industry. Complete blood counts were obtained by an automated cell counter. Serum iron, total iron binding capacity (TIBC) and ferritin were determined respectively, by colorimetric, turbidimetric methods and chemiluminescence. Blood lead was measured by atomic absorption spectrophotometry. The impact of several parameters for assessment of iron status (haemoglobin, serum iron, TIBC, transferrin saturation, ferritin, red cell indices and red cell distribution width) and variables (gender, age, mother's education, income, body mass index, iron intake, and distance from home to lead-manipulating industry) on blood lead concentration was determined by multiple linear regression. There were significant negative associations between blood lead and the distance from home to the lead-manipulating industry (P<0.001), Hb (P=0.019), and ferritin (P=0.023) (R(2)=0.14). Based on these results, further epidemiological studies are necessary to investigate the impact of interventions like iron supplementation or fortification, as an attempt to decrease blood lead in children.

  16. Non-invasive detection of iron deficiency by fluorescence measurement of erythrocyte zinc protoporphyrin in the lip

    PubMed Central

    Hennig, Georg; Homann, Christian; Teksan, Ilknur; Hasbargen, Uwe; Hasmüller, Stephan; Holdt, Lesca M.; Khaled, Nadia; Sroka, Ronald; Stauch, Thomas; Stepp, Herbert; Vogeser, Michael; Brittenham, Gary M.

    2016-01-01

    Worldwide, more individuals have iron deficiency than any other health problem. Most of those affected are unaware of their lack of iron, in part because detection of iron deficiency has required a blood sample. Here we report a non-invasive method to optically measure an established indicator of iron status, red blood cell zinc protoporphyrin, in the microcirculation of the lower lip. An optical fibre probe is used to illuminate the lip and acquire fluorescence emission spectra in ∼1 min. Dual-wavelength excitation with spectral fitting is used to distinguish the faint zinc protoporphyrin fluorescence from the much greater tissue background fluorescence, providing immediate results. In 56 women, 35 of whom were iron-deficient, the sensitivity and specificity of optical non-invasive detection of iron deficiency were 97% and 90%, respectively. This fluorescence method potentially provides a rapid, easy to use means for point-of-care screening for iron deficiency in resource-limited settings lacking laboratory infrastructure. PMID:26883939

  17. Dopamine D(3) receptor deficiency sensitizes mice to iron deficiency-related deficits in motor learning.

    PubMed

    Klinker, F; Hasan, K; Dowling, P; Paulus, W; Liebetanz, D

    2011-07-07

    Iron deficiency is a widespread form of malnutrition and is known to interfere with cognitive performance and development. To elucidate the role of dopamine D3 and iron deficiency (ID) in inducing cognitive deficits, we studied wildtype and D3 knockout mice on normal or iron-deficient diets subjected to a running wheel-based motor skill sequence. Surprisingly, ID alone had no effect on motor learning in this study, whereas combined ID and dopamine D(3) receptor (D3R)-deficiency significantly interfered with the acquisition of motor skills. Reduced D3R function may serve as a predisposing factor towards ID-related effects on motor learning. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. Association between iron deficiency anemia and febrile seizure in children.

    PubMed

    Derakhshanfar, Hojjat; Abaskhanian, Ali; Alimohammadi, Hosein; ModanlooKordi, Mona

    2012-08-01

    Febrile convulsion (FC) is a common cause of seizure in young children, with an excellent prognosis. In addition to genetic predisposition, FCs are generally thought to be induced by elemental changes such as iron deficiency. Regarding the high prevalence of febrile seizure and iron deficiency anemia in children, the aim was to investigate the role of iron deficiency anemia in FC patients. This case-control study was performed in 500 children with febrile seizures (case) and 500 febrile children without seizures (control), referred to Mofid hospital in Tehran during one year (Nov 2009-Nov 2010). All children were aged between 6-60 months. The groups were matched in age and gender and use of supplemental iron. Laboratory tests consisted of Complete Blood Count (CBC). Serum iron, plasma ferritin and Total Iron Binding Capacity (TIBC) analyses were done in each patient. The patients and controls were 26.49+12.65 and 26.84+11.70 months of mean age, respectively. The amount of Hb, Hct, MCV, MCH, MCHC, RBC count, serum iron and plasma ferritin were significantly higher and TIBC was significantly lower among the cases with febrile convulsion than the controls. The incidence of iron deficiency anemia was significantly higher in controls compared with the cases (p less than 0.016). The mean of temperature peak on admission was significantly higher in the febrile convulsion group than controls. The results of this study suggest that the risk of febrile seizure occurrence in anemic children is less common as compared to non-anemic ones.

  19. Celiac disease unmasked by acute severe iron deficiency anemia

    PubMed Central

    Meseeha, Marcelle G.; Attia, Maximos N.; Kolade, Victor O.

    2016-01-01

    The prevalence of celiac disease (CD) appears to be increasing in the United States. However, the proportion of new CD cases with atypical presentations is also rising. We present the case of a 49-year-old woman who was diagnosed with CD in the setting of new, severe iron-deficiency anemia, 13 years into treatment of diarrhea-predominant irritable bowel syndrome associated with chronic mildly elevated liver function tests. While CD and iron deficiency anemia are common, this is a rare presentation of CD. PMID:27406450

  20. [Iron deficiency and overload. Implications in oxidative stress and cardiovascular health].

    PubMed

    Toxqui, L; De Piero, A; Courtois, V; Bastida, S; Sánchez-Muniz, F J; Vaquero, Ma P

    2010-01-01

    Although iron is an essential mineral for maintaining good health, excessive amounts are toxic. Nowadays, much interest is focused on the mechanisms and regulation of iron metabolism by down-regulation of the hormone hepcidin. The HAMP gene encodes for hepcidin appears to be exceptionally preserved. Disorders of iron metabolism could lead to iron overload, mainly causing the rare disease hereditary hemochromatosis, or on the other hand, iron deficiency and iron deficiency anaemia. Currently, these alterations constitute an important problem of public health. The genetic variation implicated in iron overload and iron deficiency anaemia, involves mutations in several genes such as HFE, TFR2,HAMP, HJV, Tf and TMPRSS6. Iron has the capacity to accept and donate electrons easily and can catalyze reactions of free radicals production. Therefore, iron overload causes lipid peroxidation and increases cardiovascular risk. Recently, a relationship between iron metabolism and insulin resistance and obesity has been described. In contrast, regarding a possible relationship between iron deficiency anaemia and cardiovascular disease, many aspects remain controversial. This review presents an overview of the most recent information concerning iron metabolism, iron bioavailability and iron overload/deficiency related diseases. The relation between iron and cardiovascular risk, in iron overload and in iron deficiency situations, is also examined. Finally, strategies to modify dietary iron bioavailability in order to prevent iron deficiency or alleviate iron overload are suggested.

  1. Iron Deficiency Is Common During Remission in Children With Inflammatory Bowel Disease

    PubMed Central

    Wikholm, Emma; Malmborg, Petter; Forssberg, Maria; Hederos, Carl-Axel; Wikström, Sverre

    2016-01-01

    The aim was to study prevalence of iron deficiency in children with inflammatory bowel disease (IBD) during remission. In addition, there was an observational evaluation of hematological response to oral iron. A population-based retrospective study including 90 Swedish children (median 13 years) with IBD was performed. Patient records covered in median 25 months. Iron deficiency was present in 70/77 children (91%) in which iron status could be assessed. In clinical and biochemical remission, iron deficiency was found in 57/67 (85%) of children, and 23 (34%) of them had iron deficiency anemia. Thirty-six iron-deficient children were prescribed oral iron supplementation and 32 (89%) improved hemoglobin levels over 6 months. In conclusion, iron deficiency is common during clinical remission in children with IBD, even in cohorts with low prevalence of anemia. Therefore, regular biochemical screening for iron deficiency is warranted during all stages of disease, irrespective of symptoms and inflammatory blood markers. PMID:27336004

  2. Iron deficiency anemia after subtotal gastrectomy for gastric cancer.

    PubMed

    Roviello, Franco; Fotia, Giuseppe; Marrelli, Daniele; De Stefano, Alfonso; Macchiarelli, Raffaele; Pinto, Enrico

    2004-01-01

    Sideropenic anemia after a gastrectomy is a frequent complication. The aim of the present study was to evaluate the role of different factors, such as sex, age, atrophic chronic gastritis, Helicobacter pylori infection and iron malabsorption, in iron deficiency after surgery for gastric cancer. Thirty-seven patients who underwent subtotal gastrectomy for carcinoma of the stomach were prospectively studied following a specific three-year protocol. Iron deficiency was evaluated by hemochromocytometric analysis and serum iron-ferritin level assays. Of the different variables analyzed, atrophic chronic gastritis was associated with a lower mean serum iron level, in particular two years after surgery (65mg/dL vs. 103 mg/dL in subjects without gastritis, P<0.01); a correlation between Helicobacter pylori infection of the gastric stump and lower mean serum ferritin level was also found (25+/-6.3 mg/dL vs. 53+/-0.4 mg/dL, P<0.05). On the contrary, no association was observed with the other factors that were evaluated. Among the factors involved in iron deficiency after gastrectomy for cancer of the stomach, atrophic gastritis seems to be the most important, although Helicobacter pylori infection of the gastric stump also seems to play an important role.

  3. Heart failure in patients with kidney disease and iron deficiency; the role of iron therapy.

    PubMed

    Cases Amenós, Aleix; Ojeda López, Raquel; Portolés Pérez, José María

    2017-06-10

    Chronic kidney disease and anaemia are common in heart failure (HF) and are associated with a worse prognosis in these patients. Iron deficiency is also common in patients with HF and increases the risk of morbidity and mortality, regardless of the presence or absence of anaemia. While the treatment of anaemia with erythropoiesis-stimulating agents in patients with HF have failed to show a benefit in terms of morbidity and mortality, treatment with IV iron in patients with HF and reduced ejection fraction and iron deficiency is associated with clinical improvement. In a posthoc analysis of a clinical trial, iron therapy improved kidney function in patients with HF and iron deficiency. In fact, the European Society of Cardiology's recent clinical guidelines on HF suggest that in symptomatic patients with reduced ejection fraction and iron deficiency, treatment with IV ferric carboxymaltose should be considered to improve symptoms, the ability to exercise and quality of life. Iron plays a key role in oxygen storage (myoglobin) and in energy metabolism, and there are pathophysiological bases that explain the beneficial effect of IV iron therapy in patients with HF. All these aspects are reviewed in this article. Copyright © 2017 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  4. Time to pump iron: iron-deficiency-signaling mechanisms of higher plants.

    PubMed

    Walker, Elsbeth L; Connolly, Erin L

    2008-10-01

    Iron is an essential nutrient for plants, yet it often limits plant growth. On the contrary, overaccumulation of iron within plant cells leads to oxidative stress. As a consequence, iron-uptake systems are carefully regulated to ensure that iron homeostasis is maintained. In response to iron limitation, plants induce expression of sets of activities that function at the root-soil interface to solubilize iron and subsequently transfer it across the plasma membrane of root cells. Recent advances have revealed key players in the signaling pathways that function to induce these iron-uptake responses. Transcription factors belonging to the basic helix-loop-helix, ABI3/VP1(B3), and NAC families appear to function either directly or indirectly in the upregulation of iron deficiency responses.

  5. Discrimination of various thalassemia syndromes and iron deficiency and utilization of reticulocyte measurements in monitoring response to iron therapy.

    PubMed

    Winichagoon, Pranee; Kumbunlue, Rawiprapa; Sirankapracha, Pornpan; Boonmongkol, Piathip; Fucharoen, Suthat

    2015-04-01

    Decreased hemoglobinization of red cells resulting in hypochromia and microcytosis are the main features of thalassemia syndromes, and also of iron deficiency anemia (IDA). A simple and reliable method is required to distinguish the two conditions in the routine laboratories. In this study we analyzed the red cell and reticulocyte parameters from 414 samples of various types of thalassemias and IDA and discovered a variety of discriminating criteria including a discrimination index (DI) which should be useful for differential diagnosis. Slightly decreased MCV and CH are suggestive of α-thalassemia 2, Hb CS, and Hb E heterozygotes whereas the increased Rbc counts are obvious in α-thalassemia 1 and β-thalassemia. In Hb E, the number of microcytic red cells was greater than the number of hypochromic red cells resulting in an increased M/H ratio. Hb H diseases are characterized by a higher number of hypochromic red cells and decreased CHCM, while broadening of hemoglobin concentration histogram results in increased HDW in β-thalassemia diseases. Iron deficiency anemia results in hypochromic-microcytic red cells and increased RDW. The number of reticulocyte with %High Retic and CHr value were increased in the first month of iron supplementation indicating the response to iron therapy. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Iron deficiency in infancy: applying a physiologic framework for prediction2

    PubMed Central

    Lozoff, Betsy; Kaciroti, Niko; Walter, Tomás

    2007-01-01

    Background Infants aged 6–24 mo are at high risk of iron deficiency. Numerous studies worldwide have sought to identify predictors of iron deficiency in this age group. Objective The objectives of the study were to apply a physiologic model to identify risk factors for iron deficiency and to consider those risk factors under different conditions of iron supplementation. We predicted that factors related to iron status at birth (lower gestational age and lower birth weight), postnatal needs for iron (more rapid growth), and bioavailable iron (more cow milk) would be major risk factors. Design The physiologic framework was assessed in 1657 Chilean infants (aged 12 mo) with birth weights ≥3 kg who were randomly assigned at age 6 mo to high or low iron supplementation or no added iron. Based on venous blood, the analysis used mean corpuscular volume and concentrations of hemoglobin, free erythrocyte protoporphyrin, and ferritin. Logistic regression models were used to identify predictors of iron deficiency anemia and iron deficiency without anemia. Results The prevalence of iron deficiency (≥2 abnormal iron measures) was 34.9% at age 12 mo. Of 186 infants with hemoglobin concentrations <110 g/L, 158 (84.9%) were iron deficient. The only consistent (and the strongest) predictor of iron deficiency or iron deficiency anemia was lower 6-mo hemoglobin. Factors related to poorer iron status at birth (lower birth weight, shorter gestation though full-term, or both) were predictors in the no-added-iron and high-iron groups. Otherwise, predictors varied by iron supplementation. Conclusion Variations in predictors of iron deficiency or iron deficiency anemia according to iron supplementation suggest that direct comparisons across studies are tenuous at best without data on early iron status and certainty that specific conditions are comparable. PMID:17158425

  7. Intravenous iron therapy in patients with idiopathic pulmonary arterial hypertension and iron deficiency

    PubMed Central

    Manders, Emmy; Happé, Chris M.; Schalij, Ingrid; Groepenhoff, Herman; Howard, Luke S.; Wilkins, Martin R.; Bogaard, Harm J.; Westerhof, Nico; van der Laarse, Willem J.; de Man, Frances S.; Vonk-Noordegraaf, Anton

    2015-01-01

    Abstract In patients with idiopathic pulmonary arterial hypertension (iPAH), iron deficiency is common and has been associated with reduced exercise capacity and worse survival. Previous studies have shown beneficial effects of intravenous iron administration. In this study, we investigated the use of intravenous iron therapy in iron-deficient iPAH patients in terms of safety and effects on exercise capacity, and we studied whether altered exercise capacity resulted from changes in right ventricular (RV) function and skeletal muscle oxygen handling. Fifteen patients with iPAH and iron deficiency were included. Patients underwent a 6-minute walk test, cardiopulmonary exercise tests, cardiac magnetic resonance imaging, and a quadriceps muscle biopsy and completed a quality-of-life questionnaire before and 12 weeks after receiving a high dose of intravenous iron. The primary end point, 6-minute walk distance, was not significantly changed after 12 weeks (409 ± 110 m before vs. 428 ± 94 m after; P = 0.07). Secondary end points showed that intravenous iron administration was well tolerated and increased body iron stores in all patients. In addition, exercise endurance time (P < 0.001) and aerobic capacity (P < 0.001) increased significantly after iron therapy. This coincided with improved oxygen handling in quadriceps muscle cells, although cardiac function at rest and maximal were unchanged. Furthermore, iron treatment was associated with improved quality of life (P < 0.05). In conclusion, intravenous iron therapy in iron-deficient iPAH patients improves exercise endurance capacity. This could not be explained by improved RV function; however, increased quadriceps muscle oxygen handling may play a role. (Trial registration: ClinicalTrials.gov identifier NCT01288651) PMID:26401247

  8. Abnormal plasma clot structure and stability distinguish bleeding risk in patients with severe factor XI deficiency.

    PubMed

    Zucker, M; Seligsohn, U; Salomon, O; Wolberg, A S

    2014-07-01

    Factor XI (FXI) deficiency is a rare autosomal recessive disorder. Many patients with even very low FXI levels (< 20 IU dL(-1) ) are asymptomatic or exhibit only mild bleeding, whereas others experience severe bleeding, usually following trauma. Neither FXI antigen nor activity predicts the risk of bleeding in FXI-deficient patients. (i) Characterize the formation, structure and stability of plasma clots from patients with severe FXI deficiency and (ii) determine whether these assays can distinguish asymptomatic patients ('non-bleeders') from those with a history of bleeding ('bleeders'). Platelet-poor plasmas were prepared from 16 severe FXI-deficient patients who were divided into bleeders or non-bleeders, based on bleeding associated with at least two tooth extractions without prophylaxis. Clot formation was triggered by recalcification and addition of tissue factor and phospholipids in the absence or presence of tissue plasminogen activator and/or thrombomodulin. Clot formation and fibrinolysis were measured by turbidity and fibrin network structure by laser scanning confocal microscopy. Non-bleeders and bleeders had similarly low FXI levels, normal prothrombin times, normal levels of fibrinogen, factor VIII, von Willebrand factor and factor XIII, and normal platelet number and function. Compared with non-bleeders, bleeders exhibited lower fibrin network density and lower clot stability in the presence of tissue plasminogen activator. In the presence of thrombomodulin, seven of eight bleeders failed to form a clot, whereas only three of eight non-bleeders did not clot. Plasma clot structure and stability assays distinguished non-bleeders from bleeders. These assays may reveal hemostatic mechanisms in FXI-deficient patients and have clinical utility for assessing the risk of bleeding. © 2014 International Society on Thrombosis and Haemostasis.

  9. Single-dose intravenous iron for iron deficiency: a new paradigm.

    PubMed

    Auerbach, Michael; Deloughery, Thomas

    2016-12-02

    Iron-deficiency anemia is the most common hematologic problem in the world. Although oral iron is often viewed as front-line therapy, extensive published evidence has accumulated that IV iron is superior, in both efficacy and safety, to oral iron in many clinical situations and should be introduced much sooner in the treatment paradigm of iron-deficient patients. In this chapter, we will review the formulations of IV iron that allow total complete replacement doses in 1 or 2 sessions including practical tips for administration. We realize safety concerns abound and therefore will analyze evidence based overstated concerns regarding serious adverse events highlighting unnecessary interventions for minor, self-limiting infusion reactions, which infrequently occur with intravenous iron administration. Recent data for the use of IV iron in a variety of clinic situations will be reviewed including women with heavy uterine bleeding, pregnancy, bariatric surgery, inflammatory bowel disease, and restless legs syndrome. Briefly discussed is the new frontier of IV iron's use in the prevention of acute (high altitude) mountain sickness. It is clear that in many clinical situations IV iron is a new and improved standard of care offering advantages over oral iron in efficacy, toxicity, and convenience to patients and health care providers. © 2016 by The American Society of Hematology. All rights reserved.

  10. Strategies to prevent iron deficiency and improve reproductive health.

    PubMed

    Berger, Jacques; Wieringa, Frank T; Lacroux, Annie; Dijkhuizen, Marjoleine A

    2011-11-01

    Anemia and iron deficiency affect billions of people worldwide, especially women of reproductive age, pregnant women, and young children. Many countries have iron and folic acid supplementation programs for pregnant women. However, the impact of these programs is uncertain. Multiple-micronutrient supplementation during pregnancy has been advocated; however, it is unclear whether this has additional advantages. Overall, programs have shown only modest impact on increasing birth weight. This review discusses the present state of knowledge on interventions to improve iron status during pregnancy and reproductive health, and investigates other possibilities such as supplementation prior to conception to improve maternal and child health. © 2011 International Life Sciences Institute.

  11. Early iron deficiency stress response in leaves of sugar beet.

    PubMed Central

    Winder, T L; Nishio, J N

    1995-01-01

    Iron nutrient deficiency was investigated in leaves of hydroponically grown sugar beets (Beta vulgaris) to determine how ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco) gene expression is affected when thylakoid components of photosynthesis are diminished. Rubisco polypeptide content was reduced by 60% in severely iron-stressed leaves, and the reduction was directly correlated to chlorophyll content. The concentration of Rubisco protein in iron-stressed leaves was found to be regulated by availability of mRNAs, and CO2 fixation by Rubisco was reduced from 45 mumol CO2 m-2 s-1 in extracts from iron-sufficient leaves to 20 mumol CO2 m-2 s-1 in extracts from severely stressed leaves. The rate of CO2 fixation was directly correlated to leaf chlorophyll content. Rubisco in iron-sufficient control leaves was 59% activated, whereas in severely stressed leaves grown under the same light, Rubisco was 43% activated. RNA synthesis was reduced by about 50% in iron-deficient leaves, but 16S and 25S rRNA and ctDNA were essentially unaffected by iron stress. PMID:7659749

  12. Iron deficiency and iron overload: effects of diet and genes.

    PubMed

    Burke, W; Imperatore, G; Reyes, M

    2001-02-01

    Like most essential nutrients, Fe needs to be maintained in the body at a defined level for optimal health, with appropriate adaptation to varying Fe needs and supply. The primary mechanism for controlling Fe level is the regulation of Fe absorption. Several different proteins have been identified as contributors to the process. Despite a complex regulatory system, Fe disorders (both Fe deficiency and Fe overload) occur. Fe deficiency is a common problem worldwide, resulting from inadequate dietary Fe and blood loss. Complications include pre-term labour, developmental delay, and impaired work efficiency. No specific genetic syndromes causing isolated Fe deficiency have been described, but animal studies and clinical observations suggest that such a relationship may be a possibility. Conversely, the known causes of Fe overload are genetic. Fe overload is less common than Fe deficiency, but can result in serious medical complications, including cirrhosis, primary liver cancer, diabetes, cardiomyopathy and arthritis. The most common and best characterized syndrome of Fe overload is hereditary haemochromatosis (HHC), an autosomal recessive disorder. Mutations in the HFE protein cause HHC, but the clinical presentation is variable. Of particular interest is the factor that some FIFE genotypes appear to be associated with protection from Fe deficiency. Other genetic variants in the regulatory pathway may influence the likelihood of Fe deficiency and Fe overload. Studies of genetic variants in HFE and other regulatory proteins provide important tools for studying the biological processes in Fe regulation. This work is likely to lead to new insights into Fe disorders and potentially to new therapeutic approaches. It will not be complete, however, until coordinated study of both genetic and nutritional factors is undertaken.

  13. Medication adherence to oral iron therapy in patients with iron deficiency anemia.

    PubMed

    Gereklioglu, Cigdem; Asma, Suheyl; Korur, Asli; Erdogan, Ferit; Kut, Altug

    2016-01-01

    This study aimed at investigating the factors affecting medication adherence in patients who use oral iron therapy due to iron deficiency anemia. A total of 96 female patients in fertile age with mean age of 30±10.1 years (range 18-53) who were admitted to Family Medicine Clinic between 01 January and 31 March 2015 and who had received iron therapy within the recent three years were enrolled in the study. Data were collected through a questionnaire form. Of the patients, 39 (40,6%) were detected not to use the medication regularly or during the recommended period. A statistically significant relationship was found between non-adherence to therapy and gastrointestinal side effects and weight gain (p<0.05). Medication adherence is deficient in patients with iron deficiency anemia. The most important reason for this seems gastrointestinal side effects, in addition to weight gain under treatment.

  14. Medication adherence to oral iron therapy in patients with iron deficiency anemia

    PubMed Central

    Gereklioglu, Cigdem; Asma, Suheyl; Korur, Asli; Erdogan, Ferit; Kut, Altug

    2016-01-01

    Objective: This study aimed at investigating the factors affecting medication adherence in patients who use oral iron therapy due to iron deficiency anemia. Methods: A total of 96 female patients in fertile age with mean age of 30±10.1 years (range 18-53) who were admitted to Family Medicine Clinic between 01 January and 31 March 2015 and who had received iron therapy within the recent three years were enrolled in the study. Data were collected through a questionnaire form. Results: Of the patients, 39 (40,6%) were detected not to use the medication regularly or during the recommended period. A statistically significant relationship was found between non-adherence to therapy and gastrointestinal side effects and weight gain (p<0.05). Conclusion: Medication adherence is deficient in patients with iron deficiency anemia. The most important reason for this seems gastrointestinal side effects, in addition to weight gain under treatment. PMID:27375698

  15. Genetics Home Reference: myopathy with deficiency of iron-sulfur cluster assembly enzyme

    MedlinePlus

    ... assembly enzyme myopathy with deficiency of iron-sulfur cluster assembly enzyme Enable Javascript to view the expand/ ... All Description Myopathy with deficiency of iron-sulfur cluster assembly enzyme is an inherited disorder that primarily ...

  16. Maternal iron deficiency anemia affects postpartum emotions and cognition.

    PubMed

    Beard, John L; Hendricks, Michael K; Perez, Eva M; Murray-Kolb, Laura E; Berg, Astrid; Vernon-Feagans, Lynne; Irlam, James; Isaacs, Washiefa; Sive, Alan; Tomlinson, Mark

    2005-02-01

    The aim of this study was to determine whether iron deficiency anemia (IDA) in mothers alters their maternal cognitive and behavioral performance, the mother-infant interaction, and the infant's development. This article focuses on the relation between IDA and cognition as well as behavioral affect in the young mothers. This prospective, randomized, controlled, intervention trial was conducted in South Africa among 3 groups of mothers: nonanemic controls and anemic mothers receiving either placebo (10 microg folate and 25 mg vitamin C) or daily iron (125 mg FeS0(4), 10 microg folate, 25 mg vitamin C). Mothers of full-term normal birth weight babies were followed from 10 wk to 9 mo postpartum (n = 81). Maternal hematologic and iron status, socioeconomic, cognitive, and emotional status, mother-infant interaction, and the development of the infants were assessed at 10 wk and 9 mo postpartum. Behavioral and cognitive variables at baseline did not differ between iron-deficient anemic mothers and nonanemic mothers. However, iron treatment resulted in a 25% improvement (P < 0.05) in previously iron-deficient mothers' depression and stress scales as well as in the Raven's Progressive Matrices test. Anemic mothers administered placebo did not improve in behavioral measures. Multivariate analysis showed a strong association between iron status variables (hemoglobin, mean corpuscular volume, and transferrin saturation) and cognitive variables (Digit Symbol) as well as behavioral variables (anxiety, stress, depression). This study demonstrates that there is a strong relation between iron status and depression, stress, and cognitive functioning in poor African mothers during the postpartum period. There are likely ramifications of this poorer "functioning" on mother-child interactions and infant development, but the constraints around this relation will have to be defined in larger studies.

  17. Iron deficiency in plants: An insight from proteomic approaches

    USDA-ARS?s Scientific Manuscript database

    Iron (Fe) deficiency chlorosis is a major nutritional disorder for crops growing in calcareous soils, and causes decreases in vegetative growth as well as marked yield and quality losses. With the advances in mass spectrometry techniques, a substantial body of knowledge has arisen on the changes in ...

  18. Deficiency of a alpha-1-antitrypsin influences systemic iron homeostasis

    EPA Science Inventory

    Abstract Background: There is evidence that proteases and anti-proteases participate in the iron homeostasis of cells and living systems. We tested the postulate that alpha-1 antitrypsin (A1AT) polymorphism and the consequent deficiency of this anti-protease in humans are asso...

  19. Iron Deficiency in Preschool Children with Autistic Spectrum Disorders

    ERIC Educational Resources Information Center

    Bilgic, Ayhan; Gurkan, Kagan; Turkoglu, Serhat; Akca, Omer Faruk; Kilic, Birim Gunay; Uslu, Runa

    2010-01-01

    Iron deficiency (ID) causes negative outcomes on psychomotor and behavioral development of infants and young children. Children with autistic spectrum disorders (ASD) are under risk for ID and this condition may increase the severity of psychomotor and behavioral problems, some of which already inherently exist in these children. In the present…

  20. Iron deficiency: an overlooked predisposing factor in angular cheilitis.

    PubMed

    Murphy, N C; Bissada, N F

    1979-10-01

    Clinicians who recommend the use of antifungal agents for angular cheilitis may be treating the symptoms and not the predisposing cause of the disease. Iron deficiency should be considered as part of the differential diagnosis whenever angular cheilitis is encountered, especially in women of child-bearing age.

  1. Deficiency of a alpha-1-antitrypsin influences systemic iron homeostasis

    EPA Science Inventory

    Abstract Background: There is evidence that proteases and anti-proteases participate in the iron homeostasis of cells and living systems. We tested the postulate that alpha-1 antitrypsin (A1AT) polymorphism and the consequent deficiency of this anti-protease in humans are asso...

  2. Iron Deficiency in Preschool Children with Autistic Spectrum Disorders

    ERIC Educational Resources Information Center

    Bilgic, Ayhan; Gurkan, Kagan; Turkoglu, Serhat; Akca, Omer Faruk; Kilic, Birim Gunay; Uslu, Runa

    2010-01-01

    Iron deficiency (ID) causes negative outcomes on psychomotor and behavioral development of infants and young children. Children with autistic spectrum disorders (ASD) are under risk for ID and this condition may increase the severity of psychomotor and behavioral problems, some of which already inherently exist in these children. In the present…

  3. [The association between iron deficiency and learning disorders in preschoolers].

    PubMed

    Gutiérrez Sigler, D; Colomer Revuelta, J; Barona, C; Momparler, P; Colomer Revuelta, C

    1992-01-01

    With the aim preventing future problems of underachievement at school, we studied the possible relationship between learning difficulties and iron deficiency in nursery-school children. To do this, we determined the prevalence of iron deficiency and the prevalence or learning difficulties in the different areas of mental development in a sample of 136 nursery school children coming from the Alaquàs public school (Valencia), aged between four and five years. Their nutritional state and ferric state, socioeconomic and cultural level, and psychomotor development were evaluated. All the children were in a good nutritional state, coming from homogeneous families as regards their socio-cultural level and being divided into two groups as regards their economic situation. The iron deficiency prevalence was 17.6% in stage I (ferritina sérica < 12 ng/l) and 22.8% in stage III (anemia ferropénica). The coefficient for overall development was 85.95, the lowest marks being in the speech area. A positive association (prevalence ratio = 2; IC 95% = 1.1-8.3) between iron deficiency in its III stage and changes in the specific area of analysis and synthesis.

  4. Iron deficiency and anemia: a common problem in female elite soccer players.

    PubMed

    Landahl, Göran; Adolfsson, Peter; Börjesson, Mats; Mannheimer, Clas; Rödjer, Stig

    2005-12-01

    The objective of the study was to determine the prevalence of iron deficiency and iron deficiency anemia among elite women soccer players. Hemoglobin, serum iron, serum total iron binding capacity, and ferritin were determined in 28 female soccer players called up for the national team. Of the investigated female soccer players, 57% had iron deficiency and 29% iron deficiency anemia 6 months before the FIFA Women's World Cup. It is concluded that iron deficiency and iron deficiency anemia is common in female soccer players at the top international level. Some might suffer from relative anemia and measurement of hemoglobin alone is not sufficient to reveal relative anemia. Regular monitoring of hemoglobin concentration and iron status is necessary to institute iron supplementation when indicated.

  5. Long-Lasting Neural and Behavioral Effects of Iron Deficiency in Infancy

    PubMed Central

    Lozoff, Betsy; Beard, John; Connor, James; Felt, Barbara; Georgieff, Michael; Schallert, Timothy

    2006-01-01

    Infants are at high risk for iron deficiency and iron-deficiency anemia. This review summarizes evidence of long-term effects of iron deficiency in infancy. Follow-up studies from preschool age to adolescence report poorer cognitive, motor, and social-emotional function, as well as persisting neurophysiologic differences. Research in animal models points to mechanisms for such long-lasting effects. Potential mechanisms relate to effects of iron deficiency during brain development on neurometabolism, myelination, and neurotransmitter function. PMID:16770951

  6. Iron Deficiency in Blood Donors: The REDS-II Donor Iron Status Evaluation (RISE) Study

    PubMed Central

    Cable, Ritchard G.; Glynn, Simone A.; Kiss, Joseph E.; Mast, Alan E.; Steele, Whitney R.; Murphy, Edward L.; Wright, David J.; Sacher, Ronald A.; Gottschall, Jerry L.; Tobler, Leslie H.; Simon, Toby L.

    2013-01-01

    Background Blood donors are at risk of iron deficiency. We evaluated the effects of blood donation intensity on iron and hemoglobin in a prospective study. Methods Four cohorts of frequent and first time or reactivated blood donors (no donation in 2 years), female and male, totaling 2425 were characterized and followed as they donated blood frequently. At enrollment and the final visit, ferritin, soluble transferrin receptor (sTfR), and hemoglobin were determined. Models to predict iron deficiency and hemoglobin deferral were developed. Iron depletion was defined at two levels: Iron Deficient Erythropoiesis (IDE) [log (soluble transferrin receptor/ferritin ≥ 2.07)] and Absent Iron Stores (AIS) (ferritin < 12 ng/mL). Results Among returning female first time/reactivated donors, 20% and 51% had AIS and IDE at their final visit, respectively; corresponding proportions for males were 8% and 20%. Among female frequent donors who returned, 27% and 62% had AIS and IDE, respectively, while corresponding proportions for males were 18% and 47%. Predictors of IDE and/or AIS included a higher frequency of blood donation in the last 2 years, a shorter interdonation interval, and being female and young; conversely, taking iron supplements reduced the risk of iron depletion. Predictors of hemoglobin deferral included female gender, Black race and a shorter interdonation interval. Conclusions There is a high prevalence of iron depletion in frequent blood donors. Increasing the interdonation interval would reduce the prevalence of iron depletion and hemoglobin deferral. Alternatively, replacement with iron supplements may allow frequent donation without the adverse outcome of iron depletion. PMID:22023513

  7. Iron deficiency in blood donors: the REDS-II Donor Iron Status Evaluation (RISE) study.

    PubMed

    Cable, Ritchard G; Glynn, Simone A; Kiss, Joseph E; Mast, Alan E; Steele, Whitney R; Murphy, Edward L; Wright, David J; Sacher, Ronald A; Gottschall, Jerry L; Tobler, Leslie H; Simon, Toby L

    2012-04-01

    Blood donors are at risk of iron deficiency. We evaluated the effects of blood donation intensity on iron and hemoglobin (Hb) in a prospective study. Four cohorts of frequent and first-time or reactivated (FT/RA) blood donors (no donation in 2 years), female and male, totaling 2425, were characterized and followed as they donated blood frequently. At enrollment and the final visit, ferritin, soluble transferrin receptor (sTfR), and Hb were determined. Models to predict iron deficiency and Hb deferral were developed. Iron depletion was defined at two levels: iron deficiency erythropoiesis (IDE) [log(sTfR/ferritin) ≥ 2.07] and absent iron stores (AIS; ferritin < 12 ng/mL). Among returning female FT and RA donors, 20 and 51% had AIS and IDE at their final visit, respectively; corresponding proportions for males were 8 and 20%. Among female frequent donors who returned, 27 and 62% had AIS and IDE, respectively, while corresponding proportions for males were 18 and 47%. Predictors of IDE and/or AIS included a higher frequency of blood donation in the past 2 years, a shorter interdonation interval, and being female and young; conversely, taking iron supplements reduced the risk of iron depletion. Predictors of Hb deferral included female sex, black race, and a shorter interdonation interval. There is a high prevalence of iron depletion in frequent blood donors. Increasing the interdonation interval would reduce the prevalence of iron depletion and Hb deferral. Alternatively, replacement with iron supplements may allow frequent donation without the adverse outcome of iron depletion. © 2011 American Association of Blood Banks.

  8. Clinical iron deficiency disturbs normal human responses to hypoxia.

    PubMed

    Frise, Matthew C; Cheng, Hung-Yuan; Nickol, Annabel H; Curtis, M Kate; Pollard, Karen A; Roberts, David J; Ratcliffe, Peter J; Dorrington, Keith L; Robbins, Peter A

    2016-06-01

    Iron bioavailability has been identified as a factor that influences cellular hypoxia sensing, putatively via an action on the hypoxia-inducible factor (HIF) pathway. We therefore hypothesized that clinical iron deficiency would disturb integrated human responses to hypoxia. We performed a prospective, controlled, observational study of the effects of iron status on hypoxic pulmonary hypertension. Individuals with absolute iron deficiency (ID) and an iron-replete (IR) control group were exposed to two 6-hour periods of isocapnic hypoxia. The second hypoxic exposure was preceded by i.v. infusion of iron. Pulmonary artery systolic pressure (PASP) was serially assessed with Doppler echocardiography. Thirteen ID individuals completed the study and were age- and sex-matched with controls. PASP did not differ by group or study day before each hypoxic exposure. During the first 6-hour hypoxic exposure, the rise in PASP was 6.2 mmHg greater in the ID group (absolute rises 16.1 and 10.7 mmHg, respectively; 95% CI for difference, 2.7-9.7 mmHg, P = 0.001). Intravenous iron attenuated the PASP rise in both groups; however, the effect was greater in ID participants than in controls (absolute reductions 11.1 and 6.8 mmHg, respectively; 95% CI for difference in change, -8.3 to -0.3 mmHg, P = 0.035). Serum erythropoietin responses to hypoxia also differed between groups. Clinical iron deficiency disturbs normal responses to hypoxia, as evidenced by exaggerated hypoxic pulmonary hypertension that is reversed by subsequent iron administration. Disturbed hypoxia sensing and signaling provides a mechanism through which iron deficiency may be detrimental to human health. ClinicalTrials.gov (NCT01847352). M.C. Frise is the recipient of a British Heart Foundation Clinical Research Training Fellowship (FS/14/48/30828). K.L. Dorrington is supported by the Dunhill Medical Trust (R178/1110). D.J. Roberts was supported by R&D funding from National Health Service (NHS) Blood and Transplant and

  9. Clinical iron deficiency disturbs normal human responses to hypoxia

    PubMed Central

    Frise, Matthew C.; Cheng, Hung-Yuan; Nickol, Annabel H.; Curtis, M. Kate; Pollard, Karen A.; Roberts, David J.; Ratcliffe, Peter J.; Dorrington, Keith L.; Robbins, Peter A.

    2016-01-01

    BACKGROUND. Iron bioavailability has been identified as a factor that influences cellular hypoxia sensing, putatively via an action on the hypoxia-inducible factor (HIF) pathway. We therefore hypothesized that clinical iron deficiency would disturb integrated human responses to hypoxia. METHODS. We performed a prospective, controlled, observational study of the effects of iron status on hypoxic pulmonary hypertension. Individuals with absolute iron deficiency (ID) and an iron-replete (IR) control group were exposed to two 6-hour periods of isocapnic hypoxia. The second hypoxic exposure was preceded by i.v. infusion of iron. Pulmonary artery systolic pressure (PASP) was serially assessed with Doppler echocardiography. RESULTS. Thirteen ID individuals completed the study and were age- and sex-matched with controls. PASP did not differ by group or study day before each hypoxic exposure. During the first 6-hour hypoxic exposure, the rise in PASP was 6.2 mmHg greater in the ID group (absolute rises 16.1 and 10.7 mmHg, respectively; 95% CI for difference, 2.7–9.7 mmHg, P = 0.001). Intravenous iron attenuated the PASP rise in both groups; however, the effect was greater in ID participants than in controls (absolute reductions 11.1 and 6.8 mmHg, respectively; 95% CI for difference in change, –8.3 to –0.3 mmHg, P = 0.035). Serum erythropoietin responses to hypoxia also differed between groups. CONCLUSION. Clinical iron deficiency disturbs normal responses to hypoxia, as evidenced by exaggerated hypoxic pulmonary hypertension that is reversed by subsequent iron administration. Disturbed hypoxia sensing and signaling provides a mechanism through which iron deficiency may be detrimental to human health. TRIAL REGISTRATION. ClinicalTrials.gov (NCT01847352). FUNDING. M.C. Frise is the recipient of a British Heart Foundation Clinical Research Training Fellowship (FS/14/48/30828). K.L. Dorrington is supported by the Dunhill Medical Trust (R178/1110). D.J. Roberts was

  10. Iron regulatory protein-1 protects against mitoferrin-1-deficient porphyria.

    PubMed

    Chung, Jacky; Anderson, Sheila A; Gwynn, Babette; Deck, Kathryn M; Chen, Michael J; Langer, Nathaniel B; Shaw, George C; Huston, Nicholas C; Boyer, Leah F; Datta, Sumon; Paradkar, Prasad N; Li, Liangtao; Wei, Zong; Lambert, Amy J; Sahr, Kenneth; Wittig, Johannes G; Chen, Wen; Lu, Wange; Galy, Bruno; Schlaeger, Thorsten M; Hentze, Matthias W; Ward, Diane M; Kaplan, Jerry; Eisenstein, Richard S; Peters, Luanne L; Paw, Barry H

    2014-03-14

    Mitochondrial iron is essential for the biosynthesis of heme and iron-sulfur ([Fe-S]) clusters in mammalian cells. In developing erythrocytes, iron is imported into the mitochondria by MFRN1 (mitoferrin-1, SLC25A37). Although loss of MFRN1 in zebrafish and mice leads to profound anemia, mutant animals showed no overt signs of porphyria, suggesting that mitochondrial iron deficiency does not result in an accumulation of protoporphyrins. Here, we developed a gene trap model to provide in vitro and in vivo evidence that iron regulatory protein-1 (IRP1) inhibits protoporphyrin accumulation. Mfrn1(+/gt);Irp1(-/-) erythroid cells exhibit a significant increase in protoporphyrin levels. IRP1 attenuates protoporphyrin biosynthesis by binding to the 5'-iron response element (IRE) of alas2 mRNA, inhibiting its translation. Ectopic expression of alas2 harboring a mutant IRE, preventing IRP1 binding, in Mfrn1(gt/gt) cells mimics Irp1 deficiency. Together, our data support a model whereby impaired mitochondrial [Fe-S] cluster biogenesis in Mfrn1(gt/gt) cells results in elevated IRP1 RNA-binding that attenuates ALAS2 mRNA translation and protoporphyrin accumulation.

  11. Intravenous iron for the treatment of iron deficiency in IBD: the pendulum is swinging.

    PubMed

    Van Assche, Gert

    2013-12-01

    Intravenous (IV) iron therapy has been a major asset in the management of refractory iron-deficiency anemia in inflammatory bowel disease (IBD) and other diseases. However, the cost-effectiveness of parenteral substitution as the first-line treatment of this condition in IBD has been questioned. A study published by Reinisch et al. in this issue of the journal fails to show non-inferiority of iron isomaltose 1,000, a novel high-dose IV preparation, compared to oral iron sulfate.

  12. Iron Supplementation in Suckling Piglets: How to Correct Iron Deficiency Anemia without Affecting Plasma Hepcidin Levels

    PubMed Central

    Starzyński, Rafał R.; Laarakkers, Coby M. M.; Tjalsma, Harold; Swinkels, Dorine W.; Pieszka, Marek; Styś, Agnieszka; Mickiewicz, Michał; Lipiński, Paweł

    2013-01-01

    The aim of the study was to establish an optimized protocol of iron dextran administration to pig neonates, which better meets the iron demand for erythropoiesis. Here, we monitored development of red blood cell indices, plasma iron parameters during a 28-day period after birth (till the weaning), following intramuscular administration of different concentrations of iron dextran to suckling piglets. To better assess the iron status we developed a novel mass spectrometry assay to quantify pig plasma levels of the iron-regulatory peptide hormone hepcidin-25. This hormone is predominantly secreted by the liver and acts as a negative regulator of iron absorption and reutilization. The routinely used protocol with high amount of iron resulted in the recovery of piglets from iron deficiency but also in strongly elevated plasma hepcidin-25 levels. A similar protocol with reduced amounts of iron improved hematological status of piglets to the same level while plasma hepcidin-25 levels remained low. These data show that plasma hepcidin-25 levels can guide optimal dosing of iron treatment and pave the way for mixed supplementation of piglets starting with intramuscular injection of iron dextran followed by dietary supplementation, which could be efficient under condition of very low plasma hepcidin-25 level. PMID:23737963

  13. Iron supplementation in suckling piglets: how to correct iron deficiency anemia without affecting plasma hepcidin levels.

    PubMed

    Starzyński, Rafał R; Laarakkers, Coby M M; Tjalsma, Harold; Swinkels, Dorine W; Pieszka, Marek; Styś, Agnieszka; Mickiewicz, Michał; Lipiński, Paweł

    2013-01-01

    The aim of the study was to establish an optimized protocol of iron dextran administration to pig neonates, which better meets the iron demand for erythropoiesis. Here, we monitored development of red blood cell indices, plasma iron parameters during a 28-day period after birth (till the weaning), following intramuscular administration of different concentrations of iron dextran to suckling piglets. To better assess the iron status we developed a novel mass spectrometry assay to quantify pig plasma levels of the iron-regulatory peptide hormone hepcidin-25. This hormone is predominantly secreted by the liver and acts as a negative regulator of iron absorption and reutilization. The routinely used protocol with high amount of iron resulted in the recovery of piglets from iron deficiency but also in strongly elevated plasma hepcidin-25 levels. A similar protocol with reduced amounts of iron improved hematological status of piglets to the same level while plasma hepcidin-25 levels remained low. These data show that plasma hepcidin-25 levels can guide optimal dosing of iron treatment and pave the way for mixed supplementation of piglets starting with intramuscular injection of iron dextran followed by dietary supplementation, which could be efficient under condition of very low plasma hepcidin-25 level.

  14. Iron sucrose - characteristics, efficacy and regulatory aspects of an established treatment of iron deficiency and iron-deficiency anemia in a broad range of therapeutic areas.

    PubMed

    Beguin, Yves; Jaspers, Aurélie

    2014-10-01

    Iron is a key element in the transport and utilization of oxygen and a variety of metabolic pathways. Iron deficiency is a major cause of anemia and can be associated with fatigue, impaired physical function and reduced quality of life. Administration of oral or intravenous (i.v.) iron is the recommended treatment for iron-deficiency anemia (IDA) in different therapeutic areas. This article provides an overview of studies that evaluated i.v. iron sucrose for anemia and iron status management, either alone or in combination with erythropoiesis-stimulating agents, across various diseases and conditions. Iron sucrose is an established, effective and well-tolerated treatment of IDA in patients with acute or chronic conditions such as chronic kidney disease, inflammatory bowel disease, pregnancy (second and third trimester), postpartum period, heavy menstrual bleeding and cancer who need rapid iron supply and in whom oral iron preparations are ineffective or not tolerated. Available data on patient blood management warrant further studies on preoperative iron treatment. First experience with iron sucrose follow-on products raises questions about their therapeutic equivalence without comparative clinical data in newly diagnosed patients or patients on existing chronic treatment.

  15. Prevalence of iron deficiency and anemia among strenuously trained adolescents.

    PubMed

    Merkel, Drorit; Huerta, Michael; Grotto, Itamar; Blum, Dalit; Tal, Orna; Rachmilewitz, Eliezer; Fibach, Eitan; Epstein, Yoram; Shpilberg, Ofer

    2005-09-01

    There is a lack of awareness among physicians, dieticians, and public health planners as to the prevalence of iron deficiency and anemia among adolescents undergoing strenuous physical training. The aim of this study was to estimate the prevalence of iron deficiency and anemia among male adolescents undergoing such activity. We studied 292 male adolescents on the day of entry into a volunteer military unit. Hemoglobin (Hb), mean corpuscular volume, ferritin, iron, iron-transferrin saturation, and soluble transferrin receptor (TfR) were measured, and TfR-F index was calculated. The mean Hb level (+/-SD) in the study population was 14.7 +/- .9 g/dL (range, 10.8-16.8 g/dL), mean ferritin level was 50.6 +/- 32.6 ng/mL (range, 5.4-162.5 ng/mL), and mean iron level was 97.1 +/- 39.9 microg/dL (range, 24-267 microg/dL). The prevalence of anemia (Hb <14 g/dL) was 18.5%, and 3.4% had Hb concentrations less than 13 g/dL. Iron deficiency (ferritin <22 ng/mL) was present in 18% of the subjects, and 11.3% had ferritin levels less than 17 ng/mL. The mean soluble transferrin receptor concentration was 1.9 +/- .8 mg/L, and the mean TfR-F index was 1.21 +/- .57. Nearly 19% of the study subjects had mild anemia at recruitment, and depletion of iron stores was observed among 18%. Overall, these changes were not accompanied by a significant increase in soluble TfR. This high prevalence is most likely the result of "sports anemia" due to the intense physical training regimen adopted prior to their recruitment.

  16. Screening for iron deficiency and iron deficiency anaemia in pregnancy: a structured review and gap analysis against UK national screening criteria.

    PubMed

    Rukuni, Ruramayi; Knight, Marian; Murphy, Michael F; Roberts, David; Stanworth, Simon J

    2015-10-20

    Iron deficiency anaemia is a common problem in pregnancy despite national recommendations and guidelines for treatment. The aim of this study was to appraise the evidence against the UK National Screening Committee (UKNSC) criteria as to whether a national screening programme could reduce the prevalence of iron deficiency anaemia and/or iron deficiency in pregnancy and improve maternal and fetal outcomes. Search strategies were developed for the Cochrane library, Medline and Embase to identify evidence relevant to UK National Screening Committee (UKNSC) appraisal criteria which cover the natural history of iron deficiency and iron deficiency anaemia, the tests for screening, clinical management and evidence of cost effectiveness. Many studies evaluated haematological outcomes of anaemia, but few analysed clinical consequences. Haemoglobin and ferritin appeared the most suitable screening tests, although future options may follow recent advances in understanding iron homeostasis. The clinical consequences of iron deficiency without anaemia are unknown. Oral and intravenous iron are effective in improving haemoglobin and iron parameters. There have been no trials or economic evaluations of a national screening programme for iron deficiency anaemia in pregnancy. Iron deficiency in pregnancy remains an important problem although effective tests and treatment exist. A national screening programme could be of value for early detection and intervention. However, high quality studies are required to confirm whether this would reduce maternal and infant morbidity and be cost effective.

  17. Iron, Anemia, and Iron Deficiency Anemia among Young Children in the United States

    PubMed Central

    Gupta, Priya M.; Perrine, Cria G.; Mei, Zuguo; Scanlon, Kelley S.

    2016-01-01

    Iron deficiency and anemia are associated with impaired neurocognitive development and immune function in young children. Total body iron, calculated from serum ferritin and soluble transferrin receptor concentrations, and hemoglobin allow for monitoring of the iron and anemia status of children in the United States. The purpose of this analysis is to describe the prevalence of iron deficiency (ID), anemia, and iron deficiency anemia (IDA) among children 1–5 years using data from the 2007–2010 National Health and Nutrition Examination Survey (NHANES). Prevalence of ID, anemia, and IDA among children 1–5 years was 7.1% (5.5, 8.7), 3.2% (2.0, 4.3), and 1.1% (0.6, 1.7), respectively. The prevalence of both ID and anemia were higher among children 1–2 years (p < 0.05). In addition, 50% of anemic children 1–2 years were iron deficient. This analysis provides an update on the prevalence of ID, anemia, and IDA for a representative sample of US children. Our results suggest little change in these indicators over the past decade. Monitoring of ID and anemia is critical and prevention of ID in early childhood should remain a public health priority. PMID:27249004

  18. Iron supplementation for the control of iron deficiency in populations at risk.

    PubMed

    Viteri, F E

    1997-06-01

    Iron supplementation, mostly with a therapeutic orientation, has been a key strategy for the short-term control of iron deficiency and ferropenic anemia. It has been used almost exclusively in antenatal clinics, but in spite of its confirmed efficacy in supervised trials, it has proven ineffective in practice in most developing countries. Poor effectiveness has been attributed to various factors including insufficient dose and time of supplementation and poor adherence. These problems have led to the administration of high iron doses, which have proven equally ineffective in practice. This paper introduces four concepts: (1) that iron supplementation targeted to pregnant women should cover the full reproductive cycle, from prepregnancy to at least the end of lactation instead of only the pregnant women; (2) that entering pregnancy with iron deficiency contributes to the failure of antenatal iron supplementation and that prepregnancy iron reserves increase the effectiveness of antenatal supplementation; (3) that medium- to long-term weekly ingestion of proper iron-folate supplements, with a preventive aim and directed to all risk groups, should be community based rather than health service based but supervised by the latter (in this sense, preventive supplementation is equal to targeted iron fortification); and (4) that preventive supplementation, based on weekly dosing, has proven efficacious. Problem-oriented research to evaluate the sustainability and medium- to long-term efficacy of these concepts is called for. The bases for the concepts and suggestions are summarized in this paper.

  19. The Unexplored Crossroads of the Female Athlete Triad and Iron Deficiency: A Narrative Review.

    PubMed

    Petkus, Dylan L; Murray-Kolb, Laura E; De Souza, Mary Jane

    2017-03-13

    Despite the severity and prevalence of iron deficiency in exercising women, few published reports have explored how iron deficiency interacts with another prevalent and severe condition in exercising women: the 'female athlete triad.' This review aims to describe how iron deficiency may interact with each component of the female athlete triad, that is, energy status, reproductive function, and bone health. The effects of iron deficiency on energy status are discussed in regards to thyroid function, metabolic fuel availability, eating behaviors, and energy expenditure. The interactions between iron deficiency and reproductive function are explored by discussing the potentially impaired fertility and hyperprolactinemia due to iron deficiency and the alterations in iron metabolism due to menstrual blood loss and estrogen exposure. The interaction of iron deficiency with bone health may occur via dysregulation of the growth hormone/insulin-like growth factor-1 axis, hypoxia, and hypothyroidism. Based on these discussions, several future directions for research are presented.

  20. Effects of resistance exercise on iron absorption and balance in iron-deficient rats.

    PubMed

    Fujii, Takako; Matsuo, Tatsuhiro; Okamura, Koji

    2014-10-01

    We have previously reported that resistance exercise improved the iron status in iron-deficient rats. The current study investigated the mechanisms underlying this exercise-related effect. Male 4-week-old rats were divided into a group sacrificed at the start (week 0) (n = 7), a group maintained sedentary for 6 weeks (S) or a group that performed exercise for 6 weeks (E), and all rats in the latter groups were fed an iron-deficient diet (12 mg iron/kg) for 6 weeks. The rats in the E group performed climbing exercise (5 min × 6 sets/day, 3 days/week). Compared to the week 0 rats, the rats in the S and E groups showed lower tissue iron content, and the hematocrit, hemoglobin, plasma iron, and transferrin saturation values were all low. However, the tissue iron content and blood iron status parameters, and the whole body iron content measured using the whole body homogenates of the rats, did not differ between the S group and the E group. The messenger RNA (mRNA) expression levels of hepcidin, duodenal cytochrome b, divalent metal transporter 1, and ferroportin 1 did not differ between the S group and the E group. The apparent absorption of iron was significantly lower in the E group than in the S group. Therefore, it was concluded that resistance exercise decreases iron absorption, whereas the whole body iron content is not affected, and an increase in iron recycling in the body seems to be responsible for this effect.

  1. Novel mutation in the TMPRSS6 gene with iron-refractory iron deficiency anemia.

    PubMed

    Kodama, Koya; Noguchi, Atsuko; Adachi, Hiroyuki; Hebiguchi, Miwa; Yano, Michihiro; Takahashi, Tsutomu

    2014-08-01

    Iron-refractory iron deficiency anemia (IRIDA) is a rare autosomal recessive disease characterized by congenital hypochromic microcytic anemia, low transferrin saturation, low serum iron, normal-high serum ferritin, and increased hepcidin. This disease is caused by loss-of-function mutations in TMPRSS6 that lead to high hepcidin and result in severe anemia. We report our experience with an 11-year-old Japanese girl with hypochromic microcytic anemia, low serum iron, and high serum ferritin, with anemia that was refractory to the oral iron that was prescribed frequently from early childhood. Presence of high hepcidin suggested a diagnosis of IRIDA, which was eventually confirmed by identification of a novel homozygous mutation, p.Pro354Leu, in the TMPRSS6 gene. This case suggests that serum hepcidin should be routinely measured for differential diagnosis when patients with IDA are unresponsive to oral iron or have unusual clinical features. © 2014 Japan Pediatric Society.

  2. Iron deficiency occurs frequently in children with cystic fibrosis.

    PubMed

    Uijterschout, Lieke; Nuijsink, Marianne; Hendriks, Daniëlle; Vos, Rimke; Brus, Frank

    2014-05-01

    In adult CF patients iron deficiency (ID) is common and primarily functional due to chronic inflammation. No recent data are available on the cause of ID and iron deficiency anemia (IDA) in children with CF. Over the last decades onset of inflammation and pulmonary disease in children with CF is delayed by improved nutritional status. We questioned whether ID occurs in the same extent among children with CF as in adult CF patients. We therefore conducted a study to investigate the iron status of children with CF and to determine whether ID and IDA are associated with dietary iron intake, lung disease severity and Pseudomonas aeruginosa (PA) infection. Clinical charts of 53 children with CF aged 0-16 were reviewed. Follow-up varied from 1 to 14 years with 343 annual observations in total. Thirty-two children (60.4%) were iron deficient in at least 1 year and ID was present in 84 of 343 observations (24.5%). In 2011 ID was present in 9 children (17.0%). Ten children (18.9%) were anemic in at least 1 year and anemia was present in 13 of 328 observations (4.0%). IDA was present in at least 1 year in 6 children (11.3%). Ferritin (Fer) was positively associated with age. Higher Fer values found in older children represent an increased state of inflammation, rather than an improved iron status, and might increase the relative contribution of functional ID. This study shows that ID is common in relatively healthy, well-nourished children with CF. The mechanism of ID in children with CF is currently unknown. A prospective study using both soluble transferrin receptor and Fer as indicators for ID will provide more insight in the incidence and causes of ID in children with CF.

  3. Switching iron-deficient whole blood donors to plateletpheresis.

    PubMed

    O'Meara, Alix; Infanti, Laura; Sigle, Jörg; Stern, Martin; Buser, Andreas

    2012-10-01

    Iron deficiency is a frequent side effect of whole blood (WB) donation. In contrast, less red blood cell loss and therefore less iron loss results from plateletpheresis. WB donors presenting a decrease in either hemoglobin (Hb) or ferritin levels were offered to switch to plateletpheresis with or without iron supplementation. We analyzed the effect of this intervention on deferral rates for an insufficient Hb level in 168 donors. Further, we assessed how this intervention affected Hb and ferritin levels, anemia occurrence, and platelet (PLT) concentrate yields in the donors who presented at least four successive times for thrombapheresis. Switching WB donors to repetitive plateletpheresis procedures resulted in an increase of median Hb (+12 g/L, p < 0.001) and ferritin (+15.5 ng/mL, p = 0.002) values. Anemia and deferral rates were reduced by 23% (p = 0.004) and 13% (p < 0.001). Between high- and low-frequency apheresis donors, no significant differences in Hb and ferritin levels were found. Similarly, discrepancies in Hb and ferritin values between donors that adopted iron supplementation and those who did not were insignificant. The median PLT concentrate yield was 5.43 × 10(11) PLTs. Switching iron-deficient WB donors to plateletpheresis was an effective intervention that permitted us to correct low Hb and ferritin levels while retaining donors in our pool. © 2012 American Association of Blood Banks.

  4. Serum paraoxonase 1 activity in patients with iron deficiency anemia

    PubMed Central

    Gedikbasi, Asuman; Akalin, Nilgul; Gunaldi, Meral; Yilmaz, Deniz; Mert, Meral; Harmankaya, Ozlem; Soylu, Aliye; Karakaya, Pinar; Kumbasar, Abdulbaki

    2016-01-01

    Introduction In this study we aimed to detect paraoxonase 1 (PON-1) activity in iron deficiency anemia (IDA) and to compare it with healthy controls by observing the change after iron therapy. Material and methods In this study, 50 adult patients with IDA and 40 healthy subjects were enrolled. All patients were analyzed at the beginning and after treatment according to laboratory assessments. Results Mean paraoxonase and arylesterase activities in the iron deficiency anemia group were significantly lower than mean activities of the control group (102.4 ±19.2 U/l and 163.3 ±13.68 U/l, respectively and 157.3 ±26.4 U/l and 256.1 ±24.6 U/l, respectively; p = 0.0001 for both). Paraoxonase and arylesterase activities significantly increased after treatment for IDA (143.2 ±13.9 and 197.6 ±27.9 U/l, respectively, p = 0.0001). Mean activities after treatment with iron were significantly lower than mean activities in the control group (p = 0.002; p = 0.0001 respectively). Conclusions Paraoxonase and arylesterase activities in patients with IDA significantly increased after treatment with iron therapy. In adults IDA may also be one of the factors associated with increased risk of atherosclerosis. PMID:27478448

  5. Iron deficiency stimulates anthocyanin accumulation in grapevine apical leaves.

    PubMed

    Caramanico, Leila; Rustioni, Laura; De Lorenzis, Gabriella

    2017-10-01

    Iron chlorosis is a diffuse disorder affecting Mediterranean vineyards. Beside the commonly described symptom of chlorophyll decrease, an apex reddening was recently observed. Secondary metabolites, such as anthocyanins, are often synthetized to cope with stresses in plants. The present work aimed to evaluate grapevine responses to iron deficiency, in terms of anthocyanin metabolism (reflectance spectrum, total anthocyanin content, HPLC profile and gene expression) in apical leaves of Cabernet sauvignon and Sangiovese grown in hydroponic conditions. Iron supply interruption produced after one month an increasing of anthocyanin content associated to a more stable profile in both cultivars. In Cabernet sauvignon, the higher red pigment accumulation was associated to a lower intensity of chlorotic symptoms, while in Sangiovese, despite the activation of the metabolism, the lower anthocyanin accumulation was associated to a stronger decrease in chlorophyll concentration. Gene expression data showed a significant increase of anthocyanin biosynthesis. The effects on the expression of structural and transcription factor genes of phenylpropanoid pathway were cultivar dependent. F3H, F3'H, F3'5'H and LDOX genes, in Cabernet sauvignon, and AOMT1 and AOMT genes, in Sangiovese, were positively affected by the treatment in response to iron deficiency. All data support the hypothesis of an anthocyanin biosynthesis stimulation rather than a decreased degradation of them due to iron chlorosis. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  6. Iron deficiency suppresses ileal nitric oxide synthase activity.

    PubMed

    Goldblatt, M I; Choi, S H; Swartz-Basile, D A; Nakeeb, A; Sarna, S K; Pitt, H A

    2001-01-01

    Intestinal motility disorders are more common in women of childbearing age who are prone to iron deficiency anemia. The neurotransmitters nitric oxide (NO) and acetylcholine (ACh) play a key role in ileal smooth muscle relaxation and contraction, respectively. Iron-containing heme is known to be a cofactor for nitric oxide synthase (NOS), the enzyme responsible for NO production. Therefore we tested the hypothesis that iron deficiency would downregulate ileal NOS activity without affecting the ileum's response to ACh. Twelve adult female prairie dogs were fed either an iron-supplemented (Fe+) (200 ppm) (n = 6) or an iron-deficient (Fe-) (8 ppm) (n = 6) diet for 8 weeks. Ileal circular muscle strips were harvested to measure responses to ACh and electrical field stimulation. Under nonadrenergic noncholinergic (NANC) conditions, Nomega-nitro-L-arginine (L-NNA), an NOS inhibitor, and VIP(10-28), a vasoactive intestinal peptide (VIP) inhibitor, were added prior to electrical field stimulation. NANC inhibitory responses are expressed as a percentage of optimal relaxation from EDTA. The excitatory response to ACh was similar in both groups (1.1 +/- 0.3 N/cm(2) vs. 1.5 +/- 0.3 N/cm(2), P = 0.45). The inhibitory response to electrical field stimulation under NANC conditions was greater in the Fe+ group (34.7 +/- 2.9%) compared to the Fe- group (23.9 +/- 3.2%; P<0.01). L-NNA eliminated the inhibitory response in the Fe+ group (0.02 +/- 0.02%) but not in the Fe- group (8.38 +/- 2.15%; P <0.01). VIP(10-28) led to greater relaxation in the Fe+ animals (45.8 +/- 6.6%) than in the Fe- animals (23.4 +/- 5.8%; P <0.05). Both L-NNA and VIP(10-28) had no inhibitory response (0.02 +/- 0.02%) in the Fe+ animals, whereas the Fe- animals had some residual inhibition (2.54 +/- 1.04%; P <0.05). These data suggest that ileal NANC relaxation is due to NOS and that iron deficiency results in (1) decreased NANC relaxation, (2) a compensatory relaxation due to a non-NOS, non-VIP mechanism, and

  7. Evaluation of reticulocyte haemoglobin content as marker of iron deficiency and predictor of response to intravenous iron in haemodialysis patients.

    PubMed

    Kim, J M; Ihm, C H; Kim, H J

    2008-02-01

    Because serum ferritin and transferrin saturation (TS) have a limitation in estimating iron status in haemodialysis patients, the reticulocyte haemoglobin content (CHr) has been proposed as a new tool. We investigate the accuracy of CHr in comparison with conventional tests and the relationship between changes in CHr and haemoglobin levels after therapy. We selected 140 haemodialysis patients receiving rHuEPO and intravenous iron supplementation and measured their complete blood count, CHr and iron parameters. Iron deficiency was defined as a ferritin <100 microg/l and/or a TS <20%. Hb, CHr, ferritin and TS levels were determined 1 month after therapy. Fifty-three patients were iron deficient. CHr were distributed with 33.7 +/- 1.4 pg in the iron sufficient group and with 29.9 +/- 1.9 pg in the iron deficient group (P = 0.001). The cutoff value of CHr for detecting iron deficiency was <32.4 pg. In iron deficient patients, a significant correlation was found between CHr and TS. The change in CHr after therapy was significantly larger in iron-deficient patients, and a lower baseline CHr is associated with a greater haemoglobin change. CHr is useful in screening iron status in dialysis patients, and a CHr cut-off value of 32 pg is appropriate for the assessment of iron deficiency. Moreover, CHr may serve as a predictor of the response to anaemia treatment.

  8. Iron deficiency in women and its potential impact on military effectiveness.

    PubMed

    Wilson, Candy; Brothers, Michael

    2010-06-01

    Iron deficiency is recognized as a significant health concern for women of childbearing age in the civilian population. In the military, most women are of childbearing age. Not only do they carry the normal risks for developing iron deficiency, but they also have the added threats of possible decreased choices of food high in iron content, increased physical activity, and weight loss. This can put these women at risk for decreased energy efficiency and impaired cognitive performance. This article describes the pathophysiology of iron deficiency and iron deficiency anemia, the consequences of each, and the need to routinely screen military women for iron depletion. Published by Elsevier Inc.

  9. Oxidative stress, HDL functionality and effects of intravenous iron administration in women with iron deficiency anemia.

    PubMed

    Meroño, Tomás; Dauteuille, Carolane; Tetzlaff, Walter; Martín, Maximiliano; Botta, Eliana; Lhomme, Marie; Saez, María Soledad; Sorroche, Patricia; Boero, Laura; Arbelbide, Jorge; Chapman, M John; Kontush, Anatol; Brites, Fernando

    2017-04-01

    Iron deficiency anemia (IDA) affects around 20-30% of adults worldwide. An association between IDA and cardiovascular disease (CVD) has been reported. Oxidative stress, inflammation and low concentration of high-density lipoproteins (HDL) were implicated on endothelial dysfunction and CVD in IDA. We studied the effects of iron deficiency and of an intravenous iron administration on oxidative stress and HDL characteristics in IDA women. Two studies in IDA women are presented: a case-control study, including 18 patients and 18 age-matched healthy women, and a follow-up study 72hr after the administration of intravenous iron (n = 16). Lipids, malondialdehyde, cholesteryl ester transfer protein (CETP), paraoxonase-1 (PON-1) and HDL chemical composition and functionality (cholesterol efflux and antioxidative activity) were measured. Cell cholesterol efflux from iron-deficient macrophages to a reference HDL was also evaluated. IDA patients showed higher triglycerides and CETP activity and lower HDL-C than controls (all p < 0.001). HDL particles from IDA patients showed higher triglyceride content (+30%,p < 0.05) and lower antioxidative capacity (-23%,p < 0.05). Although HDL-mediated cholesterol efflux was similar between the patients and controls, iron deficiency provoked a significant reduction in macrophage cholesterol efflux (-25%,p < 0.05). Arylesterase activity of PON-1 was significantly lower in IDA patients than controls (-16%,p < 0.05). The intravenous administration of iron was associated with a decrease in malondialdehyde levels and an increase in arylesterase activity of PON-1 (-22% and +18%, respectively, p < 0.05). IDA is associated with oxidative stress and functionally deficient HDL particles. It remains to be determined if such alterations suffice to impair endothelial function in IDA. Copyright © 2016 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  10. Ethylene response factor AtERF72 negatively regulates Arabidopsis thaliana response to iron deficiency.

    PubMed

    Liu, Wei; Li, Qiwei; Wang, Yi; Wu, Ting; Yang, Yafei; Zhang, Xinzhong; Han, Zhenhai; Xu, Xuefeng

    2017-09-23

    Ethylene regulates the plant's response to stress caused by iron (Fe) deficiency. However, specific roles of ERF proteins in response to Fe deficiency remain poorly understood. Here, we investigated the role of ERF72 in response to iron deficiency in Arabidopsis thaliana. In this study, the levels of the ethylene response factor AtERF72 increased in leaves and roots induced under the iron deficient conditions. erf72 mutant plants showed increased growth compared to wild type (WT) when grown in iron deficient medium for 5 d. erf72 mutants had increased root H(+) velocity and the ferric reductase activity, and increase in the expression of the iron deficiency response genes iron-regulated transporter 1 (IRT1) and H(+)-ATPase (HA2) levels in iron deficient conditions. Compared to WT plants, erf72 mutants retained healthy chloroplast structure with significantly higher Fe and Mg content, and decreased chlorophyll degradation gene pheophorbide a oxygenase (PAO) and chlorophyllase (CLH1) expression when grown in iron deficient media. Yeast one-hybrid analysis showed that ERF72 could directly bind to the promoter regions of iron deficiency responses genes IRT1, HA2 and CLH1. Based on our results, we suggest that ethylene released from plants under iron deficiency stress can activate the expression of ERF72, which responds to iron deficiency in the negative regulation. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Intravenous Iron Therapy in Patients with Iron Deficiency Anemia: Dosing Considerations

    PubMed Central

    Koch, Todd A.; Myers, Jennifer; Goodnough, Lawrence Tim

    2015-01-01

    Objective. To provide clinicians with evidence-based guidance for iron therapy dosing in patients with iron deficiency anemia (IDA), we conducted a study examining the benefits of a higher cumulative dose of intravenous (IV) iron than what is typically administered. Methods. We first individually analyzed 5 clinical studies, averaging the total iron deficit across all patients utilizing a modified Ganzoni formula; we then similarly analyzed 2 larger clinical studies. For the second of the larger studies (Study 7), we also compared the efficacy and retreatment requirements of a cumulative dose of 1500 mg ferric carboxymaltose (FCM) to 1000 mg iron sucrose (IS). Results. The average iron deficit was calculated to be 1531 mg for patients in Studies 1–5 and 1392 mg for patients in Studies 6-7. The percentage of patients who were retreated with IV iron between Days 56 and 90 was significantly (p < 0.001) lower (5.6%) in the 1500 mg group, compared to the 1000 mg group (11.1%). Conclusions. Our data suggests that a total cumulative dose of 1000 mg of IV iron may be insufficient for iron repletion in a majority of patients with IDA and a dose of 1500 mg is closer to the actual iron deficit in these patients. PMID:26257955

  12. Iron may play a role in pancreatic atrophy in copper deficiency

    SciTech Connect

    Fields, M.; Lewis, C.G.; Lure, M.D. Dept. of Agriculture, Beltsville, MD Univ. of Maryland, College Park )

    1991-03-15

    The present study was undertaken to determine if pancreatic atrophy in copper deficient rats fed fructose is associated with excessive iron deposition. Weanling male and female rats were fed a copper deficient or copper adequate diet containing 62% carbohydrate as either fructose or starch. Another group of weanling rats consumed a copper deficient diet containing fructose that was low in iron. After consuming their respective diets for five weeks, the highest pancreatic iron concentration was seen in male rats consuming the copper deficient diet containing fructose. These animals also exhibited pancreatic atrophy. In contrast, neither copper deficient female rats fed fructose nor males fed starch exhibited pancreatic atrophy and their pancreata did not contain high levels of iron. In addition, reducing the availability of dietary iron in copper deficient rats fed fructose decreased pancreatic iron concentration and ameliorated the pathology. The data suggest that pancreatic atrophy in copper deficiency may be related to iron deposition in that tissue.

  13. [Advances on the study of iron deficiency and mental development in children].

    PubMed

    Guo, Hongxia; Zeng, Guo; Zhang, Qian

    2012-01-01

    Childhood is a critical period for mental development. Iron deficiency will affect the development of nerve system and depress the learning ability, memory and cognitive function of children. There are a large number of literatures focusing on the mechanism of iron deficiency on mental retardation and the effect of iron reinforcement on iron deficient children in recent years. More attention has been paid to the prevention of iron deficiency. It has been proposed that the prevention of iron deficiency during early life of infants is more important than the reinforcement of iron in childhood. Exploring the relationship between iron deficiency and mental development is very important to improve the intelligence of children and the quality of whole population.

  14. The Iron Supplementation Dose for Perinatal Iron Deficiency Differentially Alters the Neurochemistry of Frontal Cortex and Hippocampus in Adult Rats

    PubMed Central

    Rao, Raghavendra; Tkac, Ivan; Unger, Erica L.; Ennis, Kathleen; Hurst, Amy; Schallert, Timothy; Connor, James; Felt, Barbara; Georgieff, Michael K.

    2013-01-01

    Background Long-term prefrontal cortex and hippocampus-based cognitive deficits are the sequelae of perinatal iron deficiency, despite iron supplementation starting in the newborn period. Whether high dose iron supplementation prevents these deficits is not known. Methods Perinatal iron deficiency was induced in rat pups using low-iron (3 mg/kg diet) diet during gestation until postnatal day (P) 8. Iron was supplemented using standard (40 mg/kg diet) or 10-fold higher (400 mg/kg diet) iron-containing diet until P21. Prefrontal cortex and hippocampal neurochemistry was determined using in vivo 1H nuclear magnetic resonance spectroscopy at 9.4 tesla on P90. Results Both iron supplementation doses corrected anemia and brain iron deficiency by P21. The neurochemical profile of the prefrontal cortex in both supplementation groups was comparable to the control group. In the hippocampus, standard-dose iron supplementation resulted in lower N-acetylaspartate and phosphoethanolamine, and higher N-acetylaspartylglutamate and glycerophosphocholine + phosphocholine concentrations. High-dose iron supplementation resulted in lower phosphoethanolamine and higher glycerophosphocholine + phosphocholine concentrations. Conclusions The iron supplementation dose for perinatal iron deficiency differentially alters the neurochemical profile of the prefrontal cortex and hippocampus in adulthood. The neurochemical changes suggest altered glutamatergic neurotransmission, hypomyelination and abnormal phospholipid metabolism in the formerly iron-deficient hippocampus. PMID:23095980

  15. Effect of maternal iron deficiency anaemia on foetal outcome.

    PubMed

    Rusia, U; Madan, N; Agarwal, N; Sikka, M; Sood, S K

    1995-07-01

    One hundred and two pregnant women and their neonates were examined to evaluate the effect of maternal haemoglobin concentration (Hb. conc) and iron deficiency anaemia on the placental weight and the foetal outcome. Haematological and serum ferritin values were determined. It was observed that 34.3% of the pregnant women were anaemic. Maternal Hb conc. and serum ferritin showed a highly significant correlation (r = 0.40, p < 0.001) indicating that iron deficiency was the most important cause of anaemia amongst them. The maternal Hb conc. showed a significant correlation with placental weight (p < 0.05), birth weight (p < 0.01), Apgar score (p < 0.001) and birth asphyxia. Maternal serum ferritin also correlated positively with cord ferritin (p < 0.001). The study did not reveal any association between high Hb and adverse foetal outcome.

  16. Iron deficiency in adolescent female athletes - is iron status affected by regular sporting activity?

    PubMed

    Sandström, Göran; Börjesson, Mats; Rödjer, Stig

    2012-11-01

    To determine the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) among a group of female athletes and compare with an age-matched group of female nonathletes. To study lifestyle factors that could play a role in the development of ID and IDA and compare these factors between the groups. A controlled clinical trial. A senior high school for athletes in Gothenburg, Sweden. All female athletes at a senior high school for top-level athletes were offered to take part. Fifty-seven female athletes accepted to participate in the study. The control group consisted of a random sample of 130 age-matched nonathlete students; 92 accepted to participate in the study. Intervention was not an actual part of this study but those with ID and IDA were treated with iron by the regular school doctor. Iron deficiency anemia and ID were determined by levels of hemoglobin, serum iron, total iron-binding capacity, transferrin saturation, and serum ferritin. The main result of the study is the finding that ID and IDA are common among young adolescent female athletes and that there was no difference between female athletes and nonathletes. In the athlete group, 30 of 57 individuals (52%) had ID compared with 43 of 92 individuals (48%) in the nonathlete group (P > 0.3). Comparisons of the 2 groups showed no significant difference in hemoglobin (P > 0.30). In total, we found that 5 of 57 athletes (8.6%) had IDA compared with 3 of 92 nonathletes (3.3%), the difference being not statistically significant (P = 0.24). The main finding of this study is that ID and IDA are common among female adolescents but not more common among athletes than nonathletes. The results are despite factors that should favor a better iron status in the athlete group, such as better iron intake and less menstrual bleeding. Other factors that might have an impact on iron balance, must therefore be considered.

  17. Cucumis sativus secretes 4'-ketoriboflavin under iron-deficient conditions.

    PubMed

    Satoh, Junichi; Koshino, Hiroyuki; Sekino, Kouta; Ito, Shinsaku; Katsuta, Ryo; Takeda, Kouji; Yoshimura, Etsuro; Shinmachi, Fumie; Kawasaki, Shinji; Niimura, Youichi; Nukada, Tomoo

    2016-01-01

    A new compound in cucumber, Cucumis sativus, nutrient solution that appears under iron-deficient conditions, but not under ordinary culture conditions, has been revealed by HPLC analysis. The chemical structure of this compound was identified using LC-MS and NMR techniques as that of 4'-ketoriboflavin. This is the first report to show that 4'-ketoriboflavin can be found in metabolites from organisms.

  18. Iron deficiency anaemia in childhood and thyroid function.

    PubMed

    Tienboon, Prasong; Unachak, Kewalee

    2003-01-01

    Studies in animals and adults have indicated iron deficiency anaemia to be associated with altered thyroid hormone metabolism. The aim of the present study was to determine the effect of iron deficiency anaemia on the thyroid function of young children. Concentrations of thyroxine (T4) and triiodothyronine (T3), free thyroid hormones (fT4 and fT3), thyroxine binding globulin (TBG), and thyroid stimulating hormone (TSH) were measured in the basal state and in response to an intravenous bolus of thyrotropin releasing hormone (TRH) in nine children one to three years of age with iron deficiency anaemia (IDA) before and after treatment with oral iron. The results of the anaemic children were also compared to basal and stimulated concentrations of thyroid hormones, TBG, and TSH of eight iron sufficient, age-matched children. Seven of the IDA and 6 of the control children were male. The mean haemoglobin (Hb) and serum ferritin (SF) in the IDA children at baseline were 93g/L (range 81-102) and 6g/L (range 1-12) which increased to 121g/L (range 114-129) and 54g/L (range 19-175), respectively, after a mean of 2.3 months (SD 0.5) of iron therapy. In the control group, mean Hb and SF were 125g/L (range 114-130) and 51 g/L (range 24-144), respectively. The basal values of TBG and thyroid hormones of the IDA children before and after iron treatment were not different from the control children. Similarly, there was no statistical difference in the thyroid hormones in the IDA children before compared to after resolution of the anaemia. Compared to the control children, the TSH response over time to TRH, TSH area under the curve (TSHAUC), and the peak TSH value after stimulation were all lower in the IDA children both before and after resolution of anaemia, but the differences were not significant. Iron therapy and resolution of anaemia had no effect among the IDA children. The time to reach the peak TSH concentration was longer in the IDA children (P=0.08) than the control

  19. [Functional iron deficiency, inflammation and fatigue after radiotherapy].

    PubMed

    Grellier, Noémie; Deray, Gilbert; Yousfi, Amani; Khodari, Wassim; Bouaita, Ryan; Belkacemi, Yazid

    2015-09-01

    Radiation therapy is associated with a fatigue in the majority of patients with a relative variability according to the type of the tumour, comorbidities, associated treatments and the extent of the irradiation. Its origin is multifactorial. One explanation described is that fatigue could be related to the inflammation caused by irradiation exposure. One of the suspected mechanisms is a functional iron deficiency following pro-inflammatory cytokines synthesis, particularly the interleukins 1 and 6. This phenomenon is accompanied by a reduced availability of iron, while iron reserves are normal or increased. Thus, iron inaccessibility induces lower coefficient of transferrin saturation, which can lead to a non-regenerative normocytic or microcytic anaemia. The availability of iron is controlled by hepcidin that is synthesized in the liver as a response to radiation-induced inflammatory. The presence of hepcidin blocks iron absorption in the intestine and decreases its recycling from senescent red blood cells. A direct relationship between elevated levels of hepcidin, inflammation markers and radiation-induced side effects have been reported. The aim of the article is to review the literature related to fatigue in radiotherapy and understand the mechanisms involved or worsening its occurrence to consider better care and improve patients' quality.

  20. Helicobacter pylori Antibodies and Iron Deficiency in Female Adolescents

    PubMed Central

    Sandström, Göran; Rödjer, Stig; Kaijser, Bertil; Börjesson, Mats

    2014-01-01

    Objective Iron deficiency (ID) is a common clinical problem worldwide, affecting primarily females. Helicobacter pylori (HP) infection has been shown to be associated with ID. The objective of this study was to define the prevalence of HP antibodies in female adolescents, and to find out if there was a correlation between HP infection and ID. The secondary aim was to study if regularly performed sporting activity, have any association to HP infection, in itself. Design A controlled clinical trial. Setting A senior high school in Gothenburg, Sweden. Subjects All female athletes at a senior high school for top-level athletes were offered to take part, and 56 athletes took part in the study. The control group consisted of a random sample of age-matched non-athlete students of which 71 entered the study. Main outcome measures Iron deficiency (ID) and iron deficiency anaemia (IDA) were defined by the use of levels of haemoglobin, serum iron, total iron-binding capacity, transferrin saturation, and serum ferritin, as previously described. HP IgG-antibodies were detected by ELISA. Results 18 of 127 (14%) adolescent females had antibodies against HP. Only 3% had IDA, while 50% had ID. In total, 66% of the HP positive females had ID compared to 48% of the negative females (p = 0.203). No correlation between sporting activity and HP infection was found. Regarding ethnicity, 11/28 of subjects from medium-high risk areas were HP-positive, compared to 7/99 coming from low-risk areas (p<0.001). Conclusion The main finding of this study is that the prevalence of HP IgG antibodies was 14% in adolescent females. We could not find any difference regarding frequency of ID and IDA, between HP positive and negative individuals. Ethnicity is of great importance for the risk of HP infection, while sporting activity itself seems to have no association to HP-infection. PMID:25409451

  1. Helicobacter pylori antibodies and iron deficiency in female adolescents.

    PubMed

    Sandström, Göran; Rödjer, Stig; Kaijser, Bertil; Börjesson, Mats

    2014-01-01

    Iron deficiency (ID) is a common clinical problem worldwide, affecting primarily females. Helicobacter pylori (HP) infection has been shown to be associated with ID. The objective of this study was to define the prevalence of HP antibodies in female adolescents, and to find out if there was a correlation between HP infection and ID. The secondary aim was to study if regularly performed sporting activity, have any association to HP infection, in itself. A controlled clinical trial. A senior high school in Gothenburg, Sweden. All female athletes at a senior high school for top-level athletes were offered to take part, and 56 athletes took part in the study. The control group consisted of a random sample of age-matched non-athlete students of which 71 entered the study. Iron deficiency (ID) and iron deficiency anaemia (IDA) were defined by the use of levels of haemoglobin, serum iron, total iron-binding capacity, transferrin saturation, and serum ferritin, as previously described. HP IgG-antibodies were detected by ELISA. 18 of 127 (14%) adolescent females had antibodies against HP. Only 3% had IDA, while 50% had ID. In total, 66% of the HP positive females had ID compared to 48% of the negative females (p = 0.203). No correlation between sporting activity and HP infection was found. Regarding ethnicity, 11/28 of subjects from medium-high risk areas were HP-positive, compared to 7/99 coming from low-risk areas (p<0.001). The main finding of this study is that the prevalence of HP IgG antibodies was 14% in adolescent females. We could not find any difference regarding frequency of ID and IDA, between HP positive and negative individuals. Ethnicity is of great importance for the risk of HP infection, while sporting activity itself seems to have no association to HP-infection.

  2. Comparison of two doses of elemental iron in the treatment of latent iron deficiency: efficacy, side effects and blinding capabilities.

    PubMed

    Leonard, Alecia J; Chalmers, Kerry A; Collins, Clare E; Patterson, Amanda J

    2014-04-04

    Adherence to iron supplementation can be compromised due to side effects, and these limit blinding in studies of iron deficiency. No studies have reported an efficacious iron dose that allows participants to remain blinded. This pilot study aimed to determine a ferrous sulfate dose that improves iron stores, while minimising side effects and enabling blinding. A double-blinded RCT was conducted in 32 women (18-35 years): 24 with latent iron deficiency (serum ferritin < 20 µg/L) and 8 iron sufficient controls. Participants with latent iron deficiency were randomised to 60 mg or 80 mg elemental iron or to placebo, for 16 weeks. The iron sufficient control group took placebo. Treatment groups (60 mg n = 7 and 80 mg n = 6) had significantly higher ferritin change scores than placebo groups (iron deficient n = 5 and iron sufficient n = 6), F(1, 23) = 8.46, p ≤ 0.01. Of the 24 who completed the trial, 10 participants (77%) on iron reported side effects, compared with 5 (45%) on placebo, but there were no differences in side effects (p = 0.29), or compliance (p = 0.60) between iron groups. Nine (69%) participants on iron, and 11 (56%) on placebo correctly guessed their treatment allocation. Both iron doses were equally effective in normalising ferritin levels. Although reported side-effects were similar for both groups, a majority of participants correctly guessed their treatment group.

  3. Iron polymaltose versus ferrous gluconate in the prevention of iron deficiency anemia of infancy.

    PubMed

    Jaber, Lutfi; Rigler, Shmuel; Taya, Ahmad; Tebi, Fadel; Baloum, Mohamad; Yaniv, Isaac; Haj Yehia, Mohamad; Tamary, Hanna

    2010-11-01

    We prospectively compared the efficacy and safety of iron deficiency anemia prophylaxis with iron gluconate (IG) or iron polymaltose complex (IPC) in healthy infants attending a community pediatric center. Participants were randomly assigned to receive one of the test drugs from age 4 to 6 months to age 12 months. Parents/guardians were given extensive information on iron-rich diets and anemia prevention. Main outcome measures were blood levels of hemoglobin, hematocrit, mean corpuscular volume, red blood cell distribution width, and serum iron, ferritin, and transferrin, in addition to adverse effects. One hundred five children completed the study: 53 in the IG group and 52 in the IPC group Mean hemoglobin levels at study end were significantly higher in the IG group (12.04±0.09 g/dL vs. 11.68±0.11, P<0.014). A hemoglobin level <11 g/dL was detected in 3 infants of the IG group, and in 10 infants of the IPC group (P<0.04). Adverse effects (spitting, vomiting, diarrhea, constipation, discolored teeth) were significantly more common in the IG group (47% vs. 25%, P>0.025). In conclusion, both oral IG and IPC prevent iron deficiency anemia in infants. Iron gluconate seems to be more effective but less tolerable.

  4. Proanthocyanidins inhibit iron absorption from soybean (Glycine max) seed ferritin in rats with iron deficiency anemia.

    PubMed

    Yun, Shaojun; Zhang, Tuo; Li, Meiliang; Chen, Bin; Zhao, Guanghua

    2011-09-01

    The objective of this study was to evaluate the effect of proanthocyanidins (PAs) on iron uptake from soybean seed ferritin (SSF) crude by rats with iron deficiency anemia (IDA) for the first time. Six groups of Sprague-Dawley (SD) rats (n = 10) were used, which contain (1) SSF crude group; (2) SSF crude + PAs group; (3) PAs group; (4) FeSO(4) group; (5) iron deficiency control group; and (6) control group. The bioavailability of iron was examined by measuring hemoglobin (Hb) concentration value, red blood cell (RBC) numbers, and serum iron stores. After 8 weeks, Hb concentration was almost recovered to the normal level upon feeding SSF crude or FeSO(4) to rats. In contrast, Hb concentration was recovered to less extent when SSF crude plus PAs was used instead of SSF crude alone (P < 0.05). A similar profile was observed with these three sample groups when serum iron and RBC were used as parameters. All rats in PAs group died at the 8th week. Taken together, all these results demonstrated that PAs inhibited iron uptake of rats from SSF, and are toxic for rats with IDA.

  5. [Iron-deficiency anaemia in patients in their 80s].

    PubMed

    de Rooij, Sophia E; Royen, Hilde; Hamaker, Marije; Blom, Harmjo; Portielje, Johanneke; Bartelsman, Joep F

    2012-01-01

    Iron-deficiency anaemia in very old patients is a frequent finding; this often poses a diagnostic dilemma for the physician. For example, should additional testing take place? And if so, what kind of tests? Is prescribing iron supplement therapy and adopting an expectative course sufficient? The two cases in this article illustrate different treatment strategies. If doubts about which strategy to choose arise, it is recommended that iron first be supplied and the effect of this treatment checked after three weeks. The haemoglobin level should have risen at least 0.7 mmol/l. If there has been no effect, supplemental (endoscopic) examinations may be considered, provided they meet a therapeutic goal.

  6. [Prevalence of iron deficiency in healthy 12-month-old infants].

    PubMed

    Durá Travé, T; Díaz Vélaz, L

    2002-09-01

    Iron deficiency is the most prevalent nutritional deficiency among infants in industrialized countries. There is ample documentation of both short- and long-term adverse effects of iron deficiency. To study the prevalence of iron deficiency in 12-month-old infants and to investigate the influence of several factors (dietary, growth, etc.) on iron status. A random sample of 94 healthy infants from a basic health district was studied. Maternal and perinatal variables, dietary intake and anthropometry were assessed at regular intervals from birth to the age of 12 months. Hemoglobin, mean corpuscular volume, transferrin saturation and serum ferritin were also evaluated. The prevalence of iron deficiency was 9.6 % and that of iron deficiency anemia was 4.3 %. Of the nine infants with iron deficiency, four had been breast-fed for more than 6 months with late introduction of complementary foods and another had not been fed an iron-fortified formula while the 85 children without iron deficiency had received an appropriate diet (p < 0.05). Weight increase in the first year of life was significantly and positively correlated with hemoglobin and serum ferritin. Iron deficiency is relatively common in 12-month-old-infants but is limited to groups with inadequate feeding practices. Iron deficiency screening should be performed only in children with risk factors and/or inadequate diets.

  7. Psychological and electroencephalographic study in school children with iron deficiency.

    PubMed

    Otero, G A; Aguirre, D M; Porcayo, R; Fernández, T

    1999-08-01

    Two groups were chosen from a randomly selected group of one hundred 6-12 years old primary school children. One group was formed by iron deficient (ID), not anemic children, and a control group (C) by iron replete children. Both groups, matched by age, sex, and sociocultural level, were studied using WISC-R, a computerized test of learning (DEL) and a qEEG. The WISC-R test showed that ID children had significantly lower values in WISC items of information, comprehension and verbal, performance and full scale IQ than C children. On the other hand, the EEG power spectrum showed more theta energy in all leads using Laplacian montage and more delta energy in frontal areas using referential montage in ID than in C children. It was found that beside the well known effect of iron deficiency upon intellectual performance during childhood, the EEG power spectrum of ID children had a slower activity than in iron replete children suggesting a developmental lag and/or a CNS dysfunction.

  8. [Treatment of iron deficiency in predialysis state by low molecular weight iron dextran high doses intravenously].

    PubMed

    Fievet, Patrick; Coppin, Mathilde; Brazier, François; Lefèvre, Magali; Stephan, Robin; Demontis, Renato

    2012-02-01

    Anemia is a common complication of chronic kidney disease (CKD) in predialysis stage. Iron deficiency is more common than in normal patients and plays a key role in the genesis of anemia. Its correction avoids the use of erythropoiesis stimulating agents (ESA) or reduces their dosage. Treatment with oral iron is often poorly tolerated and ineffective, necessitating the use of intravenous iron. New forms of injectable iron allow the use of high doses and correct iron deficiency in a single administration with consequent preservation of venous capital and lower costs. We studied the effectiveness of iron dextran of low molecular weight (LMWID) in high doses to correct iron deficiency and treat anemia in predialysis CKD patients. Twenty-nine doses of 500 to 1600 mg were administered to 25 patients followed for CKD (GFR between 60 and 10 ml/min per 1.73 m(2)), selected on biological criteria of iron deficiency defined by a ratio of transferrin saturation (TSAT) <20% and/or serum ferritin of less than 100 μg/L. Patients received treatment by ESA in 16 cases out of 29. One month after treatment, hemoglobin (Hb) increased significantly (11.4±1.6 vs 10.4±1.4 g/dL, P=0.0003) along with a significant increase in TSAT (21.3±7.3 vs 13.3±3.8%, P=0.000003) and serum ferritin (286±253 vs 91±60 μg/L, P=0.00005). Six patients had a serum ferritin greater than 500 μg/L after treatment, which may put them at risk of iron overload. Their serum ferritin was higher than the rest of the population before treatment, while the TSAT was no different, reflecting a functional deficiency. Their hemoglobin did not increase after treatment in contrast to the rest of the population suggesting the unavailability of iron for erythropoiesis with accumulation in the reticuloendothelial system. Renal function did not change significantly and there were no cases of acute renal failure. No immediate side effect was observed. Three patients presented delayed reactions to such self

  9. Nuclear magnetic resonance metabolomics of iron deficiency in soybean leaves.

    PubMed

    Lima, Marta R M; Diaz, Sílvia O; Lamego, Inês; Grusak, Michael A; Vasconcelos, Marta W; Gil, Ana M

    2014-06-06

    Iron (Fe) deficiency is an important agricultural concern that leads to lower yields and crop quality. A better understanding of the condition at the metabolome level could contribute to the design of strategies to ameliorate Fe-deficiency problems. Fe-sufficient and Fe-deficient soybean leaf extracts and whole leaves were analyzed by liquid (1)H nuclear magnetic resonance (NMR) and high-resolution magic-angle spinning NMR spectroscopy, respectively. Overall, 30 compounds were measurable and identifiable (comprising amino and organic acids, fatty acids, carbohydrates, alcohols, polyphenols, and others), along with 22 additional spin systems (still unassigned). Thus, metabolite differences between treatment conditions could be evaluated for different compound families simultaneously. Statistically relevant metabolite changes upon Fe deficiency included higher levels of alanine, asparagine/aspartate, threonine, valine, GABA, acetate, choline, ethanolamine, hypoxanthine, trigonelline, and polyphenols and lower levels of citrate, malate, ethanol, methanol, chlorogenate, and 3-methyl-2-oxovalerate. The data indicate that the main metabolic impacts of Fe deficiency in soybean include enhanced tricarboxylic acid cycle activity, enhanced activation of oxidative stress protection mechanisms and enhanced amino acid accumulation. Metabolites showing accumulation differences in Fe-starved but visually asymptomatic leaves could serve as biomarkers for early detection of Fe-deficiency stress.

  10. Proline synthesis in barley under iron deficiency and salinity.

    PubMed

    Arias-Baldrich, Cirenia; Bosch, Nadja; Begines, Digna; Feria, Ana B; Monreal, José A; García-Mauriño, Sofía

    2015-07-01

    This work investigates proline synthesis in six barley varieties subjected to iron deficiency, salinity or both stresses. The highest growth under Fe sufficiency corresponded to Belgrano and Shakira. A moderate augment of leaf phosphoenolpyruvate carboxylase (PEPC) activity was observed in all six varieties in response to Fe deficiency, consistently in leaves and sporadically in roots. All six varieties accumulated proline under Fe deficiency, to a higher extent in leaves than in roots. The decrease of Fe supply from 100 μM NaFe(III)-EDTA to 0.5 μM NaFe(III)-EDTA reduced growth and photosynthetic pigments similarly in the six barley varieties. On the contrary, differences between varieties could be observed with respect to increased or, conversely, decreased proline content as a function of the amount of NaFe(III)-EDTA supplied. These two opposite types were represented by Belgrano (higher proline under Fe deficiency) and Shakira (higher proline under Fe sufficiency). Time-course experiments suggested that leaf PEPC activity was not directly responsible for supplying C for proline synthesis under Fe deficiency. High proline levels in the leaves of Fe-deficient Belgrano plants in salinity were associated to a better performance of this variety under these combined stresses.

  11. Iron deficiency anaemia in pregnancy and postpartum: pathophysiology and effect of oral versus intravenous iron therapy.

    PubMed

    Khalafallah, Alhossain A; Dennis, Amanda E

    2012-01-01

    Nutritional iron-deficiency anaemia (IDA) is the most common disorder in the world, affecting more than two billion people. The World Health Organization's global database on anaemia has estimated a prevalence of 14% based on a regression-based analysis. Recent data show that the prevalence of IDA in pregnant women in industrialized countries is 17.4% while the incidence of IDA in developing countries increases significantly up to 56%. Although oral iron supplementation is widely used for the treatment of IDA, not all patients respond adequately to oral iron therapy. This is due to several factors including the side effects of oral iron which lead to poor compliance and lack of efficacy. The side effects, predominantly gastrointestinal discomfort, occur in a large cohort of patients taking oral iron preparations. Previously, the use of intravenous iron had been associated with undesirable and sometimes serious side effects and therefore was underutilised. However, in recent years, new type II and III iron complexes have been developed, which offer better compliance and toleration as well as high efficacy with a good safety profile. In summary, intravenous iron can be used safely for a rapid repletion of iron stores and correction of anaemia during and after pregnancy.

  12. Iron deficiency enhances bioactive phenolics in lemon juice.

    PubMed

    Mellisho, Carmen D; González-Barrio, Rocío; Ferreres, Federico; Ortuño, María F; Conejero, Wenceslao; Torrecillas, Arturo; García-Mina, José M; Medina, Sonia; Gil-Izquierdo, Angel

    2011-09-01

    This study was designed to describe the phenolic status of lemon juice obtained from fruits of lemon trees differing in iron (Fe) nutritional status. Three types of Fe(III) compound were used in the experiment, namely a synthetic chelate and two complexes derived from natural polymers of humic and lignine nature. All three Fe(III) compounds were able to improve the Fe nutritional status of lemon trees, though to different degrees. This Fe(III) compound effect led to changes in the polyphenol content of lemon juice. Total phenolics were decreased (∼33% average decrease) and, in particular, flavanones, flavones and flavonols were affected similarly. Iron-deficient trees showed higher phenolic contents than Fe(III) compound-treated trees, though Fe deficiency had negative effects on the yield and visual quality of fruits. However, from a human nutritional point of view and owing to the health-beneficial properties of their bioavailable phenolic compounds, the nutritional quality of fruits of Fe-deficient lemon trees in terms of phenolics was higher than that of fruits of Fe(III) compound-treated lemon trees. Moreover, diosmetin-6,8-di-C-glucoside in lemon juice can be used as a marker for correction of Fe deficiency in lemon trees. Copyright © 2011 Society of Chemical Industry.

  13. The effect of iron treatment on adhesion molecules in patients with iron deficiency anemia.

    PubMed

    Yuksel, Arif; Kebapcilar, Levent; Erdur, Erkan; Bozkaya, Giray; Sari, Ismail; Alacacioglu, Ahmet; Kebapcilar, Ayse Gul; Sop, Gulten

    2010-12-01

    The present study was aimed to determine the effect of iron supplementation on levels of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) in patients with iron deficiency anemia (IDA). In this study, 26 female patients diagnosed with iron deficiency were treated approximately 3 months of oral iron supplementation (99 ± 10 days; ferrous glycine sulfate; 100 mg/day of elemental iron). Levels of sICAM-1 and sVCAM-1 were assessed prior to treatment and after approximately 3 months of treatment and compared with 26 healthy female subjects. A significant increase in sVCAM levels was found in the patients with iron deficiency at the end of the treatment relative to pretreatment levels compared to controls, whereas no significant differences were determined in sICAM levels. In the posttreatment period, no significant change was observed in sICAM levels compared to the pretreatment levels, whereas sVCAM levels decreased. However, after the treatment period, the sVCAM, hemoglobin, mean corpuscular volume (MCV), and serum ferritin levels did not return to the normal range compared to the controls. Pretreatment sVCAM-1 levels were inversely correlated with levels of hemoglobin, hemotocrit, MCV, serum iron, and ferritin. After treatment, the sVCAM-1 levels were negatively correlated with ferritin levels. Levels of sVCAM were significantly higher in patients with IDA than controls. After the treatment period, the sVCAM levels were not completely normalized in patients with IDA compared to controls, regardless of the presence of inadequate levels of hemoglobin, MCV, and serum ferritin. Thus, iron supplementation not only ameliorates anemia, but may also reduce the inflammation markers in cases with IDA.

  14. Iron deficiency, but not anemia, upregulates iron absorption in breast-fed peruvian infants.

    PubMed

    Hicks, Penni D; Zavaleta, Nelly; Chen, Zhensheng; Abrams, Steven A; Lönnerdal, Bo

    2006-09-01

    Iron absorption in adults is regulated by homeostatic mechanisms that decrease absorption when iron status is high. There are few data, however, regarding the existence of a similar homeostatic regulation in infants. We studied 2 groups of human milk-fed infants using (57)Fe (given as ferrous sulfate without any milk) and (58)Fe (given at the time of a breast-milk feeding) stable isotopes to determine whether healthy infants at risk for iron deficiency would regulate their iron absorption based on their iron status. We studied 20 Peruvian infants at 5-6 mo of age and 18 infants at 9-10 mo of age. We found no effect of infant hemoglobin concentration on iron absorption with 5-6 mo-old infants absorbing 19.2 +/- 2.1% and 9- to 10-mo-old infants absorbing 25.8 +/- 2.6% of the (57)Fe dose. For (58)Fe, 5- to 6-mo-old infants absorbed 42.6 +/- 5.0% and 9 to 10-mo-old infants absorbed 51.9 +/- 10.3%. Following log transformation, iron absorption from (57)Fe (r = -0.61, P = < 0.001) and (58)Fe (r = -0.61, P = < 0.001) were inversely correlated to serum ferritin (S-Ft). For both the (57)Fe and (58)Fe doses, infants with S-Ft <12 mg/L (n = 11) had significantly higher iron absorption than those with S-Ft >12 mg/L. We concluded that iron absorption in infants is related to iron status as assessed by serum ferritin but not hemoglobin concentration. Infants with low iron status upregulate iron absorption from breast milk at both 5-6 and 9-10 mo of age.

  15. IV Ferric Carboxymaltose Vs Oral Iron in the Treatment of Post-partum Iron Deficiency Anaemia

    PubMed Central

    Thunga, Suchitra

    2016-01-01

    Introduction Iron deficiency is the most common cause of Post-partum anaemia, reported as 50-60% in India. It is primarily due to inadequate iron intake and due to peripartum blood loss. It has been associated with significant post-partum complications. Therefore, Post-partum iron deficiency warrants greater attention and higher quality care. Oral iron treatment has been considered the standard of care. However, parenteral iron treatment is expected to be advantageous in cases where oral iron therapy is not possible. As a result, there is increased interest in parenteral iron therapy. Recently, a new parenteral iron preparation, Ferric Carboxy Maltose (FCM), was developed to facilitate effective treatment of Iron Deficiency Anaemia (IDA). This study was carried out in women with Post-partum IDA who were expected to benefit from the short treatment period permitted by the larger doses given parenterally. Aim To evaluate the efficacy, safety and tolerability of intra venous FCM compared to oral iron in treating Post-partum IDA patients. Materials and Methods This was a hospital based prospective comparative study. Women with Haemoglobin (Hb) between 7-10 g/dl and peripheral smear showing microcytic hypochromic anaemia on the first Post-partum day were included in the study. These women were randomised to receive either IV FCM (single dose 1000 mg) or oral ferrous ascorbate (100 mg twice daily for 6 weeks). Statistical analysis was done by student’s paired and unpaired t-test and by chi- square test and fischer-exact t-test. Results Ninety patients (45 in each group) were followed at one week and six weeks from the start of treatment and their Hb were estimated. Significant rise in Hb was observed in subjects treated with FCM compared to oral iron. FCM treated subjects were more likely to achieve an Hb rise greater than or equal to 3.0 g/dL. FCM was better tolerated with complete adherence to treatment as compared to oral ferrous ascorbate. Conclusion FCM showed

  16. Association between functional iron deficiency and reactive thrombocytosis in hospitalised patients: a case-control study.

    PubMed

    Nicola, H; Ho, K M; Cordingley, F

    2016-11-01

    The association of deficiency in total body iron with an increased risk of reactive thrombocytosis is well known, but whether 'functional iron deficiency' is also associated with reactive thrombocytosis is unknown. This retrospective case-control study assessed the relationships between functional iron deficiency, reactive thrombocytosis and risk of thromboembolism. A total of 150 patients with reactive thrombocytosis (platelet count >400 x 10(9)/l) and 343 controls (platelet count <400 x 10(9)/l) were selected from the hospital laboratory database system. Patients with haematological disease or recent chemotherapy were excluded. Reactive thrombocytosis, infection, and an elevated C-reactive protein (CRP) concentration were all significantly more common in patients with functional iron deficiency than in those without functional iron deficiency (all P <0.01). After adjusting for infection and CRP concentration, functional iron deficiency was the only marker of iron status significantly associated with reactive thrombocytosis (odds ratio 1.66, 95% confidence interval 1.10-2.75; P=0.048). Thromboembolic events occurred in 32 patients (6.6%). This was not significantly associated with functional iron deficiency. Our results suggest that in patients without haematological malignancy or recent chemotherapy there might be a link between functional iron deficiency and reactive thrombocytosis. Whether treating patients with functional iron deficiency with intravenous iron corrects reactive thrombocytosis without inducing infection remains uncertain, but merits further investigation.

  17. The assessment of frequency of iron deficiency in athletes from the transferrin receptor-ferritin index.

    PubMed

    Malczewska, J; Szczepańska, B; Stupnicki, R; Sendecki, W

    2001-03-01

    The transferrin receptor-ferritin index (sTfR/logFerr) was determined in 131 male and 121 female athletes in order to assess the frequency of iron deficiency (threshold value of that index taken as 1.8). Blood was drawn for determining morphological indices as well as sTfR, ferritin, iron, total iron binding capacity (TIBC), and haptoglobin. A significantly (p <.01) higher incidence of iron deficiency was observed in women (26%) than in men (11%). The iron deficiency was latent, since no subject was found to be anemic. The plasma iron was significantly lower and TIBC higher (p <.001) in both iron-deficient subgroups than in the non-deficient ones. This confirmed the latent character of iron deficiency. Some hematological indices (Hb, MCH, MCHC, MCV) were significantly lower in iron-deficient female athletes than in male athletes, which suggested a more profound iron deficiency in the former. The sTfR/logFerr index might thus be useful in detecting iron deficiency in athletes, especially in those with erythropoiesis disorders, since physical loads may affect the widely used ferritin levels.

  18. Iron deficiency anaemia among apparently healthy pre-school children in Lagos, Nigeria.

    PubMed

    Akodu, Olufemi S; Disu, Elizabeth A; Njokanma, Olisamedua F; Kehinde, Omolara A

    2016-03-01

    Iron deficiency, and specifically iron deficiency anaemia, remains one of the most severe and important nutritional deficiencies in the world today. To estimate the prevalence and associated factors for iron deficiency anaemia among pre-school children in Lagos. The study was conducted from December 2009 to February 2010 at the outpatient clinics of Lagos State University Teaching Hospital, Lagos. Serum iron, total iron binding capacity, transferrin saturation and serum ferritin were assayed in subjects. The primary outcome measured was iron deficiency anaemia established based on the following criteria: hemoglobin <11.0 g/dl1 plus 2 or more of the following: MCV <70fl, transferrin saturation <10% or serum ferritin <15ng/dL. Statistical analysis included Pearson Chi square analysis and logistic regression analysis. A total of 87 apparently healthy subjects were recruited. Only one subject had iron depletion and this child belonged to the ≤ 2 years age category. None of the recruited subjects had iron deficiency without anaemia. Nine of the study subjects (10.11%) had iron deficiency anaemia. The prevalence of iron deficiency anaemia was significantly higher among younger age group than in the older age group (19.1% Vs 2.1%, p = 0.022). The prevalence of iron deficiency anaemia was significantly higher among subjects with weight-for-age, and weight-for-height Z scores below two standard scores (83.3% and 75.0% respectively, p = <0.001 and 0.001 respectively). The overall prevalence of iron deficiency anaemia among study subjects was 10.11%. Iron deficiency anaemia was more common in children aged two years and below. Weight-for-age and weight-for-height Z scores below minus two standard scores were strongly associated with iron deficiency anaemia.

  19. Effect of iron deficiency on the response of mouse lymphocytes to concanavalin A: the importance of transferrin-bound iron.

    PubMed Central

    Mainou-Fowler, T; Brock, J H

    1985-01-01

    The in vitro response to Con A of lymphocytes from iron-deficient and normal mice in media containing either 10% fetal calf serum, apotransferrin or 20% iron-saturated transferrin was similar for the iron-deficient and control groups. However, the degree of proliferation in serum-free medium containing apotransferrin was significantly lower in all groups, compared to the responses in media containing either 20% iron-saturated transferrin or 10% fetal calf serum. Proliferation of lymphocytes from normal, iron-deficient or iron-repleted mice was lower in media supplemented with serum from iron-deficient mice than when serum from normal or iron-repleted mice was used. Addition of sufficient iron to bring the iron level of the deficient serum to that of normal serum significantly improved its ability to promote proliferation, while in vivo repletion of iron-deficient mice resulted in a restoration of normal lymphocyte responses to Con A. The proportion of cells positive for Thy 1.2, Ly 1 and Ly 2 antigens did not differ significantly between any groups of mice. Protein synthesis by cells proliferating in serum-free medium containing apotransferrin or 20% iron-saturated transferrin was the same in all groups of mice. These results indicate that decreased lymphocyte proliferative responses in iron deficiency may be due to inadequate levels of circulating transferrin-bound iron, rather than to intrinsic defects in the cells themselves or changes in the proportions of different T-cell subsets, and that iron availability does not affect protein synthesis by proliferating lymphocytes. PMID:3871421

  20. Lower incidence of respiratory infections among iron-deficient children in Kilimanjaro, Tanzania.

    PubMed

    Wander, Katherine; Shell-Duncan, Bettina; Brindle, Eleanor

    2017-01-01

    Objective: We posited a trade-off in iron nutrition, with iron deficiency decreasing risk for infection by depriving infectious agents of iron while increasing risk for infection by compromising immune protection. We described associations between iron deficiency and prevalent and incident infectious disease episodes and cell-mediated immunity (CMI) among 283 children in Kilimanjaro, Tanzania. Methodology: Whole blood specimens were evaluated for hemoglobin and dried blood spots (DBS) were evaluated for biomarkers of iron deficiency (transferrin receptor) and inflammation (C-reactive protein and α1-acid glycoprotein). Prevalent and incident infectious disease episodes were identified by physician's diagnosis. CMI was evaluated as delayed-type hypersensitivity to Candida albicans (DTH-Candida). Associations between iron status and elevated inflammation, prevalent infectious disease episodes and DTH-Candida were described with logistic regression models; associations between iron status and incident infectious disease episodes were described with Cox proportional hazards models. Results: Elevated inflammation and diagnosed infectious diseases were more common among children with iron-deficiency anemia (IDA, severe iron deficiency), but not significantly so. The incidence of infectious disease was lowest among children with moderate iron deficiency (iron-deficient erythropoiesis, IDE); this pattern was most apparent for respiratory infections (aHR: 0.24; p: 0.030). DTH-Candida was not compromised among children with any degree of iron deficiency. Conclusions and implications: We observed no adverse effect of iron deficiency on CMI, but did observe patterns consistent with the hypothesis that moderate iron deficiency protects against respiratory infections and may represent a nutritional adaptation to infectious disease. This suggests that interventions targeting iron deficiency should be coupled with effective infectious disease control measures.

  1. Effect of Maternal Iron Deficiency Anemia on the Iron Store of Newborns in Ethiopia

    PubMed Central

    Birhanu, Asaye; Nigussie, Paulos; Tsegaye, Aster

    2015-01-01

    Iron deficiency anemia among pregnant women is a widespread problem in developing countries including Ethiopia, though its influence on neonatal iron status was inconsistently reported in literature. This cross-sectional study was conducted to compare hematologic profiles and iron status of newborns from mothers with different anemia status and determine correlation between maternal and neonatal hematologic profiles and iron status in Ethiopian context. We included 89 mothers and their respective newborns and performed complete blood count and assessed serum ferritin and C-reactive protein levels from blood samples collected from study participants. Maternal median hemoglobin and serum ferritin levels were 12.2 g/dL and 47.0 ng/mL, respectively. The median hemoglobin and serum ferritin levels for the newborns were 16.2 g/dL and 187.6 ng/mL, respectively. The mothers were classified into two groups based on hemoglobin and serum ferritin levels as iron deficient anemic (IDA) and nonanemic (NA) and newborns of IDA mothers had significantly lower levels of serum ferritin (P = 0.017) and hemoglobin concentration (P = 0.024). Besides, newborns' ferritin and hemoglobin levels showed significant correlation with maternal hemoglobin (P = 0.018; P = 0.039) and ferritin (P = 0.000; P = 0.008) levels. We concluded that maternal IDA may have an effect on the iron stores of newborns. PMID:25734012

  2. The strategies to reduce iron deficiency in blood donors randomized trial: design, enrolment and early retention.

    PubMed

    Bialkowski, W; Bryant, B J; Schlumpf, K S; Wright, D J; Birch, R; Kiss, J E; D'Andrea, P; Cable, R G; Spencer, B R; Vij, V; Mast, A E

    2015-02-01

    Repeated blood donation produces iron deficiency. Changes in dietary iron intake do not prevent donation-induced iron deficiency. Prolonging the interdonation interval or using oral iron supplements can mitigate donation-induced iron deficiency. The most effective operational methods for reducing iron deficiency in donors are unknown. 'Strategies To Reduce Iron Deficiency' (STRIDE) was a two-year, randomized, placebo-controlled study in blood donors. 692 donors were randomized into one of two educational groups or one of three interventional groups. Donors randomized to educational groups either received letters thanking them for donating, or, suggesting iron supplements or delayed donation if they had low ferritin. Donors randomized to interventional groups either received placebo, 19-mg or 38-mg iron pills. Iron deficient erythropoiesis was present in 52·7% of males and 74·6% of females at enrolment. Adverse events within 60 days of enrolment were primarily mild gastrointestinal symptoms (64%). The incidence of de-enrolment within 60 days was more common in the interventional groups than in the educational groups (P = 0·002), but not more common in those receiving iron than placebo (P = 0·68). The prevalence of iron deficient erythropoiesis in donors enrolled in the STRIDE study is comparable to previously described cohorts of regular blood donors. De-enrolment within 60 days was higher for donors receiving tablets, although no more common in donors receiving iron than placebo. © 2014 International Society of Blood Transfusion.

  3. [Anemia and iron deficiency in children with chronic respiratory diseases].

    PubMed

    Barja, Salesa; Capo, Eduardo; Briceño, Lilian; Jakubson, Leticia; Méndez, Mireya; Becker, Ana

    2013-01-01

    Children with chronic respiratory disease (CRD) are at increased risk of iron deficiency and anemia, which is under-diagnosed. To describe the iron (Fe) status in children with CRD and to evaluate the effects of its prophylactic indication. Prospective study of children with CRD and adequate Fe intake in the diet. At baseline we measured hemogram, C-reactive protein and Fe profile. Subsequently, those with normal plasma hemoglobin (Hb) were not supplemented with Fe (Group A) and those with iron deficiency anemia or at risk of developing it (group B) were supplemented. We evaluated them 3 months later and, after supplementing all, at 4th month. Of 40 patients, median 30 months old (0.5 to 178), 60% were male, 80% eutrophic. Ventilation or oxygen were required in 45%. Diagnoses: 50% Chronic Lung Damage, 17.5% airway diseases, 10% Bronchopulmonary Dysplasia, 7.5% Cystic Fibrosis and 13.5% other. At baseline 20% were anemic (mostly ferropenic) and 12.5% had an abnormal iron profile. At all, 25 children completed the study: in group A, serum ferritin decreased to 3(th) month (-22.9 ± 30) and incremented to 4(th)month (+12.8 ± 26) μg/L (p = 0.013), without difference in Hb. Group B had a rise in Hb (91 ± 12 to 102 ± 12% of the mean for age, p = 0.04). Anemia and ferropenia are frequent in children with CRD. Decrease of their iron reserves can be prevented if they are supplemented. We suggest monitoring properly and treating early or supplement them prophylactically. Copyright © AULA MEDICA EDICIONES 2013. Published by AULA MEDICA. All rights reserved.

  4. Intravenous Iron Repletion Does Not Significantly Decrease Platelet Counts in CKD Patients with Iron Deficiency Anemia

    PubMed Central

    Dossabhoy, Neville R.; Gascoyne, Rebecca; Turley, Steven

    2013-01-01

    Purpose. We sought to investigate the effect of IV iron repletion on platelet (PLT) counts in CKD patients with iron deficiency anemia (IDA). Methods. We conducted a retrospective chart review, including all patients with CKD and IDA who were treated with iron dextran total dose infusion (TDI) between 2002 and 2007. Patient demographics were noted, and laboratory values for creatinine, hemoglobin (Hgb), iron stores and PLT were recorded pre- and post-dose. Results. 153 patients received a total of 251 doses of TDI (mean ± SD = 971 ± 175 mg); age 69 ± 12 years and Creatinine 3.3 ± 1.9 mg/dL. All CKD stages were represented (stage 4 commonest). Hgb and Fe stores improved post-TDI (P ≪ 0.001). There was a very mild decrease in PLT (pre-TDI 255 versus post-TDI 244, P = 0.30). The mild reduction in PLT after TDI remained non-significant (P > 0.05) when data was stratified by molecular weight (MW) of iron dextran used (low versus high), as well as by dose administered (<1000 versus ≥1000 mg). Linear regression analysis between pre-dose PLT and Tsat and Fe showed R2 of 0.01 and 0.04, respectively. Conclusion. Correction of iron deficiency did not significantly lower PLT in CKD patients, regardless of MW or dose used. Correlation of PLT to severity of iron deficiency was very weak. PMID:23476772

  5. Intravenous Iron Repletion Does Not Significantly Decrease Platelet Counts in CKD Patients with Iron Deficiency Anemia.

    PubMed

    Dossabhoy, Neville R; Gascoyne, Rebecca; Turley, Steven

    2013-01-01

    Purpose. We sought to investigate the effect of IV iron repletion on platelet (PLT) counts in CKD patients with iron deficiency anemia (IDA). Methods. We conducted a retrospective chart review, including all patients with CKD and IDA who were treated with iron dextran total dose infusion (TDI) between 2002 and 2007. Patient demographics were noted, and laboratory values for creatinine, hemoglobin (Hgb), iron stores and PLT were recorded pre- and post-dose. Results. 153 patients received a total of 251 doses of TDI (mean ± SD = 971 ± 175 mg); age 69 ± 12 years and Creatinine 3.3 ± 1.9 mg/dL. All CKD stages were represented (stage 4 commonest). Hgb and Fe stores improved post-TDI (P ≪ 0.001). There was a very mild decrease in PLT (pre-TDI 255 versus post-TDI 244, P = 0.30). The mild reduction in PLT after TDI remained non-significant (P > 0.05) when data was stratified by molecular weight (MW) of iron dextran used (low versus high), as well as by dose administered (<1000 versus ≥1000 mg). Linear regression analysis between pre-dose PLT and Tsat and Fe showed R2 of 0.01 and 0.04, respectively. Conclusion. Correction of iron deficiency did not significantly lower PLT in CKD patients, regardless of MW or dose used. Correlation of PLT to severity of iron deficiency was very weak.

  6. Prevalence of iron deficiency in children with Down syndrome.

    PubMed

    Dixon, Natalia E; Crissman, Blythe G; Smith, P Brian; Zimmerman, Sherri A; Worley, Gordon; Kishnani, Priya S

    2010-12-01

    To determine the prevalence of iron deficiency (ID) and iron deficiency anemia (IDA) in a sample of children with Down syndrome (DS) and to evaluate the effect of macrocytosis on the diagnosis of ID/IDA in these children. Children with DS ≥ 12 months of age who were followed at the Duke University Medical Center Comprehensive DS Clinic from December 2004 to March 2007 were screened for ID/IDA with a complete blood count, reticulocyte count, iron panel, and erythrocytic protoporphyrins. A total of 114 children were enrolled, with a median age of 4.7 years. ID was identified in 12 subjects (10%), and IDA was identified in 3 subjects (3%). ID/IDA would not have been accurately diagnosed in 13 of 15 subjects (86%) if red blood cell (RBC) indices alone had been used for screening. Abnormal RBC indices with low transferrin saturation were 100% sensitive for ID/ IDA screening. Prevalence of ID/IDA in children with DS was comparable with that in the general pediatric population. Macrocytosis had implications for screening of ID/IDA with only RBC indices. We suggest ID/IDA screening in DS children be done with a laboratory panel at least including complete blood count, reticulocyte count, transferrin saturation, and serum ferritin. Copyright © 2010 Mosby, Inc. All rights reserved.

  7. Nutritional deficiencies in iron overloaded patients with hemoglobinopathies.

    PubMed

    Claster, Susan; Wood, John C; Noetzli, Leila; Carson, Susan M; Hofstra, Thomas C; Khanna, Rachna; Coates, Thomas D

    2009-06-01

    One of the hallmarks of both sickle cell disease (SCD) and thalassemia major (TM) is accelerated oxidative damage. Decreased antioxidant levels and increased oxidant stress biomarkers are found in both diseases. Although isolated vitamin deficiencies have been reported in TM and nontransfused SCD patients, a comprehensive evaluation of vitamin and trace mineral levels has never been performed in chronically transfused SCD or TM patients. As vitamins and trace minerals may be consumed as a result of chronic oxidative stress; we hypothesized that levels of these compounds would correlate with surrogates of iron overload, hemolysis, and inflammation in chronically transfused patients. Using a convenience sample of our group of chronically transfused patients we studied 43 patients with SCD (17 male, 26 female) and 24 patients with TM (13 male and 11 female). The age range for our patients varied from 1.5 to 31.4 years. Levels of vitamins A, thiamin, B6, B12, C, D, E as well as selenium, zinc, copper, and ceruloplasmin were measured. We found that 40-75% of the patients were deficient in A, C, D and selenium and 28-38% of the patients had low levels of B vitamins and folate. There was little association with iron overload, hemolysis, or inflammation. Although the precise mechanism of these deficiencies is unclear, they may contribute to the morbidity of chronically transfused hemoglobinopathy patients.

  8. Fetal and neonatal iron deficiency but not copper deficiency increases vascular complexity in the developing rat brain.

    PubMed

    Bastian, Thomas W; Santarriaga, Stephanie; Nguyen, Thu An; Prohaska, Joseph R; Georgieff, Michael K; Anderson, Grant W

    2015-01-01

    Anemia caused by nutritional deficiencies, such as iron and copper deficiencies, is a global health problem. Iron and copper deficiencies have their most profound effect on the developing fetus/infant, leading to brain development deficits and poor cognitive outcomes. Tissue iron depletion or chronic anemia can induce cellular hypoxic signaling. In mice, chronic hypoxia induces a compensatory increase in brain blood vessel outgrowth. We hypothesized that developmental anemia, due to iron or copper deficiencies, induces angiogenesis/vasculogenesis in the neonatal brain. To test our hypothesis, three independent experiments were performed where pregnant rats were fed iron- or copper-deficient diets from gestational day 2 through mid-lactation. Effects on the neonatal brain vasculature were determined using quantitative real-time polymerase chain reaction to assess mRNA levels of angiogenesis/vasculogenesis-associated genes and GLUT1 immunohistochemistry to assess brain blood vessel density and complexity. Iron deficiency, but not copper deficiency, increased mRNA expression of brain endothelial cell- and angiogenesis/vasculogenesis-associated genes (i.e. Glut1, Vwf, Vegfa, Ang2, Cxcl12, and Flk1) in the neonatal brain, suggesting increased cerebrovascular density. Iron deficiency also increased hippocampal and cerebral cortical blood vessel branching by 62 and 78%, respectively. This study demonstrates increased blood vessel complexity in the neonatal iron-deficient brain, which is likely due to elevated angiogenic/vasculogenic signaling. At least initially, this is probably an adaptive response to maintain metabolic substrate homeostasis in the developing iron-deficient brain. However, this may also contribute to long-term neurodevelopmental deficits.

  9. Phenotypic expression of hemoglobin A2 in beta-thalassemia trait with iron deficiency.

    PubMed

    Madan, N; Sikka, M; Sharma, S; Rusia, U

    1998-09-01

    Iron status was estimated in 463 heterozygous beta-thalassemics to delineate the effect of iron deficiency on the expression of hemoglobin A2 (HbA2) in these patients. One hundred and twenty-six (27.2%) patients with the trait were iron deficient. These iron-deficient patients had a significantly (p < 0.0002) higher prevalence of anemia (90.5%) compared with iron-replete patients with the trait (71.5%). The mean hemoglobin (Hb) concentration, MCV, and MCH were significantly (p < 0.0001) lower in patients with beta-thalassemia traits (BTT) who had iron deficiency than in those without iron deficiency. Mean RBC count and MCHC did not differ in the two groups. Mean HbA2 was not significantly different in the two groups of patients with the trait and was elevated (>3.5%) in all but one heterozygote investigated. Mean HbA2/cell was significantly (p < 0.05) lower in BTT patients with iron deficiency than in patients without iron deficiency. The presence of iron deficiency did not preclude the detection of BTT in this population. The effect of iron deficiency in BTT was apparent as a significant lowering of the Hb concentration and an increased prevalence of anemia. Iron therapy is warranted for BTT patients with iron-deficiency traits and would help to significantly raise their Hb concentration. The elevation of HbA2 was striking and could be used with reliability in making the diagnosis of BTT even in the presence of iron deficiency.

  10. Ferrous sulfate versus iron polymaltose complex for treatment of iron deficiency anemia in children.

    PubMed

    Bopche, Ankur Vikas; Dwivedi, Rashmi; Mishra, Rakesh; Patel, G S

    2009-10-01

    We assessed the clinical response and side effects of Ferrous sulfate (FS) and Iron polymaltose complex (IPC) in 118 children with Iron deficiency anemia (IDA). Subjects were randomized to receive therapy with either oral IPC (Group A, n=59) or oral FS (Group B, n=59); all were given elemental iron in three divided doses of 6 mg/kg/day. One hundred and six children could be followed up; 53 in each group. Children who received ferrous sulfate were having higher hemoglobin level, and less residual complaints as compared to those who had received iron polymaltose complex. Our study suggests ferrous sulfate has a better clinical response and less significant adverse effects during treatment of IDA in children.

  11. Jasmonate signaling is activated in the very early stages of iron deficiency responses in rice roots.

    PubMed

    Kobayashi, Takanori; Itai, Reiko Nakanishi; Senoura, Takeshi; Oikawa, Takaya; Ishimaru, Yasuhiro; Ueda, Minoru; Nakanishi, Hiromi; Nishizawa, Naoko K

    2016-07-01

    Under low iron availability, plants induce the expression of various genes involved in iron uptake and translocation at the transcriptional level. This iron deficiency response is affected by various plant hormones, but the roles of jasmonates in this response are not well-known. We investigated the involvement of jasmonates in rice iron deficiency responses. High rates of jasmonate-inducible genes were induced during the very early stages of iron deficiency treatment in rice roots. Many jasmonate-inducible genes were also negatively regulated by the ubiquitin ligases OsHRZ1 and OsHRZ2 and positively regulated by the transcription factor IDEF1. Ten out of 35 genes involved in jasmonate biosynthesis and signaling were rapidly induced at 3 h of iron deficiency treatment, and this induction preceded that of known iron deficiency-inducible genes involved in iron uptake and translocation. Twelve genes involved in jasmonate biosynthesis and signaling were also upregulated in HRZ-knockdown roots. Endogenous concentrations of jasmonic acid and jasmonoyl isoleucine tended to be rapidly increased in roots in response to iron deficiency treatment, whereas these concentrations were higher in HRZ-knockdown roots under iron-sufficient conditions. Analysis of the jasmonate-deficient cpm2 mutant revealed that jasmonates repress the expression of many iron deficiency-inducible genes involved in iron uptake and translocation under iron sufficiency, but this repression is partly canceled under an early stage of iron deficiency. These results indicate that jasmonate signaling is activated during the very early stages of iron deficiency, which is partly regulated by IDEF1 and OsHRZs.

  12. An unusual case of iron deficiency anemia is associated with extremely low level of transferrin receptor.

    PubMed

    Hao, Shuangying; Li, Huihui; Sun, Xiaoyan; Li, Juan; Li, Kuanyu

    2015-01-01

    A case study of a female patient, diagnosed with iron deficiency anemia, was unresponsive to oral iron treatment and only partially responsive to parenteral iron therapy, a clinical profile resembling the iron-refractory iron deficiency anemia (IRIDA) disorder. However, the patient failed to exhibit microcytic phenotype, one of the IRIDA hallmarks. Biochemical assays revealed that serum iron, hepcidin, interluekin 6, and transferrin saturation were within the normal range of references or were comparable to her non-anemic offspring. Iron contents in serum and red blood cells and hemoglobin levels were measured, which confirmed the partial improvement of anemia after parenteral iron therapy. Strikingly, serum transferrin receptor in patient was almost undetectable, reflecting the very low activity of bone-marrow erythropoiesis. Our data demonstrate that this is not a case of systemic iron deficiency, but rather cellular iron deficit due to the low level of transferrin receptor, particularly in erythroid tissue.

  13. An unusual case of iron deficiency anemia is associated with extremely low level of transferrin receptor

    PubMed Central

    Hao, Shuangying; Li, Huihui; Sun, Xiaoyan; Li, Juan; Li, Kuanyu

    2015-01-01

    A case study of a female patient, diagnosed with iron deficiency anemia, was unresponsive to oral iron treatment and only partially responsive to parenteral iron therapy, a clinical profile resembling the iron-refractory iron deficiency anemia (IRIDA) disorder. However, the patient failed to exhibit microcytic phenotype, one of the IRIDA hallmarks. Biochemical assays revealed that serum iron, hepcidin, interluekin 6, and transferrin saturation were within the normal range of references or were comparable to her non-anemic offspring. Iron contents in serum and red blood cells and hemoglobin levels were measured, which confirmed the partial improvement of anemia after parenteral iron therapy. Strikingly, serum transferrin receptor in patient was almost undetectable, reflecting the very low activity of bone-marrow erythropoiesis. Our data demonstrate that this is not a case of systemic iron deficiency, but rather cellular iron deficit due to the low level of transferrin receptor, particularly in erythroid tissue. PMID:26339443

  14. Impact of Fetal-Neonatal Iron Deficiency on Recognition Memory at 2 Months of Age.

    PubMed

    Geng, Fengji; Mai, Xiaoqin; Zhan, Jianying; Xu, Lin; Zhao, Zhengyan; Georgieff, Michael; Shao, Jie; Lozoff, Betsy

    2015-12-01

    To assess the effects of fetal-neonatal iron deficiency on recognition memory in early infancy. Perinatal iron deficiency delays or disrupts hippocampal development in animal models and thus may impair related neural functions in human infants, such as recognition memory. Event-related potentials were used in an auditory recognition memory task to compare 2-month-old Chinese infants with iron sufficiency or deficiency at birth. Fetal-neonatal iron deficiency was defined 2 ways: high zinc protoporphyrin/heme ratio (ZPP/H > 118 μmol/mol) or low serum ferritin (<75 μg/L) in cord blood. Late slow wave was used to measure infant recognition of mother's voice. Event related potentials patterns differed significantly for fetal-neonatal iron deficiency as defined by high cord ZPP/H but not low ferritin. Comparing 35 infants with iron deficiency (ZPP/H > 118 μmol/mol) to 92 with lower ZPP/H (iron-sufficient), only infants with iron sufficiency showed larger late slow wave amplitude for stranger's voice than mother's voice in frontal-central and parietal-occipital locations, indicating the recognition of mother's voice. Infants with iron sufficiency showed electrophysiological evidence of recognizing their mother's voice, whereas infants with fetal-neonatal iron deficiency did not. Their poorer auditory recognition memory at 2 months of age is consistent with effects of fetal-neonatal iron deficiency on the developing hippocampus. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. The association of pagophagia with Helicobacter pylori infection in patients with iron-deficiency anemia.

    PubMed

    Asma, Suheyl; Boga, Can; Ozdogu, Hakan; Serin, Ender

    2009-07-01

    This study aimed to determine the relationship between pagophagia (compulsive ice eating) and H. pylori infection in patients with iron-deficiency anemia. We identified H. pylori infection using the (13)C-urea breath test in 45 patients with iron-deficiency anemia (group 1) and 55 patients with iron-deficiency anemia and pagophagia (group 2). Subgroups for testing oral intestinal iron absorption were randomly assigned from both groups. These subgroups consisted of (a) 10 patients with iron-deficiency anemia, (b) 10 patients with iron-deficiency anemia and pagophagia, (c) 10 patients with iron-deficiency anemia, pagophagia, and H. pylori infection before the eradication of H. pylori and (d) subgroup c after eradication therapy. There was no difference in the rate of H. pylori infection in the iron-deficiency anemia groups, with or without pagophagia. Furthermore, oral intestinal iron absorption was not influenced by pagophagia and/or H. pylori infection. Pagophagia did not increase the risk of H. pylori infection in patients with iron-deficiency anemia. Pagophagia and H. pylori infection do not synergistically affect the development of intestinal iron absorption abnormalities.

  16. Impact of fetal-neonatal iron deficiency on recognition memory at two months of age

    PubMed Central

    Geng, Fengji; Mai, Xiaoqin; Zhan, Jianying; Xu, Lin; Zhao, Zhengyan; Georgieff, Michael; Shao, Jie; Lozoff, Betsy

    2015-01-01

    Objective To assess the effects of fetal-neonatal iron deficiency on recognition memory in early infancy. Perinatal iron deficiency delays or disrupts hippocampal development in animal models and thus may impair related neural functions in human infants, such as recognition memory. Study design Event-related potentials were used in an auditory recognition memory task to compare 2-month-old Chinese infants with iron sufficiency or deficiency at birth. Fetal- neonatal iron deficiency was defined two ways: high zinc protoporphyrin/heme ratio (ZPP/H > 118 μmol/mol) or low serum ferritin (< 75 μg/l) in cord blood. Late slow wave (LSW) was used to measure infant recognition of mother’s voice. Results ERP patterns differed significantly for fetal-neonatal iron deficiency as defined by high cord ZPP/H but not low ferritin. Comparing 35 infants with iron deficiency (ZPP/H > 118 μmol/mol) to 92 with lower ZPP/H (iron-sufficient), only infants with iron sufficiency showed larger LSW amplitude for stranger’s voice than mother’s voice in frontal-central and parietal-occipital locations, indicating the recognition of mother’s voice. Conclusions Infants with iron sufficiency showed electrophysiological evidence of recognizing their mother’s voice, whereas infants with fetal-neonatal iron deficiency did not. Their poorer auditory recognition memory at two months of age is consistent with effects of fetal-neonatal iron deficiency on the developing hippocampus. PMID:26382625

  17. Food fortification for addressing iron deficiency in Filipino children: benefits and cost-effectiveness.

    PubMed

    Detzel, Patrick; Wieser, Simon

    2015-01-01

    Iron deficiency is one of the most widespread nutritional disorders in both developing and industrialized countries, making it a global public health concern. Anemia, mainly due to iron deficiency, affects one third of the world's population and is concentrated in women and children below 5 years of age. Iron deficiency anemia has a profound impact on human health and productivity, and the effects of iron deficiency are especially pronounced in the first 1,000 days of life. This critical window of time sets the stage for an individual's future physiological and cognitive health, underscoring the importance of addressing iron deficiency in infants and young children. This review focuses on the use of fortified foods as a cost-effective tool for addressing iron deficiency in infants and young children in the Philippines.

  18. Impairment of the peripheral lymphoid compartment in iron-deficient piglets.

    PubMed

    Svoboda, M; Drabek, J; Krejci, J; Rehakova, Z; Faldyna, M

    2004-06-01

    The aim of this study was to investigate the effect of neonatal iron deficiency on immune functions in young piglets. While control piglets were not given any iron preparation until the age of 21 days, another group of piglets was given 200 mg of Fe(3+)-dextran i.m. on day 3. Red blood cell parameters in the former, iron-deficient group were characteristic of hypochromic anaemia. In addition, the total leucocyte count (P < 0.01), relative and absolute neutrophil count (P < 0.01) and absolute lymphocyte count (P < 0.05) in peripheral blood were found significantly lower in iron-deficient piglets than in their iron-supplemented counterparts. Lymphocyte activity as measured by in vitro lymphocyte transformation test was impaired in iron-deficient piglets. A statistically significant decrease in circulating B-lymphocyte numbers was found in non-supplemented animals. Iron deficiency apparently negatively influenced the immunocompetence in piglets.

  19. Kidney injury in infants and children with iron-deficiency anemia before and after iron treatment.

    PubMed

    Hassan, Rasha H; Kandil, Shaimaa M; Zeid, Mayada S; Zaki, Maysaa E; Fouda, Ashraf E

    2017-10-01

    Our study aimed to investigate the effects of iron-deficiency anemia (IDA) on renal tubular functions before and after iron treatment for infants and children with IDA. We measured urinary levels of two kidney injury markers: neutrophil gelatinase-associated lipocalin (NGAL) and liver-type fatty acid-binding protein (L-FABP). Thirty-six infants and children with IDA and 20 matched healthy controls were included. We assessed different laboratory parameters, estimated glomerular filtration rate, urinary levels of NGAL, and L-FABP. Urinary kidney injury markers were measured in IDA patients before and after 3 months of oral iron therapy. IDA patients had significantly higher urinary NGAL and L-FABP levels compared to their healthy controls. After 3 months of oral iron treatment, there was a significant improvement (decrease) in urinary NGAL and L-FABP in infants and children with IDA. Urinary markers returned to normal levels (healthy control levels) in children with IDA, but not for infants with IDA compared to their healthy controls. Subclinical kidney injury was found in infants and children with IDA. This injury was completely reversible in older children with IDA and partially reversible in infants with IDA after iron therapy. Higher urinary levels of kidney injury molecules in IDA infants after iron treatment are suggestive of more sensitivity of these infants to oxidative stress caused by iron therapy or may be due to the immaturity of the kidney and more damage caused by IDA which may require more time to recover.

  20. The strategies to reduce iron deficiency in blood donors randomized trial: design, enrolment and early retention

    PubMed Central

    Bialkowski, W.; Bryant, B. J.; Schlumpf, K. S.; Wright, D. J.; Birch, R.; Kiss, J. E.; D’Andrea, P.; Cable, R. G.; Spencer, B. R.; Vij, V.; Mast, A. E.

    2014-01-01

    Background and Objectives Repeated blood donation produces iron deficiency. Changes in dietary iron intake do not prevent donation-induced iron deficiency. Prolonging the interdonation interval or using oral iron supplements can mitigate donation-induced iron deficiency. The most effective operational methods for reducing iron deficiency in donors are unknown. Materials and Methods ‘Strategies To Reduce Iron Deficiency’ (STRIDE) was a two-year, randomized, placebo-controlled study in blood donors. 692 donors were randomized into one of two educational groups or one of three interventional groups. Donors randomized to educational groups either received letters thanking them for donating, or, suggesting iron supplements or delayed donation if they had low ferritin. Donors randomized to interventional groups either received placebo, 19-mg or 38-mg iron pills. Results Iron deficient erythropoiesis was present in 52.7% of males and 74.6% of females at enrolment. Adverse events within 60 days of enrolment were primarily mild gastrointestinal symptoms (64%). The incidence of de-enrolment within 60 days was more common in the interventional groups than in the educational groups (P = 0.002), but not more common in those receiving iron than placebo (P = 0.68). Conclusion The prevalence of iron deficient erythropoiesis in donors enrolled in the STRIDE study is comparable to previously described cohorts of regular blood donors. De-enrolment within 60 days was higher for donors receiving tablets, although no more common in donors receiving iron than placebo. PMID:25469720

  1. Laboratory variables for assessing iron deficiency in REDS-II Iron Status Evaluation (RISE) blood donors.

    PubMed

    Kiss, Joseph E; Steele, Whitney R; Wright, David J; Mast, Alan E; Carey, Patricia M; Murphy, Edward L; Gottschall, Jerry L; Simon, Toby L; Cable, Ritchard G

    2013-11-01

    Iron deficiency is common in regular blood donors. We evaluated the diagnostic sensitivity and specificity of red blood cell (RBC) hematology analyzer indices to assess iron status as a part of donor management. A total of 1659 male and female donors from the Retrovirus Epidemiology Donor Study-II (REDS-II) Donor Iron Status Evaluation (RISE) study who were either first-time/reactivated (FT/RA; no donations for 2 years) or frequent donors were recruited into a longitudinal study of regular donation of RBCs. Of these, 1002 donors returned 15 to 24 months later for a final assessment. Absent iron stores (AIS) was defined as plasma ferritin level of less than 12 μg/L. Logarithm of the ratio of soluble transferrin receptor to ferritin of at least 2.07 (≥97.5% in FT/RA males) was used to define iron-deficient erythropoiesis (IDE). Receiver operating characteristics analysis was performed to assess selected RBC indices (e.g., percentage of hypochromic mature RBCs, proportion of hypochromic mature RBCs [HYPOm], and hemoglobin [Hb] content of reticulocytes [CHr]) in identifying AIS and IDE. HYPOm and CHr detected IDE with comparable sensitivity, 72% versus 69%, but differed in specificity: HYPOm 68% and CHr 53%. For detecting AIS, sensitivity was improved to 85% for HYPOm and 81% for CHr but specificity was reduced for both. Venous Hb had high specificity but poor sensitivity for IDE and AIS. A plasma ferritin level of less than 26.7 μg/L was a good surrogate for assessing IDE. RBC indices correlate with AIS and IDE and are more informative than Hb measurement, but lack sufficient sensitivity and specificity to be used as diagnostic tools in blood donors at risk for iron deficiency. © 2013 American Association of Blood Banks.

  2. Laboratory variables for assessing iron deficiency in REDS-II Iron Status Evaluation (RISE) blood donors

    PubMed Central

    Kiss, Joseph E.; Steele, Whitney R.; Wright, David J.; Mast, Alan E.; Carey, Patricia M.; Murphy, Edward L.; Gottschall, Jerry L.; Simon, Toby L.; Cable, Ritchard G.

    2014-01-01

    BACKGROUND Iron deficiency is common in regular blood donors. We evaluated the diagnostic sensitivity and specificity of red blood cell (RBC) hematology analyzer indices to assess iron status as a part of donor management. STUDY DESIGN AND METHODS A total of 1659 male and female donors from the Retrovirus Epidemiology Donor Study-II (REDS-II) Donor Iron Status Evaluation (RISE) study who were either first-time/reactivated (FT/ RA; no donations for 2 years) or frequent donors were recruited into a longitudinal study of regular donation of RBCs. Of these, 1002 donors returned 15 to 24 months later for a final assessment. Absent iron stores (AIS) was defined as plasma ferritin level of less than 12 µ.g/L. Logarithm of the ratio of soluble transferrin receptor to ferritin of at least 2.07 (≥97.5% in FT/RA males) was used to define iron-deficient erythropoiesis (IDE). Receiver operating characteristics analysis was performed to assess selected RBC indices (e.g., percentage of hypochromic mature RBCs, proportion of hypochromic mature RBCs [HYPOm], and hemoglobin [Hb] content of reticulocytes [CHr]) in identifying AIS and IDE. RESULTS HYPOm and CHr detected IDE with comparable sensitivity, 72% versus 69%, but differed in specificity: HYPOm 68% and CHr 53%. For detecting AIS, sensitivity was improved to 85% for HYPOm and 81% for CHr but specificity was reduced for both. Venous Hb had high specificity but poor sensitivity for IDE and AIS. A plasma ferritin level of less than 26.7 u.g/L was a good surrogate for assessing IDE. CONCLUSION RBC indices correlate with AIS and IDE and are more informative than Hb measurement, but lack sufficient sensitivity and specificity to be used as diagnostic tools in blood donors at risk for iron deficiency. PMID:23617531

  3. Coexistence of Essential Thrombocythemia, Iron-Refractory Iron Deficiency Anemia and Renal Cell Carcinoma

    PubMed Central

    Tekgündüz, Emre; Altuntaş, Fevzi

    2016-01-01

    Essential thrombocythemia (ET) is a Philadelphia chromosome (Ph)-negative myeloproliferative neoplasm. It is characterized by thrombocytosis and megakaryocytic hyperplasia of the bone marrow with JAK2V617F mutation. Iron-refractory iron deficiency anemia (IRIDA) is an autosomal recessive disorder, which is mainly characterized by iron deficiency anemia not responding to oral iron intake, but partially responding to parenteral iron therapy. Recently, it has been shown that IRIDA has stemmed from mutations in the gene TMPRSS6, which encodes a transmembrane serine protease (matriptase-2) expressed by the liver. Renal cell carcinoma (RCC) accounts for 2-3% of all cancers. As the most common solid lesion in the kidneys, it represents approximately 90% of all renal malignancies. Approximately 30% of patients with symptomatic RCCs seem to display paraneoplastic syndromes. The symptom that may result from erythrocytosis is the most well-known paraneoplastic hematological event. Here, we report a patient who presents with coexistence of RCC and thrombocytosis, which hasn’t been caused by hormonal factors that are produced in tumor cells. This patient has been therefore diagnosed with ET. The patient who was expected to display RCC with polycythemia, conversely present with IRIDA. PMID:27103977

  4. Coexistence of Essential Thrombocythemia, Iron-Refractory Iron Deficiency Anemia and Renal Cell Carcinoma.

    PubMed

    Namdaroğlu, Sinem; Tekgündüz, Emre; Altuntaş, Fevzi

    2016-03-17

    Essential thrombocythemia (ET) is a Philadelphia chromosome (Ph)-negative myeloproliferative neoplasm. It is characterized by thrombocytosis and megakaryocytic hyperplasia of the bone marrow with JAK2V617F mutation. Iron-refractory iron deficiency anemia (IRIDA) is an autosomal recessive disorder, which is mainly characterized by iron deficiency anemia not responding to oral iron intake, but partially responding to parenteral iron therapy. Recently, it has been shown that IRIDA has stemmed from mutations in the gene TMPRSS6, which encodes a transmembrane serine protease (matriptase-2) expressed by the liver. Renal cell carcinoma (RCC) accounts for 2-3% of all cancers. As the most common solid lesion in the kidneys, it represents approximately 90% of all renal malignancies. Approximately 30% of patients with symptomatic RCCs seem to display paraneoplastic syndromes. The symptom that may result from erythrocytosis is the most well-known paraneoplastic hematological event. Here, we report a patient who presents with coexistence of RCC and thrombocytosis, which hasn't been caused by hormonal factors that are produced in tumor cells. This patient has been therefore diagnosed with ET. The patient who was expected to display RCC with polycythemia, conversely present with IRIDA.

  5. Maternal iron deficiency alters circulating thyroid hormone levels in developing neonatal rats

    EPA Science Inventory

    Thyroid hormone insufficiency and iron deficiency (FeD) during fetal and neonatal life are both similarly deleterious to mammalian development suggesting a possible linkage between iron and thyroid hormone insufficiencies. Recent published data from our laboratory demonstrate a r...

  6. Maternal iron deficiency alters circulating thyroid hormone levels in developing neonatal rats

    EPA Science Inventory

    Thyroid hormone insufficiency and iron deficiency (FeD) during fetal and neonatal life are both similarly deleterious to mammalian development suggesting a possible linkage between iron and thyroid hormone insufficiencies. Recent published data from our laboratory demonstrate a r...

  7. Iron deficiency alters expression of genes implicated in Alzheimer disease pathogenesis.

    PubMed

    Carlson, Erik S; Magid, Rhamy; Petryk, Anna; Georgieff, Michael K

    2008-10-27

    Neonatal brain iron deficiency occurs after insufficient maternal dietary iron intake, maternal hypertension, and maternal diabetes mellitus and results in short and long-term neurologic and behavioral deficits. Early iron deficiency affects the genomic profile of the developing hippocampus that persists despite iron repletion. The purpose of the present study was threefold: 1) quantitative PCR confirmation of our previous microarray results, demonstrating upregulation of a network of genes leading to beta-amyloid production and implicated in Alzheimer disease etiology in iron-deficient anemic rat pups at the time of hippocampal differentiation; 2) investigation of the potential contributions of iron deficiency anemia and iron treatment to this differential gene expression in the hippocampus; and 3) investigation of these genes over a developmental time course in a mouse model where iron deficiency is limited to hippocampus, is not accompanied by anemia and is not repletable. Quantitative PCR confirmed altered regulation in 6 of 7 Alzheimer-related genes (Apbb1, C1qa, Clu, App, Cst3, Fn1, Htatip) in iron-deficient rats relative to iron-sufficient controls at P15. Comparison of untreated to treated iron-deficient animals at this age suggested the strong role of iron deficiency, not treatment, in the upregulation of this gene network. The non-anemic hippocampal iron-deficient mouse demonstrated upregulation of all 7 genes in this pathway from P5 to P25. Our results suggest a role for neonatal iron deficiency in dysregulation of genes that may set the stage for long-term neurodegenerative disease and that this may occur through a histone modification mechanism.

  8. Iron deficiency is unacceptably high in refugee children from Burma.

    PubMed

    Kemmer, Teresa M; Bovill, Maria E; Kongsomboon, Wantanee; Hansch, Steven J; Geisler, Karen L; Cheney, Carrie; Shell-Duncan, Bettina K; Drewnowski, Adam

    2003-12-01

    Iron-deficiency anemia (IDA) in refugees is reported to be among the major medical problems worldwide. Because food rations are typically inadequate in iron, long-term reliance is a key predictor of anemia among displaced people. Comprehensive nutritional assessments of refugee children from Burma have not previously been completed. Refugee children aged 6-59 mo were studied to determine 1) the prevalences of anemia, iron deficiency (ID) and IDA and 2) the factors associated with anemia and ID. Cluster sampling in three camps and convenience sampling in two additional camps were used. Hemoglobin (Hb) levels were measured and micro mol zinc protoporphyrin/mol heme were determined in 975 children. Logistic regression analyses (95% CI) determined predictors of anemia and ID. The prevalences of IDA, anemia and ID in these refugee children were 64.9, 72.0 and 85.4%, respectively. Predictors of anemia included young age (P < 0.001), food ration lasting <1 mo (P = 0.001), daily consumption of dietary iron inhibitors (P < 0.05), weight-for-height Z-score of <-2 (P < 0.05), male gender (P < 0.05) and uneducated father (P < 0.001). Predictors of ID were young age (P < 0.001) and recently reported illness (P < 0.05). Laboratory tests confirmed that anemia and ID are major health problems among these refugee children and that ID is the leading cause of anemia. A comprehensive nutrition and public health-focused approach to combating anemia and ID is essential. Following the presentation of results to policy makers, the improvement of the micronutrient content of rations has been initiated.

  9. Autoimmune gastritis presenting as iron deficiency anemia in childhood.

    PubMed

    Gonçalves, Cristina; Oliveira, Maria Emília; Palha, Ana M; Ferrão, Anabela; Morais, Anabela; Lopes, Ana Isabel

    2014-11-14

    To characterize clinical, laboratorial, and histological profile of pediatric autoimmune gastritis in the setting of unexplained iron deficiency anemia investigation. A descriptive, observational study including pediatric patients with a diagnosis of autoimmune gastritis (positive parietal cell antibody and gastric corpus atrophy) established in a 6 year period (2006-2011) in the setting of refractory iron deficiency anemia (refractoriness to oral iron therapy for at least 6 mo and requirement for intravenous iron therapy) investigation, after exclusion of other potentially contributing causes of anemia. Helicobacter pylori (H. pylori) infection and anti-secretory therapy were also excluded. Data were retrospectively collected from clinical files, including: demographic data (age, gender, and ethnic background), past medical history, gastrointestinal symptoms, familial history, laboratorial evaluation (Hb, serum ferritin, serum gastrin, pepsinogen I/ pepsinogen II, B12 vitamin, intrinsic factor autoantibodies, thyroid autoantibodies, and anti-transglutaminase antibodies), and endoscopic and histological findings (HE, Periodic Acid-Schiff/Alcian blue, gastrin, chromogranin A and immunochemistry analysis for CD3, CD20 and CD68). Descriptive statistical analysis was performed (mean, median, and standard deviation). We report a case-series concerning 3 girls and 2 boys with a mean age of 13.6 ± 2.8 years (3 Caucasian and 2 African). One girl had type I diabetes. Familial history was positive in 4/5 cases, respectively for autoimmune thyroiditis (2/5), sarcoidosis (1/5) and multiple myeloma (1/5). Laboratorial evaluation on admission included: Hb: 9.5 ± 0.7 g/dL; serum ferritin: 4.0 ± 0.9 ng/mL; serum gastrin: 393 ± 286 pg/mL; low pepsinogen I/ pepsinogen II ratio in 1/5 patients; normal vitamin B12 levels (analyzed in 3 patients). Endoscopy findings included: duodenal nodularity (2/5) and gastric fold softening (2/5), and histological evaluation showed

  10. [Asymptomatic gastric phytobezoar and anaemia due to iron deficiency revealing an autoimmune gastritis].

    PubMed

    Granel, B; Serratrice, J; Disdier, P; Laugier, R; Weiller, P-J

    2004-10-09

    This observation recalls that gastric phytobezoar should lead to a search for an underlying disease and that a iron deficiency can be associated and hide macrocytosis related to a vitamin B12 deficiency. A 19 year-old woman consulted for asthenia. Microcyte anaemia associated with iron deficiency was diagnosed. Upper digestive endoscopy revealed severe, totally asymptomatic phytobezoar. Biological investigations revealed a vitamin B12 deficiency, high serum gastrin level and strong positivity for gastric antiparietal anti-cell antibodies, suggestive of an autoimmune gastritis. Total immunoglobulin A deficiency was also noted. Autoimmune gastritis is responsible for megaloblastic anaemia (vitamin B12 deficiency) but can also provoke microcytic (iron-deficiency) anaemia due to insufficient absorption of the latter and related to gastric achlorhydria. Phytobezoar might also be related to achlorhydria and/or gastroparesia associated with autoimmune gastritis. Hence, autoimmune gastritis should be searched for when confronted with unexplained gastric bezoar or iron-deficiency anaemia.

  11. Severe iron deficiency anaemia associated with heavy lice infestation in a young woman.

    PubMed

    Althomali, Sarah Ali; Alzubaidi, Lamya Mohammed; Alkhaldi, Dhelal Musleh

    2015-11-05

    Lice feed on human blood, and heavy and chronic lice infestation can lead to chronic blood loss with resultant iron deficiency anaemia. Although no definite relationship between lice infestation and iron deficiency anaemia has been described, the concurrent presence of these two conditions has been reported in children and adults, as well as in cattle. We present a case of a young woman with severe iron deficiency anaemia that could not be explained by the known causes of iron deficiency anaemia. However, the patient was found to have heavy and chronic head lice infestation.

  12. [Diagnosis and treatment of iron deficiency, with or without anemia, before and after bariatric surgery].

    PubMed

    Jericó, Carlos; Bretón, Irene; García Ruiz de Gordejuela, Amador; de Oliveira, Ana Carla; Rubio, Miguel Ángel; Tinahones, Francisco J; Vidal, Josep; Vilarrasa, Nuria

    2016-01-01

    Bariatric surgery (BS) is an increasingly used therapeutic option for severe obesity which allows patients to achieve sustained weight loss over time and resolution or improvement in most associated pathological conditions. Major mid- and long-term complications of BS include iron deficiency and iron-deficient anemia, which may occur in up to 50% of cases and significantly impair patient quality of life. These changes may be present before surgery. The aim of this review was to prepare schemes for diagnosis and treatment of iron deficiency and iron-deficient anemia before and after bariatric surgery.

  13. The effect of iron deficiency anemia on intelligence quotient (IQ) in under 17 years old students.

    PubMed

    Goudarzi, A; Mehrabi, M R; Goudarzi, K

    2008-05-15

    The aim of this study was to evaluate the effects of iron deficiency on intelligence of 11-17 years students. This study conducted on the 540 students (11-17 years) that educated at guidance and high school of Boroujerd city. Laboratory investigations were included serum iron, TIBC (total iron binding capacity) and ferretin. Riven matrix was used in order to determine intelligence quotient. Data were analyzed using SPSS 13 and chi2 and t-tests. Results showed that 78 (14.4%) students had iron deficiency and 14 (25.9%) had iron deficiency anemia. There was no significant difference between different sexes for iron deficiency distribution (p > 0.05), while iron deficiency anemia was significantly higher in girls as compared with boys (p > 0.05). Mean quotient was 115 +/- 12.1 in iron deficiency students, while it was 113.7 +/- 13.9 in patients without iron deficiency. There was also no significant difference between normal and iron deficient students for intelligence quotient (p > 0.05).

  14. RET-Y and RBC-Y in the diagnosis of iron deficiency associated with anaemia of inflammation.

    PubMed

    Jayaranee, S; Sthaneshwar, P

    2010-10-01

    We evaluated the usefulness of RET-Y and RBC-Y in distinguishing functional iron deficiency from iron-deficiency anaemia (IDA) in patients with anaemia of inflammation (AI). Sixty healthy blood donors constituted the control group. We studied RET-Y and RBC-Y in 115 patients with hypochromic/microcytic anaemia. Of these 42 patients had uncomplicated IDA and 73 had AI. The AI patients were further subdivided into AI with IDA and AI with functional IDA based on soluble transferrin receptor (sTfR) levels. The mean RBC-Y and RET-Y values in iron-deficient patients were 122.4 and 119.8, respectively, which were significantly lower than the control (P < 0.001). The mean level of RET-Y in patients with AI associated with IDA was 149.3 and this level in AI patients with functional iron deficiency was 147.4. RET-Y levels in both subgroups of AI patients were significantly lower than control but no significant difference was observed between the two subgroups. Similar findings were observed for RBC-Y. Receiver operating characteristic analysis also showed lower specificity for RBC-Y and RET-Y compared with that of sTfR and its log ferritin ratio (F-index). RET-Y and RBC-Y are useful in the diagnosis of simple IDA but have limited utility in the diagnosis of IDA with AI.

  15. Usefulness of Iron Deficiency Correction in Management of Patients With Heart Failure [from the Registry Analysis of Iron Deficiency-Heart Failure (RAID-HF) Registry].

    PubMed

    Wienbergen, Harm; Pfister, Otmar; Hochadel, Matthias; Michel, Stephan; Bruder, Oliver; Remppis, Björn Andrew; Maeder, Micha Tobias; Strasser, Ruth; von Scheidt, Wolfgang; Pauschinger, Matthias; Senges, Jochen; Hambrecht, Rainer

    2016-12-15

    Iron deficiency (ID) has been identified as an important co-morbidity in patients with heart failure (HF). Intravenous iron therapy reduced symptoms and rehospitalizations of iron-deficient patients with HF in randomized trials. The present multicenter study investigated the "real-world" management of iron status in patients with HF. Consecutive patients with HF and ejection fraction ≤40% were recruited and analyzed from December 2010 to October 2015 by 11 centers in Germany and Switzerland. Of 1,484 patients with HF, iron status was determined in only 923 patients (62.2%), despite participation of the centers in a registry focusing on ID and despite guideline recommendation to determine iron status. In patients with determined iron status, a prevalence of 54.7% (505 patients) for ID was observed. Iron therapy was performed in only 8.5% of the iron-deficient patients with HF; 2.6% were treated with intravenous iron therapy. The patients with iron therapy were characterized by a high rate of symptomatic HF and anemia. In conclusion, despite strong evidence of beneficial effects of iron therapy on symptoms and rehospitalizations, diagnostic and therapeutic efforts on ID in HF are low in the actual clinical practice, and the awareness to diagnose and treat ID in HF should be strongly enforced. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Characterization of MxFIT, an iron deficiency induced transcriptional factor in Malus xiaojinensis.

    PubMed

    Yin, Lili; Wang, Yi; Yuan, Mudan; Zhang, Xinzhong; Xu, Xuefeng; Han, Zhenhai

    2014-02-01

    Iron deficiency often results in nutritional disorder in fruit trees. Transcription factors play an important role in the regulation of iron uptake. In this study, we isolated an iron deficiency response transcription factor gene, MxFIT, from an iron-efficient apple genotype of Malus xiaojinensis. MxFIT encoded a basic helix-loop-helix protein and contained a 966 bp open reading frame. MxFIT protein was targeted to the nucleus in onion epidermal cells and showed strong transcriptional activation in yeast cells. Spatiotemporal expression analysis revealed that MxFIT was up-regulated in roots under iron deficiency at both mRNA and protein levels, while almost no expression was detected in leaves irrespective of iron supply. Ectopic expression of MxFIT resulted in enhanced iron deficiency responses in Arabidopsis under iron deficiency and stronger resistance to iron deficiency. Thus, MxFIT might be involved in iron uptake and plays an important role in iron deficiency response.

  17. [Iron-deficiency anemia in children. A old problem not yet resolved].

    PubMed

    Ramírez-Mayans, Jaime A; Ortiz-López, Carolina; García-Campos, Margarita; Cervantes-Bustamante, Roberto; Mata-Rivera, Norberto; Zárate-Mondragón, Flora; Mason-Cordero, Thomas

    2003-01-01

    Iron-deficiency anemia is still a health problem worldwide. Iron supplementation of some foods such as milk formulas and cereals apparently has not been the solution due to bioavailability of iron. In Mexico, there is high prevalence of anemia in children to date, mainly those under 2 years of age and predominantly in the Southern part of the country. Probably the main causes are iron-deficiency anemia in pregnant women, recurrent infections, such as gastroenteritis and parasites, and the most important one undoubtedly, deficient iron intake.

  18. Two iron-regulated transporter (IRT) genes showed differential expression in poplar trees under iron or zinc deficiency.

    PubMed

    Huang, Danqiong; Dai, Wenhao

    2015-08-15

    Two iron-regulated transporter (IRT) genes were cloned from the iron chlorosis resistant (PtG) and susceptible (PtY) Populus tremula 'Erecta' lines. Nucleotide sequence analysis showed no significant difference between PtG and PtY. The predicted proteins contain a conserved ZIP domain with 8 transmembrane (TM) regions. A ZIP signature sequence was found in the fourth TM domain. Phylogenetic analysis revealed that PtIRT1 was clustered with tomato and tobacco IRT genes that are highly responsible to iron deficiency. The PtIRT3 gene was clustered with the AtIRT3 gene that was related to zinc and iron transport in plants. Tissue specific expression indicated that PtIRT1 only expressed in the root, while PtIRT3 constitutively expressed in all tested tissues. Under iron deficiency, the expression of PtIRT1 was dramatically increased and a significantly higher transcript level was detected in PtG than in PtY. Iron deficiency also enhanced the expression of PtIRT3 in PtG. On the other hand, zinc deficiency down-regulated the expression of PtIRT1 and PtIRT3 in both PtG and PtY. Zinc accumulated significantly under iron-deficient conditions, whereas the zinc deficiency showed no significant effect on iron accumulation. A yeast complementation test revealed that the PtIRT1 and PtIRT3 genes could restore the iron uptake ability under the iron uptake-deficiency condition. The results will help understand the mechanisms of iron deficiency response in poplar trees and other woody species. Copyright © 2015 Elsevier GmbH. All rights reserved.

  19. Evaluation of Reticulocyte Parameters in Iron Deficiency, Vitamin B12 Deficiency and Mixed Anemia.

    PubMed

    Balci, Yasemin Isik; Akpinar, Funda Ozgurler; Polat, Aziz; Uzun, Utku; Ergin, Ahmet

    2016-01-01

    Reticulocytes are the youngest erythrocytes released from the bone marrow into the blood and they circulate for 1-2 days before becoming mature erythrocytes. In literature, there were studies about reticulocyte parameters that could help in differentiation of iron deficiency anemia (IDA) from vitamin B12 deficiency anemia. However, in those studies there were no data about differentiation of mixed anemia (vitamin B12 deficiency and IDA). The purpose of this study is to explore a response to 'could reticulocyte parameters help in differential diagnosis of mixed anemia?' in 6-12 years old children. The study enrolled 26 patients with IDA, 22 patients with mixed anemia, 32 patients with vitamin B12 deficiency, and 32 age and gender matched healthy controls. Blood for hematological parameters such as complete blood count, reticulocyte count, CHr, MCVr, CHCMr were collected into standard tubes containing EDTA. There is a statistically significant difference of both MCV (mean corpuscular volume)/MCVr (Reticulocyte mean corpuscular volume) ratio and MCVr between IDA and controls; in controls and vitamin B12 deficiency anemia; in controls and mixed anemia; in IDA and vitamin B12 deficiency anemia; in IDA and mixed anemia. Also in terms of both CHr and CHCMr (Corpuscular mean hemoglobin concentration of reticulocyte), there is a statistically significant difference between controls and IDA; controls and mixed anemia; IDA and mixed anemia; IDA and vitamin B12 deficiency anemia. In mixed anemia, MCV could be normal or decreased, and in peripheral blood smear erythrocytes cells could be morphologically normal. For this reason diagnosis of mixed anemia is not easy and needs additional laboratory investigations. Our results suggest that in a differential diagnosis of mixed anemia from vitamin B12 deficiency, IDA, and healthy controls, CHr, CHCMr, and MCVr (together with MCV and individually) could be useful. So, with a simple and cheap laboratory parameter, differentiation of

  20. Iron deficiency or anemia of inflammation? : Differential diagnosis and mechanisms of anemia of inflammation.

    PubMed

    Nairz, Manfred; Theurl, Igor; Wolf, Dominik; Weiss, Günter

    2016-10-01

    Iron deficiency and immune activation are the two most frequent causes of anemia, both of which are based on disturbances of iron homeostasis. Iron deficiency anemia results from a reduction of the body's iron content due to blood loss, inadequate dietary iron intake, its malabsorption, or increased iron demand. Immune activation drives a diversion of iron fluxes from the erythropoietic bone marrow, where hemoglobinization takes place, to storage sites, particularly the mononuclear phagocytes system in liver and spleen. This results in iron-limited erythropoiesis and anemia. This review summarizes current diagnostic and pathophysiological concepts of iron deficiency anemia and anemia of inflammation, as well as combined conditions, and provides a brief outlook on novel therapeutic options.

  1. Alkaline stress and iron deficiency regulate iron uptake and riboflavin synthesis gene expression differently in root and leaf tissue: implications for iron deficiency chlorosis.

    PubMed

    Hsieh, En-Jung; Waters, Brian M

    2016-10-01

    Iron (Fe) is an essential mineral that has low solubility in alkaline soils, where its deficiency results in chlorosis. Whether low Fe supply and alkaline pH stress are equivalent is unclear, as they have not been treated as separate variables in molecular physiological studies. Additionally, molecular responses to these stresses have not been studied in leaf and root tissues simultaneously. We tested how plants with the Strategy I Fe uptake system respond to Fe deficiency at mildly acidic and alkaline pH by measuring root ferric chelate reductase (FCR) activity and expression of selected Fe uptake genes and riboflavin synthesis genes. Alkaline pH increased cucumber (Cucumis sativus L.) root FCR activity at full Fe supply, but alkaline stress abolished FCR response to low Fe supply. Alkaline pH or low Fe supply resulted in increased expression of Fe uptake genes, but riboflavin synthesis genes responded to Fe deficiency but not alkalinity. Iron deficiency increased expression of some common genes in roots and leaves, but alkaline stress blocked up-regulation of these genes in Fe-deficient leaves. In roots of the melon (Cucumis melo L.) fefe mutant, in which Fe uptake responses are blocked upstream of Fe uptake genes, alkaline stress or Fe deficiency up-regulation of certain Fe uptake and riboflavin synthesis genes was inhibited, indicating a central role for the FeFe protein. These results suggest a model implicating shoot-to-root signaling of Fe status to induce Fe uptake gene expression in roots.

  2. Markers of iron deficiency in patients with polycythemia vera receiving ruxolitinib or best available therapy.

    PubMed

    Verstovsek, Srdan; Harrison, Claire N; Kiladjian, Jean-Jacques; Miller, Carole; Naim, Ahmad B; Paranagama, Dilan C; Habr, Dany; Vannucchi, Alessandro M

    2017-05-01

    Polycythemia vera (PV) is characterized by erythropoiesis and JAK2-activating mutations, with increased risks of morbidity and mortality. Most patients with PV are iron deficient, and treatment often includes hematocrit control with phlebotomy, which may exacerbate iron deficiency-associated complications. The phase 3 RESPONSE trial evaluated the JAK1/JAK2 inhibitor ruxolitinib (n=110) versus best available therapy (BAT; n=112) in patients with PV who were hydroxyurea-resistant/intolerant. Ruxolitinib was superior to BAT for hematocrit control, reduction in splenomegaly, and blood count normalization. This exploratory analysis, the first to evaluate iron status in a prospective study of patients with PV, investigated ruxolitinib effects on 7 serum iron markers and iron deficiency-related patient-reported outcomes (PRO). Among patients with evidence of baseline iron deficiency, ruxolitinib was associated with normalization of iron marker levels, compared with lesser improvement with BAT. Iron levels remained stable in ruxolitinib patients with normal iron levels at baseline. Regardless of baseline iron status, treatment with ruxolitinib was associated with improvements in concentration problems, cognitive function, dizziness, fatigue, headaches, and inactivity, although improvements were generally greater among patients with baseline iron deficiency. The improvements in iron deficiency markers and PROs observed with ruxolitinib are suggestive of clinical benefits that warrant further exploration. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Iron deficiency intravenous substitution in a Swiss academic primary care division: analysis of practices

    PubMed Central

    Varcher, Monica; Zisimopoulou, Sofia; Braillard, Olivia; Favrat, Bernard; Junod Perron, Noëlle

    2016-01-01

    Background Iron deficiency is a common problem in primary care and is usually treated with oral iron substitution. With the recent simplification of intravenous (IV) iron administration (ferric carboxymaltose) and its approval in many countries for iron deficiency, physicians may be inclined to overutilize it as a first-line substitution. Objective The aim of this study was to evaluate iron deficiency management and substitution practices in an academic primary care division 5 years after ferric carboxymaltose was approved for treatment of iron deficiency in Switzerland. Methods All patients treated for iron deficiency during March and April 2012 at the Geneva University Division of Primary Care were identified. Their medical files were analyzed for information, including initial ferritin value, reasons for the investigation of iron levels, suspected etiology, type of treatment initiated, and clinical and biological follow-up. Findings were assessed using an algorithm for iron deficiency management based on a literature review. Results Out of 1,671 patients, 93 were treated for iron deficiency. Median patients’ age was 40 years and 92.5% (n=86) were female. The average ferritin value was 17.2 μg/L (standard deviation 13.3 μg/L). The reasons for the investigation of iron levels were documented in 82% and the suspected etiology for iron deficiency was reported in 67%. Seventy percent of the patients received oral treatment, 14% IV treatment, and 16% both. The reasons for IV treatment as first- and second-line treatment were reported in 57% and 95%, respectively. Clinical and biological follow-up was planned in less than two-thirds of the cases. Conclusion There was no clear overutilization of IV iron substitution. However, several steps of the iron deficiency management were not optimally documented, suggesting shortcuts in clinical reasoning. PMID:27445502

  4. Iron deficiency and the role of nutrition among female military recruits.

    PubMed

    Israeli, Eran; Merkel, Drorit; Constantini, Naama; Yanovich, Ran; Evans, Rachel K; Shahar, Danit; Moran, Daniel S

    2008-11-01

    The impact of iron deficiency is considerable when enhanced physical fitness is required. Female military recruits represent a unique population faced with intense physical and cognitive demands. To examine the prevalence of iron deficiency and the impact of dietary habits among female recruits in the Israel Defense Forces. Three hundred and forty-eight recruits completed the study (188 female combatants, 58 male combatants, and 92 noncombat females). Dietary intake was assessed using a Food Frequency Questionnaire. Blood samples were collected for complete blood cell count, iron indices, and vitamin B12. The common definitions for anemia and iron store deficiency were used as follows: hemoglobin <12 g x dL for females and <14 g x dL for males; serum ferritin <12 mg x dL. The prevalence of iron deficiency and iron deficiency anemia was 29.8% and 12.8%, respectively, among female combatants. Similar data were found among noncombat females (27.2% and 17.4%, respectively) as compared with 5.2% and 0% among males. No significant difference in iron or total calorie intake was detected between subjects with iron deficiency (with or without anemia) when compared with subjects with normal iron status in the same study group. Plant sources constituted 85% of dietary iron source for females, in comparison to 73% for males. The contribution of red meat to the daily iron intake was 2% for females and 20% for males. A high prevalence of iron deficiency was found among female recruits. Coupled with the iron loss during menstruation, inadequate iron intake may have a permissive role for iron deficiency in female recruits and is an important issue facing females in the military.

  5. The treatment of iron-deficiency anaemia with a new intramuscular iron preparation (Ferastral).

    PubMed

    Ogunbode, O; Oluboyede, O A; Ayeni, O

    1977-01-01

    The treatment of iron-deficiency anaemia in pregnancy with a new intramuscular iron preparation, iron-poly (sorbitol-gluconic acid) complex (Ferastral), has been assessed and compared with oral iron therapy. Sixty-one of the eighty-four patients studied, many of whom had mild to moderate degree of anaemia were treated with Ferastral. The results were satisfactory, the mean increase of haematocrit at the sixth post treatment week was 28.7% for the whole series. Complete correction of anaemia was achieved in most patients between the 4th and 6th week of treatment. The mean haematocrit of the group treated with oral iron was initially significantly higher than for the group treated with Ferastral. At the first follow-up, two weeks after beginning treatment, the mean values for both groups were similar; at four weeks, those receiving Ferastral had a significantly higher mean PCV than those on oral iron, and remained so through the period of observation. No side-effects were detected using 10 ml of Ferastral intramuscularly on alternate days. The mean hospitalization time of patients with severe to moderate anaemia was reduced when given parenteral therapy, and the frequency of blood transfusion in these patients was also decreased.

  6. Serum zinc levels in patients with iron deficiency anemia and its association with symptoms of iron deficiency anemia.

    PubMed

    Kelkitli, Engin; Ozturk, Nurinnisa; Aslan, Nevin Alayvaz; Kilic-Baygutalp, Nurcan; Bayraktutan, Zafer; Kurt, Nezahat; Bakan, Nuri; Bakan, Ebubekir

    2016-04-01

    Iron deficiency anemia (IDA) is a major public health problem especially in underdeveloped and developing countries. Zinc is the co-factor of several enzymes and plays a role in iron metabolism, so zinc deficiency is associated with IDA. In this study, it was aimed to investigate the relationship of symptoms of IDA and zinc deficiency in adult IDA patients. The study included 43 IDA patients and 43 healthy control subjects. All patients were asked to provide a detailed history and were subjected to a physical examination. The hematological parameters evaluated included hemoglobin (Hb); hematocrit (Ht); red blood cell (erythrocyte) count (RBC); and red cell indices mean corpuscular volume (MCV), mean corpuscular hemoglobin (МСН), mean corpuscular hemoglobin concentration (МСНС), and red cell distribution width (RDW). Anemia was defined according to the criteria defined by the World Health Organization (WHO). Serum zinc levels were measured in the flame unit of atomic absorption spectrophotometer. Symptoms attributed to iron deficiency or depletion, defined as fatigue, cardiopulmonary symptoms, mental manifestations, epithelial manifestations, and neuromuscular symptoms, were also recorded and categorized. Serum zinc levels were lower in anemic patients (103.51 ± 34.64 μ/dL) than in the control subjects (256.92 ± 88.54 μ/dL; <0.001). Patients with zinc level <99 μ/dL had significantly more frequent mental manifestations (p < 0.001), cardiopulmonary symptoms (p = 0.004), restless leg syndrome (p = 0.016), and epithelial manifestations (p < 0.001) than patients with zinc level > 100 μ/dL. When the serum zinc level was compared with pica, no statistically significant correlation was found (p = 0.742). Zinc is a trace element that functions in several processes in the body, and zinc deficiency aggravates IDA symptoms. Measurement of zinc levels and supplementation if necessary should be considered for IDA patients.

  7. Low vitamin D levels are associated with both iron deficiency and anemia in children and adolescents.

    PubMed

    Lee, Jun Ah; Hwang, Jin Soon; Hwang, Il Tae; Kim, Dong Ho; Seo, Ju-Hee; Lim, Jung Sub

    2015-03-01

    We aimed to examine the association between vitamin D deficiency and anemia in a nationally representative sample of Korean children and adolescents. Cross-sectional data on 2526 children and adolescents aged 10-20 years from the Korea National Health and Nutrition Examination Survey-V (2010-2012) were used. Anemia was defined according to specifications of the World Health Organization. Iron deficiency was defined as serum ferritin level of <12 ng/mL and transferrin saturation (TSAT) <16%. The prevalence of vitamin D deficiency in Korean children and adolescents was high especially in female (35.7% vs. 50.9%, P < 0.001). The prevalence of anemia was also higher in female (1.1% vs. 6.8%; P < 0.001). In logistic regression, risk factors for anemia were female sex, old age, post-menarche, low household income, vitamin D deficiency, and iron deficiency. The Odds Ratio for anemia, iron deficiency and iron deficiency anemia (IDA) in subjects with vitamin D deficiency (<15 ng/mL) were 1.81(95% CI, 1.13-2.88), 1.94(95% CI, 1.27-2.97), and 2.26 (95% CI, 1.20-4.24) after controlling for other risk factors. However, after examining the sexes separately, only female subjects showed statistical significance. After further controlling for iron deficiency, the risk of anemia was not significant (P = 0.261). Vitamin D deficiency is associated with increased risk of anemia, especially iron deficiency anemia, in healthy female children and adolescents. However, the association is attenuated after adjustment for iron deficiency. Further studies are needed to determine whether vitamin D deficiency is the cause of anemia, or bystander of nutritional deficiency which cause iron deficiency.

  8. Prevalence of iron deficiency anemia among adolescent schoolgirls from Kermanshah, Western Iran.

    PubMed

    Akramipour, Reza; Rezaei, Mansour; Rahimi, Zohreh

    2008-12-01

    Iron deficiency anemia is a major health problem in developing countries. Anemia reduces physical work capacity and cognitive function and adversely affects learning and scholastic performance in schoolgirls entering adolescence. A cross-sectional study was conducted to determine the prevalence of iron deficiency, iron deficiency anemia and anemia among adolescent school girls aged 14-20 years from 20 different high schools located in three educational areas of Kermanshah, the capital of Kermanshah province in Western Iran. The prevalence of anemia (Hb<12 mg/dl) among adolescent school girls was 21.4%. Iron deficiency using a ferritin level <12 microg/l was found in 23.7% of studied girls. There were 47 girls (12.2%) with iron deficiency anemia (Hb<12 g/dl and ferritin <20 microg/l). Around 57.3% of anemic girls were iron deficient. There were no significant differences between the presence of anemia and the level of education of parents. The mean levels of hemoglobin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), mean cell hemoglobin (MCH) and mean cell hemoglobin concentration (MCHC) in studied adolescent girls from Western Iran were found to be lower than those reported for females aged 12-18 years. In conclusion, regarding the detrimental long-term effects and high prevalence of iron deficiency, iron deficiency anemia and anemia in Kermanshah, Western Iran its prevention could be a high priority in the programs of health system of the country and supplementation of a weekly iron dose is recommended.

  9. Intravenous iron alone resolves anemia in patients with functional iron deficiency and lymphoid malignancies undergoing chemotherapy.

    PubMed

    Hedenus, Michael; Karlsson, Torbjörn; Ludwig, Heinz; Rzychon, Beate; Felder, Marcel; Roubert, Bernard; Birgegård, Gunnar

    2014-12-01

    This randomized trial evaluated ferric carboxymaltose without erythropoiesis-stimulating agents (ESA) for correction of anemia in cancer patients with functional iron deficiency. Patients on treatment for indolent lymphoid malignancies, who had anemia [hemoglobin (Hb) 8.5-10.5 g/dL] and functional iron deficiency [transferrin saturation (TSAT) ≤ 20%, ferritin >30 ng/mL (women) or >40 ng/mL (men)], were randomized to ferric carboxymaltose (1,000 mg iron) or control. Primary end point was the mean change in Hb from baseline to weeks 4, 6 and 8 without transfusions or ESA. Difficulties with patient recruitment led to premature termination of the study. Seventeen patients (8 ferric carboxymaltose and 9 control) were included in the analysis. In the ferric carboxymaltose arm, mean Hb increase was significantly higher versus control at week 8 (p = 0.021). All ferric carboxymaltose-treated patients achieved an Hb increase >1 g/dL (control 6/9; p = 0.087), and mean TSAT was >20% from week 2 onwards. No treatment-related adverse events were reported. In conclusion, ferric carboxymaltose without ESA effectively increased Hb and iron status in this small patient population.

  10. The transcription factor IDEF1 regulates the response to and tolerance of iron deficiency in plants

    PubMed Central

    Kobayashi, Takanori; Ogo, Yuko; Itai, Reiko Nakanishi; Nakanishi, Hiromi; Takahashi, Michiko; Mori, Satoshi; Nishizawa, Naoko K.

    2007-01-01

    Iron is essential for most living organisms and is often the major limiting nutrient for normal growth. Plants induce iron utilization systems under conditions of low iron availability, but the molecular mechanisms of gene regulation under iron deficiency remain largely unknown. We identified the rice transcription factor IDEF1, which specifically binds the iron deficiency-responsive cis-acting element IDE1. IDEF1 belongs to an uncharacterized branch of the plant-specific transcription factor family ABI3/VP1 and exhibits the sequence recognition property of efficiently binding to the CATGC sequence within IDE1. IDEF1 transcripts are constitutively present in rice roots and leaves. Transgenic tobacco plants expressing IDEF1 under the control of the constitutive cauliflower mosaic virus 35S promoter transactivate IDE1-mediated expression only in iron-deficient roots. Transgenic rice plants expressing an introduced IDEF1 exhibit substantial tolerance to iron deficiency in both hydroponic culture and calcareous soil. IDEF1 overexpression leads to the enhanced expression of the iron deficiency-induced transcription factor gene OsIRO2, suggesting the presence of a sequential gene regulatory network. These findings reveal cis element/trans factor interactions that are functionally linked to the iron deficiency response. Manipulation of IDEF1 also provides another approach for producing crops tolerant of iron deficiency to enhance food and biomass production in calcareous soils. PMID:18025467

  11. The transcription factor IDEF1 regulates the response to and tolerance of iron deficiency in plants.

    PubMed

    Kobayashi, Takanori; Ogo, Yuko; Itai, Reiko Nakanishi; Nakanishi, Hiromi; Takahashi, Michiko; Mori, Satoshi; Nishizawa, Naoko K

    2007-11-27

    Iron is essential for most living organisms and is often the major limiting nutrient for normal growth. Plants induce iron utilization systems under conditions of low iron availability, but the molecular mechanisms of gene regulation under iron deficiency remain largely unknown. We identified the rice transcription factor IDEF1, which specifically binds the iron deficiency-responsive cis-acting element IDE1. IDEF1 belongs to an uncharacterized branch of the plant-specific transcription factor family ABI3/VP1 and exhibits the sequence recognition property of efficiently binding to the CATGC sequence within IDE1. IDEF1 transcripts are constitutively present in rice roots and leaves. Transgenic tobacco plants expressing IDEF1 under the control of the constitutive cauliflower mosaic virus 35S promoter transactivate IDE1-mediated expression only in iron-deficient roots. Transgenic rice plants expressing an introduced IDEF1 exhibit substantial tolerance to iron deficiency in both hydroponic culture and calcareous soil. IDEF1 overexpression leads to the enhanced expression of the iron deficiency-induced transcription factor gene OsIRO2, suggesting the presence of a sequential gene regulatory network. These findings reveal cis element/trans factor interactions that are functionally linked to the iron deficiency response. Manipulation of IDEF1 also provides another approach for producing crops tolerant of iron deficiency to enhance food and biomass production in calcareous soils.

  12. Responses of Sugar Beet Roots to Iron Deficiency. Changes in Carbon Assimilation and Oxygen Use1

    PubMed Central

    López-Millán, Ana Flor; Morales, Fermín; Andaluz, Sofía; Gogorcena, Yolanda; Abadía, Anunciación; Rivas, Javier De Las; Abadía, Javier

    2000-01-01

    Different root parts with or without increased iron-reducing activities have been studied in iron-deficient and iron-sufficient control sugar beet (Beta vulgaris L. Monohil hybrid). The distal root parts of iron-deficient plants, 0 to 5 mm from the root apex, were capable to reduce Fe(III)-chelates and contained concentrations of flavins near 700 μm, two characteristics absent in the 5 to 10 mm sections of iron-deficient plants and the whole root of iron-sufficient plants. Flavin-containing root tips had large pools of carboxylic acids and high activities of enzymes involved in organic acid metabolism. In iron-deficient yellow root tips there was a large increase in carbon fixation associated to an increase in phosphoenolpyruvate carboxylase activity. Part of this carbon was used, through an increase in mitochondrial activity, to increase the capacity to produce reducing power, whereas another part was exported via xylem. Root respiration was increased by iron deficiency. In sugar beet iron-deficient roots flavins would provide a suitable link between the increased capacity to produce reduced nucleotides and the plasma membrane associated ferric chelate reductase enzyme(s). Iron-deficient roots had a large oxygen consumption rate in the presence of cyanide and hydroxisalycilic acid, suggesting that the ferric chelate reductase enzyme is able to reduce oxygen in the absence of Fe(III)-chelates. PMID:11027736

  13. Iron uptake and homeostasis related genes in potato cultivated in vitro under iron deficiency and overload.

    PubMed

    Legay, Sylvain; Guignard, Cédric; Ziebel, Johanna; Evers, Danièle

    2012-11-01

    Potato is one of the most important staple food in the world because it is a good source of vitamin C, vitamin B6 but also an interesting source of minerals including mainly potassium, but also magnesium, phosphorus, manganese, zinc and iron to a lesser extent. The lack of iron constitutes the main form of micronutrient deficiency in the world, namely iron deficiency anemia, which strongly affects pregnant women and children from developing countries. Iron biofortification of major staple food such as potato is thus a crucial issue for populations from these countries. To better understand mechanisms leading to iron accumulation in potato, we followed in an in vitro culture experiment, by qPCR, in the cultivar Désirée, the influence of media iron content on the expression of genes related to iron uptake, transport and homeostasis. As expected, plantlets grown in a low iron medium (1 mg L(-1) FeNaEDTA) displayed a decreased iron content, a strong induction of iron deficiency-related genes and a decreased expression of ferritins. Inversely, plantlets grown in a high iron medium (120 mg L(-1) FeNaEDTA) strongly accumulated iron in roots; however, no significant change in the expression of our set of genes was observed compared to control (40 mg L(-1) FeNaEDTA).

  14. Dietary education and iron deficiency anaemia in the inner city

    PubMed Central

    Childs, F; Aukett, A; Darbyshire, P; Ilett, S; Livera, L

    1997-01-01

    Accepted 26 October 1996
 OBJECTIVES—To assess if a dietary health education programme could be used within existing health resources to reduce the incidence of iron deficiency anaemia in an inner city population.
DESIGN—Prospective cohort study.
SETTING—Inner city areas of west and south Birmingham.
SUBJECTS—A total of 1000 children recorded on the child health computer register.
INTERVENTION—Children were recruited at birth and randomised into control and intervention groups. Families in the intervention group received specific health education information at key ages by face to face contact using a range of materials. The control group received standard health education as delivered by the health visitors at the time.
MAIN OUTCOME MEASURES—Haemoglobin estimation and iron content of the diet at 18 months of age.
RESULTS—A total of 455 children completed the study. Sixty nine (27%) of the control group and 55 (28%) of the intervention group were anaemic as defined by haemoglobin less than 110 g/l. There was no difference in the iron content of the diets offered to the two groups of children.
CONCLUSION—In this deprived population we have shown no reduction in anaemia using a targeted nutritional programme and have highlighted the difficulties in conducting health education programmes within the scope of current health resources.

 PMID:9068306

  15. Delayed CNS maturation in iron-deficient anaemic infants.

    PubMed

    Ayala, Rosalva; Otero, Gloria A; Porcayo Mercado, Rosario; Pliego-Rivero, F Bernardo

    2008-04-01

    Direct evidence of CNS developmental alterations in iron-deficient anaemic (IDA) infants was obtained. Twenty 3-15-month-old IDA and 20 non-IDA infants (age and gender matched), healthy in every other respect, were studied. Complete blood and iron kinetics tests determined an IDA status. Psychomotor development was assessed through the test of Rogers and co-workers [Rogers SJ, Donovan CM, D'Eugenio D, Brown SL, Whiteside E, Moersch MS, Schafer DS. (eds) Developmental Programming for Infants and Young Children, Vol 2. University of Michigan Press, 1981] and under the 10-20 International System qEEG was performed (sleep/stage II). A Pearson's correlation test was applied between haematological, psychomotor and broad band EEG variables, and through ANOVA psychomotor and AP means were compared. IDA infants showed lower scores in cognition, fine motor and social/emotional areas, higher delta/theta and lower alpha power. Most correlations between haematological/psychological variables were positive. Delta/theta correlations were negative with self-care/gross and motor items while alpha/beta AP showed positive correlations with psychomotor and haematological variables. A clear association was found between EEG alterations and a low haematological/iron profile leading to a delayed psychomotor development.

  16. [Efficacy of to'thema in the treatment of iron deficiency anemia in early childhood with concomitant copper deficiency].

    PubMed

    Mtvarelidze, Z; Kvezereli-Kopadze, A; Kvezereli-Kopadze, M; Pagava, K

    2005-04-01

    IDA is still the major medico-social problem in pediatric hematology, especially in early childhood. In this correction ferroresistant forms of IDA are interesting. The aim of our investigation was: studying the Efficacy of Tot'hema in the treatment of Iron Deficiency Anemia in Early childhood with concomitant copper deficiency. We observed 42 patients with IDA (age 0,4 - 3 years) in open control investigation. The carried-out investigations revealed that IDA in early childhood is often proceeded by the concomitant copper deficiency and ceruloplasmin, mainly in premature infants and in children with prolonged diarrhea in anamnesis. In such cases it is important to investigate the copper metabolism together with the peripheral blood index and iron metabolism. Tot'hema improves hematologic and biochemical index, completely supplies iron and copper deficiency, prevents of iron resistant form of IDA. Tot'hema has no side effects.

  17. FUNCTIONAL SIGNIFICANCE OF EARLY-LIFE IRON DEFICIENCY: OUTCOMES AT 25 YEARS

    PubMed Central

    Lozoff, Betsy; Smith, Julia B.; Kaciroti, Niko; Clark, Katy M.; Guevara, Silvia; Jimenez, Elias

    2013-01-01

    Objective To determine adulthood functioning following chronic iron deficiency in infancy. Study design At 25 years, we compared 33 participants with chronic iron deficiency in infancy to 89 who were iron-sufficient before and/or after iron therapy. Outcomes included education, employment, marital status, physical and mental health. Results Adjusting for sex and SES, a higher proportion of the chronic iron-deficient group did not complete secondary school (58.1% vs.19.8% in iron-sufficient group, Wald-value = 8.74, p = .003), were not pursuing further education/training (76.1% vs. 31.5%, Wald-value = 3.01, p = .08; suggestive trend), and were single (83.9% vs. 23.7%, Wald-value = 4.49, p = .03). They reported poorer emotional health and more negative emotions and feelings of dissociation/detachment. Results were similar in secondary analyses comparing the chronic iron-deficient group to participants in the iron-sufficient group who had been iron-deficient before treatment in infancy. Path analysis showed direct paths for chronic iron deficiency in infancy and being single and more detachment/dissociation at 25 years. There were indirect paths for chronic iron deficiency and not completing secondary school via poorer cognitive functioning in early adolescence and more negative emotions via behavior problems in adolescence, indicating a cascade of adverse outcomes. Conclusion The observational nature of the study limits causal inference, despite control for background factors. Nonetheless, the results indicate substantial loss of human potential. There may be broader societal implications, because many adults worldwide had chronic iron deficiency in infancy. Iron deficiency can be prevented or treated before it becomes chronic or severe. PMID:23827739

  18. Functional significance of early-life iron deficiency: outcomes at 25 years.

    PubMed

    Lozoff, Betsy; Smith, Julia B; Kaciroti, Niko; Clark, Katy M; Guevara, Silvia; Jimenez, Elias

    2013-11-01

    To evaluate adulthood function following chronic iron deficiency in infancy. At 25 years, we compared 33 subjects with chronic iron deficiency in infancy to 89 who were iron-sufficient before and/or after iron therapy. Outcomes included education, employment, marital status, and physical and mental health. Adjusting for sex and socioeconomic status, a higher proportion of the group with chronic iron deficiency did not complete secondary school (58.1% vs 19.8% in iron-sufficient group; Wald value = 8.74; P = .003), were not pursuing further education/training (76.1% vs 31.5%; Wald value = 3.01; P = .08; suggestive trend), and were single (83.9% vs 23.7%, Wald value = 4.49; P = .03). They reported poorer emotional health and more negative emotions and feelings of dissociation/detachment. Results were similar in secondary analyses comparing the chronic iron-deficient group with subjects in the iron-sufficient group who had been iron-deficient before treatment in infancy. Path analysis showed direct paths for chronic iron deficiency in infancy and being single and more detachment/dissociation at 25 years. There were indirect paths for chronic iron deficiency and not completing secondary school via poorer cognitive functioning in early adolescence and more negative emotions via behavior problems in adolescence, indicating a cascade of adverse outcomes. The observational nature of this study limits our ability to draw causal inference, even when controlling for background factors. Nonetheless, our results indicate substantial loss of human potential. There may be broader societal implications, considering that many adults worldwide had chronic iron deficiency in infancy. Iron deficiency can be prevented or treated before it becomes chronic or severe. Copyright © 2013 Mosby, Inc. All rights reserved.

  19. Iron status biomarkers in iron deficient women consuming oily fish versus red meat diet.

    PubMed

    Navas-Carretero, S; Pérez-Granados, A M; Schoppen, S; Sarria, B; Carbajal, A; Vaquero, M P

    2009-06-01

    Specific recommendations for anemic individuals consist in increasing red meat intake, but the population at large is advised to reduce consumption of red meat and increase that of fish, in order to prevent the risk of developing cardiovascular disease. This study aimed to determine the effects of consuming an oily fish compared to a red meat diet on iron status in women with low iron stores. The study was designed attending the Consolidated Standards of Reporting Trials (CONSORT) statement guidelines. It was a randomised crossover dietary intervention study of two 8-week periods. Twenty-five young women with low iron stores completed the study. Two diets containing a total of 8 portions of fish, meat and poultry per week were designed differing only in their oily fish or red meat content (5 portions per week). At the beginning and the end of each period blood samples were taken and hemoglobin, hematocrit, serum ferritin, serum iron, serum transferrin, serum transferrin receptor-2 and the Zn-protoporphyrin/free-protoporphyrin ratio were determined. Food intake and body weight were monitored. During the oily fish diet, PUFA intake was significantly higher (p=0.010) and iron intake lower (mean+/-SD, 11.5+/-3.4 mg/day vs. 13.9+/-0.1 mg/day, p=0.008), both diets providing lower mean daily iron intake than recommended for menstruating women. Although there were no significant differences after 16 weeks, serum ferritin moderately decreased and soluble transferrin receptor increased with the oily fish, while changes with the red meat diet were the opposite. In conclusion, an oily fish diet compared to a red meat diet does not decrease iron status after 8 weeks in iron deficient women.

  20. Fortification of drinking water to control iron-deficiency anemia in preschool children.

    PubMed

    Dutra-de-Oliveira, José Eduardo; Lamounier, Joel A; de Almeida, Carlos A Nogueira; Marchini, Julio Sergio

    2007-06-01

    Iron-deficiency anemia is the most common type of micronutrient malnutrition in the world. Its etiology and control are well understood, but the problem persists and is increasing in some developing countries. Iron fortification of mass-consumption foods is considered one of the most viable approaches to deliver bioavailable iron to the population. To review and analyze the use of drinking water as an iron vehicle to reduce ferropenic anemia in developing countries. Drinking water with added iron compounds was offered to preschool children at day-care centers in Brazil. Iron solutions were prepared with 10 mg to 20 mg iron/L. Clinical and anthropometric measurements and blood hemoglobin concentrations were obtained at the beginning of each study and 4 to 8 months later. No problems with acceptability or side effects were observed. Daily water intake by children was around 500 mL. Iron-deficiency anemia was found in all studies. Control children not receiving iron supplementation mantained their initial hemoglobin level. Anemia was reduced in the groups receiving iron-fortified drinking water. Based on physical properties, tests in rats, and studies on preschool children at Brazilian day-care centers, we have shown that drinking water locally fortified with iron compounds should be considered and used as a worldwide available vehicle to control iron-deficiency anemia. Drinking water, besides being universally available, is a locally available vehicle, easily fortified, can be a vehicle for hydrosoluble iron, and reduces iron-deficiency anemia in preschool children.

  1. Physical performance of migrant schoolchildren with marginal and severe iron deficiency in the suburbs of Beijing.

    PubMed

    Wang, Jie; Huo, Jun-Sheng; Sun, Jing; Ning, Zheng-Xiang

    2009-08-01

    To investigate relationship between iron deficiency of different degrees and physical performance and habitual activity of migrant schoolchildren at the age of 11-14 years. Ninety one randomly selected schoolchildren were divided into three groups according to their iron status. Iron status including hemoglobin (Hb), serum ferritin (SF), serum iron (SI) and sTfR was determined. Physical performance tests included maximum oxygen consumption (VO2max) and maximum work time. Energy expenditure (EE) and daily physical activity were estimated by recording 24-h heart rate (HR). Dietary intake was assessed with frequency questionnaires, and physical activity level was estimated with frequency and physical activity questionnaires. Severe iron deficiency (IDA) impaired the aerobic capacity and habitual physical activity. When fat-free mass (FFM) was considered, VO2max (VO2max/FFM) was significantly lower in the iron-marginal group than in the iron-adequate groups among girls (P = 0.02), but such a deference was not found among boys (P = 0.28). Aerobic activity and EE at leisure were significantly lower in the severe iron deficient group than in the marginal iron deficient and iron adequate groups. Net HR at leisure time was correlated with Hb, log SF, body weight, and FFM (P < 0.05). The functional effect of iron deficiency on physical performance and habitual physical activity rely on the degree of current iron deficiency. Severe iron deficiency significantly impairs both aerobic capacity and habitual physical activity. Iron-marginal deficiency impairs VO2max/FFM in girls, rather than in boys.

  2. Clinical efficacy of two forms of intravenous iron--saccharated ferric oxide and cideferron--for iron deficiency anemia.

    PubMed

    Araki, T; Takaai, M; Miyazaki, A; Ohshima, S; Shibamiya, T; Nakamura, T; Yamamoto, K

    2012-12-01

    Over 90% of iron deficiency anemia cases are due to iron deficiency associated with depletion of stored iron or inadequate intake. Parenteral iron supplementation is an important part of the management of anemia, and some kinds of intravenous iron are used. However, few studies have evaluated the clinical efficacy of these drugs. The purpose of this study was to compare and assess the clinical efficacy of two types of intravenous iron injection, saccharated ferric oxide (SFO) and cideferron (CF). Medical records were obtained for 91 unrelated Japanese anemia patients treated with SFO (n = 37) or CF (n = 54) from May 2005 to May 2010 at Gunma University Hospital. Patients treated with blood transfusion, erythropoietin or oral iron were excluded. Hemoglobin (Hb) values measured on day 0, 7 and 14 were used to assess the efficacy of intravenous irons. A significant increase was observed in the mean Hb value by day 14 of administration in both the CF group and SFO group, and the mean Hb increase due to administration of CF for 7 days was comparable to that of SFO for 14 days. Age and sex did not affect improvement of Hb value. CF is fast acting and highly effective compared with SFO for the treatment of iron deficiency anemia. The use of CF may shorten a therapeutic period for iron deficiency anemia, and CF may be feasible for reducing the hospitalization period.

  3. Diagnosis of iron deficiency anaemia in hospital patients: Use of the reticulocyte haemoglobin content to differentiate iron deficiency anaemia from anaemia of chronic disease.

    PubMed

    Schapkaitz, Elise; Buldeo, Suvarna; Mahlangu, Johnny Ndoni

    2015-11-20

    The diagnosis of iron deficiency anaemia in hospital patients with chronic infections and inflammation presents a challenge. Recently laboratory tests such as the reticulocyte haemoglobin content, which are independent of infection and inflammation, have become available for routine diagnostic use.

  4. Artificial intelligence models for predicting iron deficiency anemia and iron serum level based on accessible laboratory data.

    PubMed

    Azarkhish, Iman; Raoufy, Mohammad Reza; Gharibzadeh, Shahriar

    2012-06-01

    Iron deficiency anemia (IDA) is the most common nutritional deficiency worldwide. Measuring serum iron is time consuming, expensive and not available in most hospitals. In this study, based on four accessible laboratory data (MCV, MCH, MCHC, Hb/RBC), we developed an artificial neural network (ANN) and an adaptive neuro-fuzzy inference system (ANFIS) to diagnose the IDA and to predict serum iron level. Our results represent that the neural network analysis is superior to ANFIS and logistic regression models in diagnosing IDA. Moreover, the results show that the ANN is likely to provide an accurate test for predicting serum iron levels with high accuracy and acceptable precision.

  5. Dhatrilauha: Right choice for iron deficiency anemia in pregnancy.

    PubMed

    Roy, Anuradha; Dwivedi, Manjari

    2014-01-01

    Anemia in pregnancy is multi-factorial. Iron deficiency anemia (IDA) is the most common one. Major cause is increased demand of iron during pregnancy. In Ayurveda, under Pandu-Roga the features of anemia are described. It is characterized by Vaivarnyata or Varnanasha (change/destruction in normal color of the body), a disorder of Pitta vitiation. Ayurvedic management is an effective way of curing anemia in general by a large number of Lauha preparations of which Dhatrilauha has been used widely for centuries. To evaluate the effect of Dhatrilauha in the management of IDA based on the scientific parameters among pregnant patients. A total of 58 cases were selected by simple randomized sampling method as per inclusion criteria of pregnant women between 4(th) and 7(th) months of pregnancy with a clinical diagnosis and laboratory confirmation of IDA. Dhatrilauha 500 mg in two divided doses after food with normal potable water were given for 45 days with three follow-ups, each of 15 days intervals. Final assessment was done after completion of 45 days and results were statistically analyzed by using Cochran's Q-test and Student's t-test. Dhatrilauha showed statistically significant (P < 0.01) improvement in the majority of sign-symptoms and objective parameters such as weakness, fatigue, palpitation, effort intolerance, breathlessness, heartburn, pallor, constipation, hemoglobin, red blood cells (RBC), hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, RBC distribution width, mean platelet volume, serum iron, and total iron binding capacity. Dhatrilauha possesses many fold effectiveness in anemia (IDA), which was evidenced with the significant results obtained in the majority of parameters in this study.

  6. Investigation and treatment for iron deficiency in heart failure: the unmet need in Lower and Middle Income Countries.

    PubMed

    Makubi, Abel; Roberts, David J

    2017-06-01

    Frank iron deficiency has been associated with a wide range of cardiac and pulmonary abnormalities including non-ischaemic cardiomyopathy. Iron deficiency anaemia and isolated iron deficiency are well-defined adverse prognostic factors in non-ischaemic cardiac failure. Furthermore, iron-deficient patients in chronic heart failure with a serum ferritin of <100 μg/l or <300 μg/l with reduced transferrin saturation of <20%, who were given intravenous iron showed improved clinical outcomes. Iron deficiency with or without anaemia affects over a quarter of the world's population, but the impact of iron deficiency in heart failure and the effective management of iron deficiency in heart failure in Lower and Middle Income Countries (LMICs) is not well described. Heart failure in African cohorts occurs at a younger age than in North America and Europe and is more likely to be due to hypertension. Recent studies suggest that iron deficiency anaemia, which is very common in heart failure patients in Africa, and iron deficiency are independently associated with a poor prognosis in heart failure. Preliminary data suggest that iron deficiency in patients with heart failure can be treated with oral iron, with significant beneficial effects on haematological and physiological variables. Cost may prohibit the use of intravenous iron on a large scale in LMICs and optimal regimes to treat iron deficiency in heart failure patients with oral iron therapy remain to be defined. © 2017 John Wiley & Sons Ltd.

  7. Iron deficiency and anaemia in bariatric surgical patients: causes, diagnosis and proper management.

    PubMed

    Muñoz, M; Botella-Romero, F; Gómez-Ramírez, S; Campos, A; García-Erce, J A

    2009-01-01

    Obesity-induced chronic inflammation leads to activation of the immune system that causes alterations of iron homeostasis including hypoferraemia, iron-restricted erythropoiesis, and finally mild-to-moderate anaemia. Thus, preoperative anaemia and iron deficiency are common among obese patients scheduled for bariatric surgery (BS). Assessment of patients should include a complete haematological and biochemical laboratory work-up, including measurement of iron stores, vitamin B12 and folate. In addition, gastrointestinal evaluation is recommended for most patients with iron-deficiency anaemia. On the other hand, BS is a long-lasting inflammatory stimulus in itself and entails a reduction of the gastric capacity and/or exclusion from the gastrointestinal tract which impair nutrients absorption, including dietary iron. Chronic gastrointestinal blood loss and iron-losingenteropathy may also contribute to iron deficiency after BS. Perioperative anaemia has been linked to increased postoperative morbidity and mortality and decreased quality of life after major surgery, whereas treatment of perioperative anaemia, and even haematinic deficiency without anaemia, has been shown to improve patient outcomes and quality of life. However, long-term follow-up data in regard to prevalence, severity, and causes of anaemia after BS are mostly absent. Iron supplements should be administered to patients after BS, but compliance with oral iron is no good. In addition, once iron deficiency has developed, it may prove refractory to oral treatment. In these situations, IV iron (which can circumvent the iron blockade at enterocytes and macrophages) has emerged as a safe and effective alternative for perioperative anaemia management. Monitoring should continue indefinitely even after the initial iron repletion and anaemia resolution, and maintenance IV iron treatment should be provided as required. New IV preparations, such ferric carboxymaltose, are safe, easy to use and up to 1000 mg can

  8. The effect of Helicobacter pylori infection on iron stores and iron deficiency in urban Alaska Native adults.

    PubMed

    Miernyk, Karen; Bruden, Dana; Zanis, Carolyn; McMahon, Brian; Sacco, Frank; Hennessy, Thomas; Parkinson, Alan; Bruce, Michael

    2013-06-01

    Helicobacter pylori (H. pylori) infection has been correlated with low serum ferritin and iron deficiency. As a secondary analysis of a study of H. pylori reinfection, we investigated the association of H. pylori infection and the effect of its eradication on serum ferritin and iron deficiency. Alaska Native adults undergoing esophagogastroduodenoscopy had sera collected and a (13) C urea breath test (UBT) was performed. Those H. pylori positive were treated with an antibiotic regimen; those who tested negative 2 months after treatment were evaluated at 4, 6, 12, and 24 months by UBT and serum ferritin with an immunoradiometric assay. We excluded persons from further analysis if they were prescribed iron by their provider. We measured serum ferritin for 241 persons; 121/241 were H. pylori positive. The geometric mean ferritin (GMF) for persons with and without H. pylori infection was 37 μg/L and 50 μg/L, respectively (p = .04). At enrollment, 19/121 H. pylori-positive persons had iron deficiency compared with 8/120 H. pylori negative (p = .02). Among 66 persons tested at 24 months, the GMF was higher at 24 months (49.6 μg/L) versus enrollment (36.5 μg/L; p = .02). Six of 11 persons with iron deficiency at enrollment no longer had iron deficiency and had a higher GMF (p = .02) 24 months after treatment. H. pylori infection was correlated with lower serum ferritin and iron deficiency. After H. pylori eradication, serum ferritin increased and approximately half of persons resolved their iron deficiency. Testing for H. pylori infection and subsequent treatment of those positive could be considered in persons with unexplained iron deficiency. © 2013 John Wiley & Sons Ltd.

  9. The effects on malaria of treatment of iron-deficiency anaemia with oral iron in Gambian children.

    PubMed

    Smith, A W; Hendrickse, R G; Harrison, C; Hayes, R J; Greenwood, B M

    1989-03-01

    In order to determine whether giving iron to iron-deficient children increases their susceptibility to malaria, 213 Gambian children aged between 6 months and 5 years with iron-deficiency anaemia were randomized to receive either oral iron or placebo during the rainy season when malaria transmission is maximal. Haematological and iron measurements improved significantly in the group given iron. Regular morbidity surveys showed that fever associated with parasitaemia occurred more frequently in the iron-treated group than in the placebo group. This difference was not significant for all parasitaemias grouped together, but became significant and progressively larger for parasitaemias of ten or more positive fields per 100 high power fields (P less than 0.025), and for parasitaemias of 50 or more positive fields per 100 high power fields (P less than 0.01). Three children in the iron-treated group but none in the placebo group had more than one episode of fever and parasitaemia. Splenomegaly rates rose appreciably during the study in both groups, but in children at age 2 years the splenomegaly rate at the end of the study was significantly greater in the iron-treated group. We concluded that there is a significantly increased risk of fever associated with severe malarial parasitaemia for children with iron-deficiency anaemia given iron during the season of maximal malaria transmission in this part of The Gambia.

  10. Malondialdehyde, antioxidant enzymes, and renal tubular functions in children with iron deficiency or iron-deficiency anemia.

    PubMed

    Altun, Demet; Kurekci, Ahmet Emin; Gursel, Orhan; Hacıhamdioglu, Duygu Ovunc; Kurt, Ismail; Aydın, Ahmet; Ozcan, Okan

    2014-10-01

    We aimed to investigate the effects of iron deficiency (ID) or iron-deficiency anemia (IDA) on oxidative stress and renal tubular functions before and after treatment of children. A total of 30 children with a diagnosis of IDA constituted the IDA group and 32 children with a diagnosis of ID constituted the ID group. Control group consisted 38 age-matched children. Serum ferritin, soluble transferrin receptor (sTfR), serum, and urinary sodium (Na), potassium (K), calcium (Ca), phosphorus (P), creatinine (Cr), uric acid (UA), urinary N-acetyl-β-D-glucosaminidase (NAG) levels, and intra-erythrocyte malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) levels were measured before and after iron therapy in the IDA and ID groups, whereas it was studied once in the control group. We have divided the study group in groups according to age (infants <2 years, children 3-9 years, and adolescents 10-15 years). Patients with IDA (infant, adolescent) and ID (infant, children, and adolescent) had a significantly high level of MDA in post-treatment period in comparison to those of healthy control. Patients with IDA (children, adolescent) and ID (infant, children) had a significantly high level of pre-treatment GSH-Px than controls. Post-treatment SOD was lower in IDA (children and adolescent) groups than control and post-treatment CAT was lower in IDA and ID (adolescent) groups than control. These findings show that ferrous sulfate used in the treatment of ID or IDA could lead to oxidative stress; however, a marked deterioration of in proximal renal tubular functions was not seen.

  11. Functional Significance of Iron Deficiency. Annual Nutrition Workshop Series, Volume III.

    ERIC Educational Resources Information Center

    Enwonwu, Cyril O., Ed.

    Iron deficiency anemia impairs cognitive performance, physical capacity, and thermoregulation. Recent evidence suggests that these functional impairments are also evident in subclinical nonanemic iron deficiency. Very little is known about the relevance of the latter to the health of blacks, who have been shown to have the highest prevalence of…

  12. Iron Deficiency's Long-Term Effects: An Interview with Pediatrician Betsy Lozoff

    ERIC Educational Resources Information Center

    National Scientific Council on the Developing Child, 2006

    2006-01-01

    Betsy Lozoff is among the world's leading experts on iron deficiency and its effects on infant brain development and behavior. Iron deficiency is the most common single nutrient disorder in the world, affecting more than half of the world's infants and young children. Research by Lozoff and others has shown that there are long-lasting…

  13. Developmental Scores of Iron Deficient Infants and the Effects of Therapy.

    ERIC Educational Resources Information Center

    Honig, Alice S.; Oski, Frank A.

    This study investigated the cognitive and behavioral functions associated with iron deficiency anemia in infants and toddlers and the short-term effects of therapy on such behaviors. Subjects were 24 iron deficient and anemic infants, 9 to 26 months old. The subjects were randomly assigned to a treatment or control group. The Bayley Scales of…

  14. Functional Significance of Iron Deficiency. Annual Nutrition Workshop Series, Volume III.

    ERIC Educational Resources Information Center

    Enwonwu, Cyril O., Ed.

    Iron deficiency anemia impairs cognitive performance, physical capacity, and thermoregulation. Recent evidence suggests that these functional impairments are also evident in subclinical nonanemic iron deficiency. Very little is known about the relevance of the latter to the health of blacks, who have been shown to have the highest prevalence of…

  15. Iron Deficiency's Long-Term Effects: An Interview with Pediatrician Betsy Lozoff

    ERIC Educational Resources Information Center

    National Scientific Council on the Developing Child, 2006

    2006-01-01

    Betsy Lozoff is among the world's leading experts on iron deficiency and its effects on infant brain development and behavior. Iron deficiency is the most common single nutrient disorder in the world, affecting more than half of the world's infants and young children. Research by Lozoff and others has shown that there are long-lasting…

  16. Spatial memory deficits in maternal iron deficiency paradigms are associated with altered glucocorticoid levels.

    PubMed

    Ranade, Sayali C; Nawaz, Sarfaraz; Chakrabarti, Arnab; Gressens, Pierre; Mani, Shyamala

    2013-06-01

    "The goal of this study was to examine the effect of maternal iron deficiency on the developing hippocampus in order to define a developmental window for this effect, and to see whether iron deficiency causes changes in glucocorticoid levels. The study was carried out using pre-natal, post-natal, and pre+post-natal iron deficiency paradigm. Iron deficient pregnant dams and their pups displayed elevated corticosterone which, in turn, differentially affected glucocorticoid receptor (GR) expression in the CA1 and the dentate gyrus. Brain Derived Neurotrophic Factor (BDNF) was reduced in the hippocampi of pups following elevated corticosterone levels. Reduced neurogenesis at P7 was seen in pups born to iron deficient mothers, and these pups had reduced numbers of hippocampal pyramidal and granule cells as adults. Hippocampal subdivision volumes also were altered. The structural and molecular defects in the pups were correlated with radial arm maze performance; reference memory function was especially affected. Pups from dams that were iron deficient throughout pregnancy and lactation displayed the complete spectrum of defects, while pups from dams that were iron deficient only during pregnancy or during lactation displayed subsets of defects. These findings show that maternal iron deficiency is associated with altered levels of corticosterone and GR expression, and with spatial memory deficits in their pups." Copyright © 2013 Elsevier Inc. All rights reserved.

  17. [Integrated management of childhood illness (IMCI) for iron deficiency in children].

    PubMed

    López, Diana F; Benjumea, María V

    2011-02-01

    Evaluating implementing the integrated management of childhood illness (IMCI) strategy in the prevention, detection and treatment of iron deficiency in children aged less than 5 who were treated at ASSBASALUD's Clinica La Asunción in Manizales, Colombia, during 2007. This was a cross-sectional study of 310 children aged 6 to 71 months who attended the first-level Clinica La Asunción in Manizales. Iron deficiency prevalence was evaluated in the children, as was IMCI implementation for prevention, diagnosis and treatment by health professionals responsible for child-care at that centre. Most children were aged less than 24 months, came within category 2 in the Identification and Classification System for Potential Beneficiaries for Social Programmes (SISBEN) and had been treated by Growth and Development section nurses. Children suffering from iron deficiency without anaemia accounted for most of those affected by iron deficiency. In half the population suffering anaemia this was due to iron deficiency; anaemia prevalence was higher than other types of infection-associated anaemia. For every child suffering iron deficiency-related anaemia, almost three had iron deficiency. Only six people accompanying the children being studied said that they had received indications for the dietary prevention of anaemia and this was wrong in half of the cases. These results showed that when caring for children aged less than five, prevention, diagnosis and treatment of iron deficiency anaemia did not follow the guidelines provided by the IMCI strategy.

  18. Impact of iron deficiency anaemia on T lymphocytes & their subsets in children.

    PubMed

    Mullick, Shalini; Rusia, Usha; Sikka, Meera; Faridi, M A

    2006-12-01

    While there is evidence of an altered immune profile in iron deficiency, the precise immunoregulatory role of iron is not known. Information particular in children who are vulnerable to iron deficiency and infection, is lacking. We undertook this study with the aim of documenting the changes in T cell subsets in children in the age group of 1 to 5 yr with iron deficiency. The levels of T lymphocytes, their CD4+ and CD8+ subsets and the CD4 : CD8 ratio were evaluated in 40 iron deficient and 30 healthy children. The impact of oral iron supplementation for three months on the same parameters was also noted in 30 children. Significantly lower levels of T lymphocytes as well as CD4+ cells was observed in the iron deficient children (P<0.01 and 0.002 respectively). The CD4 : CD8 ratio was also significantly lower in this group (P<0.05). Iron supplementation improved the CD4 counts significantly. Our study demonstrated quantitatively altered T cell subsets in iron deficiency in children, and a relationship between the severity of haematological and immunological compromise. The clinical and epidemiological implications of this relationship have topical relevance since ID is the most common micronutrient deficiency worldwide.

  19. Potential of Alginate Encapsulated Ferric Saccharate Microemulsions to Ameliorate Iron Deficiency in Mice.

    PubMed

    Mukhija, Kimmi; Singhal, Kirti; Angmo, Stanzin; Yadav, Kamalendra; Yadav, Hariom; Sandhir, Rajat; Singhal, Nitin Kumar

    2016-07-01

    Iron deficiency is one of the most prominent mineral deficiencies around the world, which especially affects large population of women and children. Development of new technologies to combat iron deficiency is on high demand. Therefore, we developed alginate microcapsule with encapsulated iron that had better oral iron bioavailability. Microcapsules containing iron with varying ratios of sodium alginate ferric(III)-saccharide were prepared using emulsification method. In vitro studies with Caco-2 cells suggested that newly synthesized microemulsions had better iron bioavailability as compared to commercially available iron dextran formulations. Ferrozine in vitro assay showed that alginate-encapsulated ferric galactose microemulsion (AFGM) had highest iron bioavailability in comparison to other four ferric saccharate microemulsions, namely AFGlM, AFMM, AFSM, and AFFM synthesized in our laboratory. Mice studies also suggested that AFGM showed higher iron absorption as indicated by increased serum iron, hemoglobin, and other hematopoietic measures with almost no toxicity at tested doses. Development of iron-loaded microemulsions leads to higher bioavailability of iron and can provide alternative strategies to treat iron deficiency.

  20. Iron deficiency stress can induce MxNRAMP1 protein endocytosis in M. xiaojinensis.

    PubMed

    Pan, Haifa; Wang, Yi; Zha, Qian; Yuan, Mudan; Yin, Lili; Wu, Ting; Zhang, Xinzhong; Xu, Xuefeng; Han, Zhenhai

    2015-08-10

    Iron deficiency is one of the most common nutritional disorders in plants, especially in fruit trees grown in calcareous soil. Iron deficiency stress can induce a series of adaptive responses in plants, the cellular and molecular mechanisms of which remain unclear. NRAMPs (natural resistance-associated macrophage proteins) play an important role in divalent metal ion transportation. In this study, we cloned MxNRAMP1, an NRAMP family gene from a highly iron-efficient apple genotype, Malus xiaojinensis. Further research showed that iron deficiency stress could induce MxNRAMP1 expression in roots and leaves. A protoplast transient expression system and immune electron microscopy localization techniques were used to prove that MxNRAMP1 mainly exists in the plasma membrane and vesicles. Interestingly, iron deficiency stress could induce the MxNRAMP protein to transport iron ions to specific organelles (lysosome and chloroplast) through vesicle endocytosis. Stable transgenic tobacco showed that MxNRAMP1 over-expression could promote iron absorption and accumulation in plants, and increase the plant's resistance against iron deficiency stress. These results showed that, in M. xiaojinensis, MxNRAMP1 not only plays an important role in iron absorption and transportation, it can also produce adaptive responses against iron deficiency through endocytosis. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Iron deficiency across chronic inflammatory conditions: International expert opinion on definition, diagnosis, and management.

    PubMed

    Cappellini, Maria Domenica; Comin-Colet, Josep; de Francisco, Angel; Dignass, Axel; Doehner, Wolfram; S P Lam, Carolyn; Macdougall, Iain C; Rogler, Gerhard; Camaschella, Clara; Kadir, Rezan; Kassebaum, Nicholas J; Spahn, Donat R; Taher, Ali T; Musallam, Khaled M

    2017-10-01

    Iron deficiency, even in the absence of anemia, can be debilitating, and exacerbate any underlying chronic disease, leading to increased morbidity and mortality. Iron deficiency is frequently concomitant with chronic inflammatory disease; however, iron deficiency treatment is often overlooked, partially due to the heterogeneity among clinical practice guidelines. In the absence of consistent guidance across chronic heart failure, chronic kidney disease and inflammatory bowel disease, we provide practical recommendations for iron deficiency to treating physicians: definition, diagnosis, and disease-specific diagnostic algorithms. These recommendations should facilitate appropriate diagnosis and treatment of iron deficiency to improve quality of life and clinical outcomes. © 2017 The Authors American Journal of Hematology Published by Wiley Periodicals, Inc.

  2. Response of the iron-deficient erythrocyte in the rat to hyperoxia

    NASA Technical Reports Server (NTRS)

    Larkin, E. C.; Kimzey, S. L.; Siler, K.

    1978-01-01

    Normal and iron-deficient rats were exposed to 90% O2 at 760 Torr for 24 or 48 h. Erythrocyte response to hyperoxia was monitored by potassium (rubidium) influx studies, by storage stress, and by ultrastructural studies. Normal rat erythrocytes exhibited morphological changes and decrease of ouabain-sensitive potassium influx compared to unexposed controls. Both components of erythrocyte potassium influx were affected by iron deficiency. Erythrocytes from unexposed iron-deficient rats showed a 50% increase in ouabain-sensitive potassium influx compared to controls. Iron-deficient rats exposed to hyperoxia for 24 or 48 h, had erythrocytes with morphological changes. Erythrocytes of iron-deficient rats exposed for 24 h showned no influx change; those exposed for 48 h showed a decrease of ouabain-sensitive influx compared to erythrocytes of controls.

  3. Pathogenesis of cardiac hypertrophy in iron deficiency anaemia: the role of noradrenaline.

    PubMed Central

    Rossi, M. A.; Carillo, S. V.

    1982-01-01

    This study examined the effect of long-term administration of reserpine, an adrenergic blocking agent, on cardiac hypertrophy in animals with severe iron deficiency anaemia. This condition was induced by feeding rats on an iron-deficient diet for 30 days from the time of weaning. Anaemia was indicated by lowering of blood haemoglobin levels. Reserpine was administered i.p. (0.15 mg/kg body wt) every day during the experiment. Marked cardiac hypertrophy, as indicated by increase heart weight and increased size of cardiac muscle cells, was evidenced in iron-deficient rats, while the heart weights and myocardial cell size of drug-treated anaemic rats were in the normal range. The successful prevention of cardiac hypertrophy in anaemic iron-deficient rats by reserpine administration supports the hypothesis that noradrenaline plays a key role in the cardiac-hypertrophy process in iron deficiency anaemia. PMID:6212077

  4. Response of the iron-deficient erythrocyte in the rat to hyperoxia

    NASA Technical Reports Server (NTRS)

    Larkin, E. C.; Kimzey, S. L.; Siler, K.

    1978-01-01

    Normal and iron-deficient rats were exposed to 90% O2 at 760 Torr for 24 or 48 h. Erythrocyte response to hyperoxia was monitored by potassium (rubidium) influx studies, by storage stress, and by ultrastructural studies. Normal rat erythrocytes exhibited morphological changes and decrease of ouabain-sensitive potassium influx compared to unexposed controls. Both components of erythrocyte potassium influx were affected by iron deficiency. Erythrocytes from unexposed iron-deficient rats showed a 50% increase in ouabain-sensitive potassium influx compared to controls. Iron-deficient rats exposed to hyperoxia for 24 or 48 h, had erythrocytes with morphological changes. Erythrocytes of iron-deficient rats exposed for 24 h showned no influx change; those exposed for 48 h showed a decrease of ouabain-sensitive influx compared to erythrocytes of controls.

  5. Breastfeeding, Mixed, or Formula Feeding at 9 Months of Age and the Prevalence of Iron Deficiency and Iron Deficiency Anemia in Two Cohorts of Infants in China.

    PubMed

    Clark, Katy M; Li, Ming; Zhu, Bingquan; Liang, Furong; Shao, Jie; Zhang, Yueyang; Ji, Chai; Zhao, Zhengyan; Kaciroti, Niko; Lozoff, Betsy

    2017-02-01

    To assess associations between breastfeeding and iron status at 9 months of age in 2 samples of Chinese infants. Associations between feeding at 9 months of age (breastfed as sole milk source, mixed fed, or formula fed) and iron deficiency anemia (IDA), iron deficiency, and iron sufficiency were determined in infants from Zhejiang (n = 142) and Hebei (n= 813) provinces. Iron deficiency was defined as body iron < 0 mg/kg, and IDA as iron deficiency + hemoglobin < 110 g/L. Multiple logistic regression assessed associations between feeding pattern and iron status. Breastfeeding was associated with iron status (P < .001). In Zhejiang, 27.5% of breastfed infants had IDA compared with 0% of formula-fed infants. The odds of iron deficiency/IDA were increased in breastfed and mixed-fed infants compared with formula-fed infants: breastfed vs formula-fed OR, 28.8 (95% CI, 3.7-226.4) and mixed-fed vs formula-fed OR, 11.0 (95% CI, 1.2-103.2). In Hebei, 44.0% of breastfed infants had IDA compared with 2.8% of formula-fed infants. With covariable adjustment, odds of IDA were increased in breastfed and mixed-fed groups: breastfed vs formula-fed OR, 78.8 (95% CI, 27.2-228.1) and mixed-fed vs formula-fed OR, 21.0 (95% CI, 7.3-60.9). In both cohorts, the odds of iron deficiency/IDA at 9 months of age were increased in breastfed and mixed-fed infants, and iron deficiency/IDA was common. Although the benefits of breastfeeding are indisputable, these findings add to the evidence that breastfeeding in later infancy identifies infants at risk for iron deficiency/IDA in many settings. Protocols for detecting and preventing iron deficiency/IDA in breastfed infants are needed. ClinicalTrials.gov: NCT00642863 and NCT00613717. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Is red meat required for the prevention of iron deficiency among children and adolescents?

    PubMed

    Savva, Savvas C; Kafatos, Anthony

    2014-01-01

    Iron deficiency remains the most common nutritional deficiency worldwide despite the fact that global prevention is a high priority. Recent guidelines suggest intake of red meat both in infants and toddlers to prevent iron deficiency. However frequent consumption of red and processed meat may be associated with an increased risk for cancer, cardiovascular disease and diabetes. Evidence also suggests that even in vegetarian diets or diets with little consumption of white or red meat, iron status may not be adversely affected. The Eastern Orthodox Christian Church dietary recommendations which is a type of periodic vegetarian diet, has proved beneficial for the prevention of iron deficiency and avoidance of excess iron intake. This paper aims to provide examples of meals for children and adolescents that may be sufficient to meet age specific iron requirements without consumption of red meat beyond the recommended consumption which is once or twice per month.

  7. Prenatal Iron Deficiency in Guinea Pigs Increases Locomotor Activity but Does Not Influence Learning and Memory.

    PubMed

    Fiset, Catherine; Rioux, France M; Surette, Marc E; Fiset, Sylvain

    2015-01-01

    The objective of the current study was to determine whether prenatal iron deficiency induced during gestation in guinea pigs affected locomotor activity and learning and memory processes in the progeny. Dams were fed either iron-deficient anemic or iron-sufficient diets throughout gestation and lactation. After weaning, all pups were fed an iron-sufficient diet. On postnatal day 24 and 40, the pups' locomotor activity was observed within an open-field test, and from postnatal day 25 to 40, their learning and memory processes were assessed within a Morris Water Maze. The behavioural and cognitive tests revealed that the iron deficient pup group had increased locomotor activity, but solely on postnatal day 40, and that there were no group differences in the Morris Water Maze. In the general discussion, we propose that prenatal iron deficiency induces an increase in nervousness due to anxiety in the progeny, which, in the current study, resulted in an increase of locomotor activity.

  8. Kleine–Levin syndrome with comorbid iron deficiency anemia

    PubMed Central

    Jain, Rajendra Singh; Kumar, Sunil; Srivastava, Trilochan; Sannegowda, Raghavendra Bakki

    2015-01-01

    Kleine–Levin syndrome (KLS) is a rare chronic sleep disorder of unknown etiopathology, which typically occurs in adolescent males. Although the severity of symptoms and disease course varies between the KLS patients, it usually resolves spontaneously, but sometime comorbid conditions may worsen the symptoms. Herein, we report a case of KLS who presented with severe episodic hypersomnia. During episodes, the patient used to sleep as long as 20 h in a day, affecting his daily living activities. All the relevant investigations including electroencephalography, magnetic resonance imaging of brain and cerebrospinal fluid analysis were normal except for severe iron deficiency anemia (IDA). In our patient, the severity of symptoms worsened due to coexistent IDA. The treatment of IDA along with modafinil decreased the severity of symptoms and shortened the hospital stay during episodes. This might be the first case report of KLS with comorbid IDA. PMID:26634130

  9. Iron deficiency regulated OsOPT7 is essential for iron homeostasis in rice.

    PubMed

    Bashir, Khurram; Ishimaru, Yasuhiro; Itai, Reiko Nakanishi; Senoura, Takeshi; Takahashi, Michiko; An, Gynheung; Oikawa, Takaya; Ueda, Minoru; Sato, Aiko; Uozumi, Nobuyuki; Nakanishi, Hiromi; Nishizawa, Naoko K

    2015-05-01

    The molecular mechanism of iron (Fe) uptake and transport in plants are well-characterized; however, many components of Fe homeostasis remain unclear. We cloned iron-deficiency-regulated oligopeptide transporter 7 (OsOPT7) from rice. OsOPT7 localized to the plasma membrane and did not transport Fe(III)-DMA or Fe(II)-NA and GSH in Xenopus laevis oocytes. Furthermore OsOPT7 did not complement the growth of yeast fet3fet4 mutant. OsOPT7 was specifically upregulated in response to Fe-deficiency. Promoter GUS analysis revealed that OsOPT7 expresses in root tips, root vascular tissue and shoots as well as during seed development. Microarray analysis of OsOPT7 knockout 1 (opt7-1) revealed the upregulation of Fe-deficiency-responsive genes in plants grown under Fe-sufficient conditions, despite the high Fe and ferritin concentrations in shoot tissue indicating that Fe may not be available for physiological functions. Plants overexpressing OsOPT7 do not exhibit any phenotype and do not accumulate more Fe compared to wild type plants. These results indicate that OsOPT7 may be involved in Fe transport in rice.

  10. Low Prevalence of Iron and Vitamin A Deficiency among Cambodian Women of Reproductive Age

    PubMed Central

    Wieringa, Frank T.; Sophonneary, Prak; Whitney, Sophie; Mao, Bunsoth; Berger, Jacques; Conkle, Joel; Dijkhuizen, Marjoleine A.; Laillou, Arnaud

    2016-01-01

    Nearly half of women of reproductive age (WRA) in Cambodia are anemic. To guide interventions, national data on nutritional causes of anemia, including iron deficiency and vitamin A deficiency, are needed. In 2012, a national household survey in WRA on antibodies to routine vaccine-preventable disease immunity was performed. We used serum samples from this survey to estimate the prevalence of iron and vitamin A deficiency in 2112 Cambodian WRA, aged 15 to 39 years. Iron deficiency was classified as low or marginal iron stores (ferritin concentrations corrected for inflammation <15 μg/L and <50 μg/L respectively; Fer), iron deficient erythropoiesis (soluble transferrin receptor concentrations >8.3 mg/L; sTfR), or low total body iron (TBI) derived from Fer and sTfR concentrations (<0 mg/kg). Vitamin A status was classified using retinol binding protein (RBP) concentrations corrected for inflammation as deficient (<0.70 μmol/L) or marginal (<1.05 μmol/L. Overall, the prevalence of low iron stores, low TBI and iron deficient erythropoiesis was 8.1%, 5.0% and 9.3% respectively. Almost 40% of the women had marginal iron stores. Iron status was better in women living in urban areas compared to rural areas (p < 0.05 for TBI and sTfR). The prevalence of vitamin A deficiency was <1%. These findings suggest that the contribution of iron and vitamin A deficiency to the high prevalence of anemia in Cambodian WRA may be limited. The etiology of anemia in Cambodia needs to be elucidated further to guide current policies on anemia. PMID:27043624

  11. Low Prevalence of Iron and Vitamin A Deficiency among Cambodian Women of Reproductive Age.

    PubMed

    Wieringa, Frank T; Sophonneary, Prak; Whitney, Sophie; Mao, Bunsoth; Berger, Jacques; Conkle, Joel; Dijkhuizen, Marjoleine A; Laillou, Arnaud

    2016-04-01

    Nearly half of women of reproductive age (WRA) in Cambodia are anemic. To guide interventions, national data on nutritional causes of anemia, including iron deficiency and vitamin A deficiency, are needed. In 2012, a national household survey in WRA on antibodies to routine vaccine-preventable disease immunity was performed. We used serum samples from this survey to estimate the prevalence of iron and vitamin A deficiency in 2112 Cambodian WRA, aged 15 to 39 years. Iron deficiency was classified as low or marginal iron stores (ferritin concentrations corrected for inflammation <15 μg/L and <50 μg/L respectively; Fer), iron deficient erythropoiesis (soluble transferrin receptor concentrations >8.3 mg/L; sTfR), or low total body iron (TBI) derived from Fer and sTfR concentrations (<0 mg/kg). Vitamin A status was classified using retinol binding protein (RBP) concentrations corrected for inflammation as deficient (<0.70 μmol/L) or marginal (<1.05 μmol/L. Overall, the prevalence of low iron stores, low TBI and iron deficient erythropoiesis was 8.1%, 5.0% and 9.3% respectively. Almost 40% of the women had marginal iron stores. Iron status was better in women living in urban areas compared to rural areas (p < 0.05 for TBI and sTfR). The prevalence of vitamin A deficiency was <1%. These findings suggest that the contribution of iron and vitamin A deficiency to the high prevalence of anemia in Cambodian WRA may be limited. The etiology of anemia in Cambodia needs to be elucidated further to guide current policies on anemia.

  12. Iron deficiency among apparently healthy children aged 6 to 24 months in Ibadan, Nigeria.

    PubMed

    Owa, Olufunke Tolulope; Brown, Biobele J; Adeodu, Oluwagbemiga O

    2016-08-01

    Iron deficiency remains a global public health challenge, with a higher burden in children in the tropics. When it occurs early in life, it may have long-term effects on neurodevelopment. The aims of this study were to assess the iron status of children aged 6-24 months, to determine the prevalence of iron deficiency and its associated factors in Ibadan, Nigeria. The authors conducted a cross-sectional study between March and June 2014. A total of 202 apparently healthy children aged between 6 and 24 months attending 2 major immunization clinics in Ibadan were included. A questionnaire was used to collect information on sociodemographic characteristics, pregnancy and birth history, and nutritional history. Physical examination was carried out on all the subjects, and serum ferritin level was determined using an enzyme-linked immunosorbent assay (ELISA) technique. Iron deficiency was defined using a cutoff value of <30 µg/L. Fifty-nine children (29.2%) had iron deficiency. No clinical features were found to be significantly associated with iron deficiency. Iron deficiency was associated with breastfeeding (P = .020) and younger age (P = .015) in the study population. One hundred and forty-three (70.8%) of the study participants had anemia, and 39 (19.3%) had iron deficiency anemia. The prevalence of iron deficiency among apparently healthy children aged 6-24 months in Ibadan, Nigeria, is high. There is the need for a national policy on routine screening for iron deficiency and iron supplementation for infants and young children as recommended by the World Health Organization.

  13. The prevalence of celiac disease in children with iron-deficiency anemia.

    PubMed

    Ertekin, Vildan; Tozun, Mahya Sultan; Küçük, Nuran

    2013-01-01

    Celiac disease is an immune-mediated enteropathy caused by a permanent sensitivity to gluten in genetically susceptible individuals. Iron-deficiency anemia is the most commonly encountered anemia in humans. Iron-deficiency anemia also is a common extraintestinal manifestation of celiac disease. To determine the celiac disease prevalence in children with iron-deficiency anemia and to compare the hematologic parameters in iron-deficiency anemia patients with and without celiac disease. A total of 61 patients aged 2-16 years who presented with iron-deficiency anemia were included in this study. Hemoglobin, red cell indices (mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, red cell distribution width), serum iron, and serum ferritin were determined. Venous blood samples for anti-tissue transglutaminase antibody immunoglobuline A were obtained from these patients. Upper gastrointestinal endoscopy was recommended to patients who had positive serology. Of 61 patients with iron-deficiency anemia, 13 (21,3%) had positive serology for celiac disease. The small intestine biopsy of all patients with positive serology showed villous atrophy (Marsh 3). The mean hemoglobin level was significantly lower in iron-deficiency anemia patients with celiac disease when compared to those without celiac disease (7,8±2,6 vs. 11,3±0,9 g/dL, p>0,05). There was a statistically significant negative correlation of tissue transglutaminase titers with hemoglobin, red cell indices, serum iron, and serum ferritin levels. Screening of celiac disease by anti-tissue transglutaminase antibody should be done as a routine investigation in children with iron-deficiency anemia. Biopsy should be recommended in patients with iron-deficiency anemia who have positive celiac disease serology.

  14. Motor hyperactivity of the iron-deficient rat - an animal model of restless legs syndrome.

    PubMed

    Lai, Yuan-Yang; Cheng, Yu-Hsuan; Hsieh, Kung-Chiao; Nguyen, Darian; Chew, Keng-Tee; Ramanathan, Lalini; Siegel, Jerome M

    2017-08-26

    Abnormal striatal dopamine transmission has been hypothesized to cause restless legs syndrome. Dopaminergic drugs are commonly used to treat restless legs syndrome. However, they cause adverse effects with long-term use. An animal model would allow the systematic testing of potential therapeutic drugs. A high prevalence of restless legs syndrome has been reported in iron-deficient anemic patients. We hypothesized that the iron-deficient animal would exhibit signs similar to those in restless legs syndrome patients. After baseline polysomnographic recordings, iron-deficient rats received pramipexole injection. Then, iron-deficient rats were fed a standard rodent diet, and polysomnographic recording were performed for 2 days each week for 4 weeks. Iron-deficient rats have low hematocrit levels and show signs of restless legs syndrome: sleep fragmentation and periodic leg movements in wake and in slow-wave sleep. Iron-deficient rats had a positive response to pramipexole treatment. After the iron-deficient rats were fed the standard rodent diet, hematocrit returned to normal levels, and sleep quality improved, with increased average duration of wake and slow-wave sleep episodes. Periodic leg movements decreased during both waking and sleep. Hematocrit levels positively correlated with the average duration of episodes in wake and in slow-wave sleep and negatively correlated with periodic leg movements in wake and in sleep. Western blot analysis showed that striatal dopamine transporter levels were higher in iron-deficient rats. The iron-deficient rat is a useful animal model of iron-deficient anemic restless legs syndrome. © 2017 International Parkinson and Movement Disorder Society. © 2017 International Parkinson and Movement Disorder Society.

  15. Detecting Congenital Central Hypothyroidism by Newborn Screening: Difficulty in Distinguishing from Congenital Thyroxine-Binding Globulin Deficiency.

    PubMed

    Connelly, Kara J; Pierce, Melinda J; Hanna, Cheryl; LaFranchi, Stephen H

    2017-09-14

    Congenital central hypothyroidism (CH-C) can be detected on newborn screening (NBS) by programs using thyroxine (T4)-reflex thyroid-stimulating hormone (TSH) test approach. CH-C must be distinguished from T4-binding globulin (TBG) deficiency. We sought to determine whether thyroid function tests reliably separate CH-C from TBG deficiency. We analyzed NBS and serum free and total T4, T3 resin uptake (T3RU) or TBG, and TSH for infants in the Northwest Regional NBS Program (NWRSP) between the years 2008 and 2015 with either CH-C or TBG deficiency. We discovered a significant overlap in T3RU and TBG levels amongst 21 cases of CH-C and 250 cases of TBG deficiency. Mean serum TBG levels were lower in CH-C cases (20.3 µg/mL, range 14.2-33.3) than what is reported in healthy infants (28.6 µg/mL, range 19.1-44.6). Serum free T4 was lower in CH-C cases than TBG deficiency but did not always differentiate between the two conditions. CH-C benefits from detection on NBS but must be distinguished from TBG deficiency. The diagnosis of CH-C rests solely on subnormal serum free T4, but is supported by the demonstration of other pituitary hormone deficiencies. As an overlap exists, serum TBG (or T3RU) levels do not play a role in the diagnosis of CH-C. © 2017 S. Karger AG, Basel.

  16. Iron deficiency, anemia, and mortality in renal transplant recipients.

    PubMed

    Eisenga, Michele F; Minović, Isidor; Berger, Stefan P; Kootstra-Ros, Jenny E; van den Berg, Else; Riphagen, Ineke J; Navis, Gerjan; van der Meer, Peter; Bakker, Stephan J L; Gaillard, Carlo A J M

    2016-11-01

    Anemia, iron deficiency anemia (IDA), and iron deficiency (ID) are highly prevalent in renal transplant recipients (RTR). Anemia is associated with poor outcome, but the role of ID is unknown. Therefore, we aimed to investigate the association of ID, irrespective of anemia, with all-cause mortality in RTR. Cox regression analyses were used to investigate prospective associations. In 700 RTR, prevalences of anemia, IDA, and ID were 34%, 13%, and 30%, respectively. During follow-up for 3.1 (2.7-3.9) years, 81 (12%) RTR died. In univariable analysis, anemia [HR, 1.72 (95%CI: 1.11-2.66), P = 0.02], IDA [2.44 (1.48-4.01), P < 0.001], and ID [2.04 (1.31-3.16), P = 0.001] were all associated with all-cause mortality. In multivariable analysis, the association of anemia with mortality became weaker after adjustment for ID [1.52 (0.97-2.39), P = 0.07] and disappeared after adjustment for proteinuria and eGFR [1.09 (0.67-1.78), P = 0.73]. The association of IDA with mortality attenuated after adjustment for potential confounders. In contrast, the association of ID with mortality remained independent of potential confounders, including anemia [1.77 (1.13-2.78), P = 0.01]. In conclusion, ID is highly prevalent among RTR and is associated with an increased risk of mortality, independent of anemia. As ID is a modifiable factor, correction of ID could be a target to improve survival. © 2016 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.

  17. Iron deficiency and Helicobacter pylori infection in children.

    PubMed

    Vendt, N; Kool, P; Teesalu, K; Lillemäe, K; Maaroos, H-I; Oona, M

    2011-09-01

    To examine the relationship between iron deficiency (ID) and Helicobacter pylori infection in school-aged children. Altogether 363 children from ambulatory admission were consecutively enrolled in the study. Haemoglobin (Hb), soluble transferrin receptor (sTfR), IgG against H. pylori and IgA against tissue transglutaminase were measured. The criteria for ID were sTfR > 5.7 mg/L in children aged 7-12 years and sTfR > 4.5 mg/L in older children, for anaemia Hb < 115 g/L in the younger group and Hb < 130 g/L for older boys and Hb < 120 g/L for girls. Iron deficiency was found in 17% of the children, 5% had also anaemia. H. pylori colonization was detected in 27% and serum markers for coeliac disease in 0.6% of the children. The prevalence of ID and H. pylori seropositivity was higher in older children (23% and 29%, vs 9% and 22%, respectively). Children with H. pylori were significantly shorter [length SDS 1.0 (0.98-1.01) vs 0.98 (0.97-0.99)]. Older children had risk for ID (OR 1.1, 95% CI 1.0-1.3, p = 0.03). Although the prevalence of H. pylori seropositivity was higher in the ID group, it was not significantly associated with ID in multivariate analysis. Helicobacter pylori seropositivity was not associated with ID. The associated factor for ID was age. © 2011 The Author(s)/Acta Paediatrica © 2011 Foundation Acta Paediatrica.

  18. Coprophagy in iron-deficient rats: II. 2 novel methods of prevention.

    PubMed

    Neale, R J

    1984-04-01

    2 novel methods of coprophagy prevention were used in iron-deficient rats to measure their effect on haemoglobin regeneration during the feeding of ferrous sulphate or several soya proteins. Neck collars produced considerable weight loss and depression in food intake compared to aluminium anal cups which were tolerated well. Both methods of coprophagy prevention reduced iron availability from a range of soya proteins and ferrous sulphate and it is suggested that the practice of coprophagy in iron-deficient and possibly iron-replete rats may overestimate iron (and possibly other mineral) absorption (retention) studies.

  19. A comparative study between intramuscular iron dextran and oral ferrous sulphate in the treatment of iron deficiency anaemia in pregnancy.

    PubMed

    Komolafe, J O; Kuti, O; Ijadunola, K T; Ogunniyi, S O

    2003-11-01

    A comparative study was conducted to demonstrate the difference, if any, in effectiveness of treatment of iron deficiency anaemia in pregnancy with either iron dextran or ferrous sulphate. Sixty pregnant women with iron deficiency anaemia were assigned randomly to either group and treated for 6 weeks. The age and parity distributions with mean packed cell volumes (PCVs) and gestational age at onset of treatment in the two groups were comparable. Comparing the mean PCVs at week 2, week 4 and week 6 of treatment the iron dextran group recorded higher and statistically significant mean PCVs (P<0.001). Thirty-six per cent of patients in the iron dextran group compared to 3.3% in the oral iron group (P=0.004) had their anaemia corrected by the sixth week. No significant side effects accompanied the use of intramuscular iron dextran. It was concluded that iron dextran corrects iron deficiency anaemia faster than ferrous sulphate. Parenteral iron should be considered in pregnant woman with moderate and asymptomatic severe anaemia between gestation ages of 28 weeks and 34 weeks; this may reduce the frequency of blood transfusion both in the antenatal and postnatal periods in these patients.

  20. Iron deficiency in children with global developmental delay and autism spectrum disorder.

    PubMed

    Sidrak, Samuel; Yoong, Terence; Woolfenden, Susan

    2014-05-01

    To investigate the prevalence of and risk factors for iron deficiency in children with global developmental delay and/or autism spectrum disorder (ASD). A retrospective review was conducted of the files of children referred to community paediatric clinics in South West Sydney from May 2009 to July 2011 who were diagnosed with global developmental delay and/or ASD. Data were extracted on iron studies and potential risk factors. Data were analysed using Pearson's ÷(2) -test and Fisher's exact test. Subjects included 122 children. The prevalence of iron depletion was 2.5% (95% CI 0.5-7.0%); that of iron deficiency was 6.6% (95% CI 2.9-12.5%), and that of iron deficiency anaemia was 4.1% (95% CI 1.3-9.3%). In children with global developmental delay without ASD, the prevalence of iron depletion was 1.8% (95% CI 0-9.7%), that of iron deficiency 5.5% (95% CI 1.1-15.1%) and that of iron deficiency anaemia 5.5% (95% CI 1.1-15.1%). In children with ASD with or without global developmental delay, the prevalence of iron depletion was 3.0% (95% CI 0.4-10.4%), that of iron deficiency 7.5% (95% CI 2.5-16.6%) and that of iron deficiency anaemia 3.0% (95% CI 0.4-10.4%). Univariate analysis demonstrated three significant potential risk factors for iron depletion, iron deficiency and iron deficiency anaemia: problems sucking, swallowing or chewing (P = 0.002); poor eating behaviour (P = 0.008); and inadequate amounts of meat, chicken, eggs or fish (P = 0.002). Iron deficiency and iron deficiency anaemia were more common in this clinical sample of children with global developmental delay and/or ASD than in the general population. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  1. Blood and hair lead in children with different extents of iron deficiency in Karachi

    SciTech Connect

    Ataur Rahman, Muhammad; Rahman, Bushra; Saeed Ahmad, Muhammad; Blann, Andrew; Ahmed, Nessar

    2012-10-15

    Childhood iron deficiency has a high incidence in Pakistan. Some but not all studies have shown that dietary iron deficiency may cause increased absorption of lead as both compete for the same transporters in the small intestine. Therefore, children in Pakistan, residing in heavily polluted cities like Karachi may be prone to lead poisoning. This hypothesis was tested by investigating blood and hair lead concentrations in children from Karachi who were divided into four groups of iron status; normal, borderline iron deficiency, iron deficiency and iron deficiency anaemia. A prospective observational study was conducted where 269 children were categorized into four groups of iron status using the World Health Organization criteria and one based on soluble transferrin receptor measurements. Blood iron status was determined using a full blood count, serum iron, ferritin, transferrin saturation and soluble transferrin receptor measurements. Blood lead was determined by graphite atomic absorption spectroscopy, whereas hair lead was assessed using an inductively coupled plasma atomic emission spectroscopy technique. Blood lead concentrations were significantly higher in children with iron deficiency anaemia (mean [95% confidence intervals] were 24.9 [22.6-27.2] {mu}g/dL) compared to those with normal iron status (19.1 [16.8-21.4] {mu}g/dL) using WHO criteria. In contrast, hair lead content was not significantly different in children of different iron status. Our findings reinforce the importance of not only reducing environmental lead pollution but also the development of national health strategies to reduce childhood iron deficiency in Pakistan.

  2. Underestimation of the coexistence of iron deficiencies and thalassemia minors: a single institution experience in Taiwan.

    PubMed

    Lin, Chung-King; Chen, Ling-Ping; Chang, Hsiu-Lin; Sung, Yung-Chuan

    2014-08-01

    Some physicians neglect the possible coexistence of an iron deficiency with a thalassemia minor and do not treat the iron deficiency accordingly. This motivated us to conduct this study. We retrospectively reviewed the records of 3892 patients who visited our clinics and had hemoglobin (Hb) electrophoreses performed in our hematologic laboratory from August 1, 2007 to December 31, 2012. The thalassemia minors were identified by characteristic complete blood count (CBC) parameters obtained from an autoanalyzer and Hb electrophoresis, and some cases were confirmed with molecular tests. Then, we checked iron studies [ferritin and/or serum iron with total iron-binding capacity (TIBC)] to determine the coexistence of an iron deficiency with a thalassemia minor and a response to iron, if such treatments were given. We found 792 cases with thalassemia minors, and excluded those without iron studies, with 661 cases as our sample. A total of 202/661 cases (31%) also had iron deficiencies. They had lower red blood cell (RBC) counts, Hb, and ferritin levels as compared to those thalassemia minor cases without coexistence of iron deficiencies. We concluded that the thalassemia minor patients did not have iron overload complications in our population. On the contrary, iron deficiencies commonly coexist in the clinical visits. We propose that if Hb < 11.5 g/dL in a case of thalassemia minor, one should screen for iron deficiency simultaneously. The sensitivity is 79.8% and the specificity is 82.6%. Therefore, physicians should be aware of this coexisting condition, and know how to recognize and treat it accordingly. Copyright © 2014. Published by Elsevier B.V.

  3. Blood and hair lead in children with different extents of iron deficiency in Karachi.

    PubMed

    Rahman, Muhammad Ataur; Rahman, Bushra; Ahmad, Muhammad Saeed; Blann, Andrew; Ahmed, Nessar

    2012-10-01

    Childhood iron deficiency has a high incidence in Pakistan. Some but not all studies have shown that dietary iron deficiency may cause increased absorption of lead as both compete for the same transporters in the small intestine. Therefore, children in Pakistan, residing in heavily polluted cities like Karachi may be prone to lead poisoning. This hypothesis was tested by investigating blood and hair lead concentrations in children from Karachi who were divided into four groups of iron status; normal, borderline iron deficiency, iron deficiency and iron deficiency anaemia. A prospective observational study was conducted where 269 children were categorized into four groups of iron status using the World Health Organization criteria and one based on soluble transferrin receptor measurements. Blood iron status was determined using a full blood count, serum iron, ferritin, transferrin saturation and soluble transferrin receptor measurements. Blood lead was determined by graphite atomic absorption spectroscopy, whereas hair lead was assessed using an inductively coupled plasma atomic emission spectroscopy technique. Blood lead concentrations were significantly higher in children with iron deficiency anaemia (mean [95% confidence intervals] were 24.9 [22.6-27.2] μg/dL) compared to those with normal iron status (19.1 [16.8-21.4] μg/dL) using WHO criteria. In contrast, hair lead content was not significantly different in children of different iron status. Our findings reinforce the importance of not only reducing environmental lead pollution but also the development of national health strategies to reduce childhood iron deficiency in Pakistan.

  4. Prenatal Iron Supplementation Reduces Maternal Anemia, Iron Deficiency, and Iron Deficiency Anemia in a Randomized Clinical Trial in Rural China, but Iron Deficiency Remains Widespread in Mothers and Neonates.

    PubMed

    Zhao, Gengli; Xu, Guobin; Zhou, Min; Jiang, Yaping; Richards, Blair; Clark, Katy M; Kaciroti, Niko; Georgieff, Michael K; Zhang, Zhixiang; Tardif, Twila; Li, Ming; Lozoff, Betsy

    2015-08-01

    Previous trials of prenatal iron supplementation had limited measures of maternal or neonatal iron status. The purpose was to assess effects of prenatal iron-folate supplementation on maternal and neonatal iron status. Enrollment occurred June 2009 through December 2011 in Hebei, China. Women with uncomplicated singleton pregnancies at ≤20 wk gestation, aged ≥18 y, and with hemoglobin ≥100 g/L were randomly assigned 1:1 to receive daily iron (300 mg ferrous sulfate) or placebo + 0.40 mg folate from enrollment to birth. Iron status was assessed in maternal venous blood (at enrollment and at or near term) and cord blood. Primary outcomes were as follows: 1) maternal iron deficiency (ID) defined in 2 ways as serum ferritin (SF) <15 μg/L and body iron (BI) <0 mg/kg; 2) maternal ID anemia [ID + anemia (IDA); hemoglobin <110 g/L]; and 3) neonatal ID (cord blood ferritin <75 μg/L or zinc protoporphyrin/heme >118 μmol/mol). A total of 2371 women were randomly assigned, with outcomes for 1632 women or neonates (809 placebo/folate, 823 iron/folate; 1579 mother-newborn pairs, 37 mothers, 16 neonates). Most infants (97%) were born at term. At or near term, maternal hemoglobin was significantly higher (+5.56 g/L) for iron vs. placebo groups. Anemia risk was reduced (RR: 0.53; 95% CI: 0.43, 0.66), as were risks of ID (RR: 0.74; 95% CI: 0.69, 0.79 by SF; RR: 0.65; 95% CI: 0.59, 0.71 by BI) and IDA (RR: 0.49; 95% CI: 0.38, 0.62 by SF; RR: 0.51; 95% CI: 0.40, 0.65 by BI). Most women still had ID (66.8% by SF, 54.7% by BI). Adverse effects, all minor, were similar by group. There were no differences in cord blood iron measures; >45% of neonates in each group had ID. However, dose-response analyses showed higher cord SF with more maternal iron capsules reported being consumed (β per 10 capsules = 2.60, P < 0.05). Prenatal iron supplementation reduced anemia, ID, and IDA in pregnant women in rural China, but most women and >45% of neonates had ID, regardless of

  5. Prenatal Iron Supplementation Reduces Maternal Anemia, Iron Deficiency, and Iron Deficiency Anemia in a Randomized Clinical Trial in Rural China, but Iron Deficiency Remains Widespread in Mothers and Neonates123

    PubMed Central

    Zhao, Gengli; Xu, Guobin; Zhou, Min; Jiang, Yaping; Richards, Blair; Clark, Katy M; Kaciroti, Niko; Georgieff, Michael K; Zhang, Zhixiang; Tardif, Twila; Li, Ming; Lozoff, Betsy

    2015-01-01

    Background: Previous trials of prenatal iron supplementation had limited measures of maternal or neonatal iron status. Objective: The purpose was to assess effects of prenatal iron-folate supplementation on maternal and neonatal iron status. Methods: Enrollment occurred June 2009 through December 2011 in Hebei, China. Women with uncomplicated singleton pregnancies at ≤20 wk gestation, aged ≥18 y, and with hemoglobin ≥100 g/L were randomly assigned 1:1 to receive daily iron (300 mg ferrous sulfate) or placebo + 0.40 mg folate from enrollment to birth. Iron status was assessed in maternal venous blood (at enrollment and at or near term) and cord blood. Primary outcomes were as follows: 1) maternal iron deficiency (ID) defined in 2 ways as serum ferritin (SF) <15 μg/L and body iron (BI) <0 mg/kg; 2) maternal ID anemia [ID + anemia (IDA); hemoglobin <110 g/L]; and 3) neonatal ID (cord blood ferritin <75 μg/L or zinc protoporphyrin/heme >118 μmol/mol). Results: A total of 2371 women were randomly assigned, with outcomes for 1632 women or neonates (809 placebo/folate, 823 iron/folate; 1579 mother-newborn pairs, 37 mothers, 16 neonates). Most infants (97%) were born at term. At or near term, maternal hemoglobin was significantly higher (+5.56 g/L) for iron vs. placebo groups. Anemia risk was reduced (RR: 0.53; 95% CI: 0.43, 0.66), as were risks of ID (RR: 0.74; 95% CI: 0.69, 0.79 by SF; RR: 0.65; 95% CI: 0.59, 0.71 by BI) and IDA (RR: 0.49; 95% CI: 0.38, 0.62 by SF; RR: 0.51; 95% CI: 0.40, 0.65 by BI). Most women still had ID (66.8% by SF, 54.7% by BI). Adverse effects, all minor, were similar by group. There were no differences in cord blood iron measures; >45% of neonates in each group had ID. However, dose-response analyses showed higher cord SF with more maternal iron capsules reported being consumed (β per 10 capsules = 2.60, P < 0.05). Conclusions: Prenatal iron supplementation reduced anemia, ID, and IDA in pregnant women in rural China, but most women

  6. Transgenic petunia with the iron(III)-phytosiderophore transporter gene acquires tolerance to iron deficiency in alkaline environments.

    PubMed

    Murata, Yoshiko; Itoh, Yoshiyuki; Iwashita, Takashi; Namba, Kosuke

    2015-01-01

    Iron is an essential nutrient for all plants. However, terrestrial plants often suffer from iron deficiency in alkaline soil due to its extremely low solubility. Alkaline soil accounts for about 30% of all cultivated ground in the world. Plants have evolved two distinct strategies, I and II, for iron uptake from the soil. Dicots and non-graminaceous monocots use Strategy I, which is primarily based on the reduction of iron(III) to iron(II) and the uptake of iron(II) by the iron-regulated transporter, IRT1. In contrast, graminaceous plants use Strategy II to efficiently acquire insoluble iron(III). Strategy II comprises the synthesis and secretion of iron-chelating phytosiderophores, such as mugineic acids and the Yellow Stripe 1 transporter proteins of the iron(III)-phytosiderophore complex. Barley, which exhibits the highest tolerance to iron deficiency in alkaline soil among graminaceous plants, utilizes mugineic acids and the specific iron(III)-mugineic acids transporter, HvYS1. In this study, we established the transgenic plant Petunia hybrida, which originally had only Strategy I, by introducing the HvYS1 transporter gene derived from barley. When the transgenic plants were grown hydroponically in media containing the iron(III)-2'-deoxymugineic acid complex, free 2'-deoxymugineic acid and its iron(III) complex were detected in the root extract of the transgenic plant by electrospray ionization-Fourier transform-ion cyclotron resonance mass spectrometry. The growth of the transgenic petunia was significantly better than that of the control host in alkaline conditions. Consequently, the transgenic plant acquired a significantly enhanced tolerance to alkaline hydroponic media in the presence of the iron(III)-2'-deoxymugineic acid complex. Furthermore, the flower color of the transgenic plant deepened. The results showed that iron-phytosiderophore complexes and their transporters can potentially be utilized to overcome the worldwide iron uptake problems to diverse

  7. Incidence of iron-deficiency anaemia in infants in a prospective study in Jordan.

    PubMed

    Kilbride, J; Baker, T G; Parapia, L A; Khoury, S A

    2000-04-01

    A high prevalence of iron-deficiency anaemia has been reported in Jordanian infants. A prospective study of infants in downtown Amman examined the relationship between anaemia in pregnancy and iron deficiency in infancy. The iron status of infants born to 107 anaemic (Hb < 11 g/dl) and 125 non-anaemic mothers was reviewed at 3, 6, 9 and 12 months. Indicators to define iron-deficiency anaemia were Hb < 11 g/dl and either plasma ferritin < 12 microg/l or zinc protoporphyrin (ZPP) > 35 microg/dl whole blood. Haemoglobin electrophoresis excluded haemoglobinopathy. There was 72% iron-deficiency anaemia throughout the year, significantly higher in infants born to anaemic mothers (81%; n = 91) compared with controls (65%; n = 112). At 12 months, 72% of the infants tested (n = 195) were anaemic. While 57% were identified as iron-deficient by research criteria of either ferritin or ZPP, only 37% were identified by ferritin alone, 40% by ZPP alone and 29% if both ferritin and ZPP were required to meet criteria. Most infant anaemia was identified as due to iron deficiency, supporting contextual setting as assisting diagnosis: infants in developing countries are recognised as vulnerable to iron deficiency. Using multiple criteria, more cases were identified when either ferritin or ZPP were abnormal than when one alone, or both parameters were required to meet research criteria.

  8. Alkaline stress and iron deficiency regulate iron uptake and riboflavin synthesis gene expression differently in root and leaf tissue: implications for iron deficiency chlorosis

    PubMed Central

    Hsieh, En-Jung; Waters, Brian M.

    2016-01-01

    Iron (Fe) is an essential mineral that has low solubility in alkaline soils, where its deficiency results in chlorosis. Whether low Fe supply and alkaline pH stress are equivalent is unclear, as they have not been treated as separate variables in molecular physiological studies. Additionally, molecular responses to these stresses have not been studied in leaf and root tissues simultaneously. We tested how plants with the Strategy I Fe uptake system respond to Fe deficiency at mildly acidic and alkaline pH by measuring root ferric chelate reductase (FCR) activity and expression of selected Fe uptake genes and riboflavin synthesis genes. Alkaline pH increased cucumber (Cucumis sativus L.) root FCR activity at full Fe supply, but alkaline stress abolished FCR response to low Fe supply. Alkaline pH or low Fe supply resulted in increased expression of Fe uptake genes, but riboflavin synthesis genes responded to Fe deficiency but not alkalinity. Iron deficiency increased expression of some common genes in roots and leaves, but alkaline stress blocked up-regulation of these genes in Fe-deficient leaves. In roots of the melon (Cucumis melo L.) fefe mutant, in which Fe uptake responses are blocked upstream of Fe uptake genes, alkaline stress or Fe deficiency up-regulation of certain Fe uptake and riboflavin synthesis genes was inhibited, indicating a central role for the FeFe protein. These results suggest a model implicating shoot-to-root signaling of Fe status to induce Fe uptake gene expression in roots. PMID:27605716

  9. [Dietary iron intake and deficiency in elite women volleyball players].

    PubMed

    Mielgo-Ayuso, J; Urdampilleta, A; Martínez-Sanz, J M; Seco, J

    2012-01-01

    Volleyball practice requires repeated impacts on arms and feet caused by vertical jumps, falls, auctions, sudden and rapid changes of direction, which is why might raise us problems in the metabolism of iron (Fe) and the recommended intake of 18 mg/day (in the women in general), is not sufficient to meet the needs of the players of volleyball female (JVF). We analyzed the FS and IST of 10 JVF a team of Spanish SuperLeague (26.6 ± 5.9 years and height 178.05 ± 8.7 cm) in two moments of the season: Week 0 (pre-start of preseason) and week 11 (after 11 weeks of training and 6 games of the regular season). Also calculated Fe intake in this period with consumption frequency questionnaire developed and tested with food dietary records of 7 days. We observed that an intake of 25.8 mg/day of dietary Fe is not sufficient to prevent 30% of the JVF suffer pre-latent iron deficiency and 20% latent deficit (pre-anemia). It could be recommended conducting periodic blood analytical and a food education, teaching which foods containing a high content of Fe-type heme, and the factors that can interfere with absorption.

  10. Patterns and determinants of functional and absolute iron deficiency in patients undergoing cardiac rehabilitation following heart surgery.

    PubMed

    Tramarin, Roberto; Pistuddi, Valeria; Maresca, Luigi; Pavesi, Marco; Castelvecchio, Serenella; Menicanti, Lorenzo; de Vincentiis, Carlo; Ranucci, Marco

    2017-01-01

    Background Anaemia and iron deficiency are frequent following major surgery. The present study aims to identify the iron deficiency patterns in cardiac surgery patients at their admission to a cardiac rehabilitation programme, and to determine which perioperative risk factor(s) may be associated with functional and absolute iron deficiency. Design This was a retrospective study on prospectively collected data. Methods The patient population included 339 patients. Functional iron deficiency was defined in the presence of transferrin saturation <20% and serum ferritin ≥100 µg/l. Absolute iron deficiency was defined in the presence of serum ferritin values <100 µg/l. Results Functional iron deficiency was found in 62.9% of patients and absolute iron deficiency in 10% of the patients. At a multivariable analysis, absolute iron deficiency was significantly ( p = 0.001) associated with mechanical prosthesis mitral valve replacement (odds ratio 5.4, 95% confidence interval 1.9-15) and tissue valve aortic valve replacement (odds ratio 4.5, 95% confidence interval 1.9-11). In mitral valve surgery, mitral repair carried a significant ( p = 0.013) lower risk of absolute iron deficiency (4.4%) than mitral valve replacement with tissue valves (8.3%) or mechanical prostheses (22.5%). Postoperative outcome did not differ between patients with functional iron deficiency and patients without iron deficiency; patients with absolute iron deficiency had a significantly ( p = 0.017) longer postoperative hospital stay (median 11 days) than patients without iron deficiency (median nine days) or with functional iron deficiency (median eight days). Conclusions Absolute iron deficiency following cardiac surgery is more frequent in heart valve surgery and is associated with a prolonged hospital stay. Routine screening for iron deficiency at admission in the cardiac rehabilitation unit is suggested.

  11. Comprehensive Sports Medicine Treatment of an Athlete Who Runs Cross-Country and is Iron Deficient.

    PubMed

    Brumitt, Jason; McIntosh, Linda; Rutt, Richard

    2009-02-01

    Optimal athletic performance may be dependent upon an athlete maintaining adequate iron levels through the consumption of dietary forms of iron and subsequent metabolism. Endurance athletes, especially female distance runners, have been identified as being at risk for developing iron deficiency. While iron deficiency is treatable, early diagnosis may be delayed if an adequate medical history and evaluation is not conducted. To describe the evaluation, diagnosis, and comprehensive sports medicine treatment of a collegiate cross-country athlete with a medical diagnosis of iron deficiency with anemia and sports-related musculoskeletal pain. A 21-year-old female collegiate cross-country athlete experienced a decline in her running performance beginning her freshman year of school. She continued to experience degradation in sports performance despite medical intervention. Two-and-a-half years after initially seeking medical attention she was diagnosed with iron deficiency with anemia by a primary care medical doctor. Additionally, the subject required rehabilitation due to the onset of sports-related musculoskeletal symptoms. Comprehensive treatment for this patient consisted of iron supplementation, therapeutic exercises, manual therapy, and modalities. The athlete was able to compete during her entire cross-country season and earn All-American status at the Division-III level. Sports medicine professionals must consider iron deficiency as a possible differential diagnosis when evaluating endurance athletes. Subtle signs of iron deficiency may, unfortunately, be overlooked ultimately delaying treatment.

  12. Comprehensive Sports Medicine Treatment of an Athlete Who Runs Cross-Country and is Iron Deficient

    PubMed Central

    McIntosh, Linda; Rutt, Richard

    2009-01-01

    Background Optimal athletic performance may be dependent upon an athlete maintaining adequate iron levels through the consumption of dietary forms of iron and subsequent metabolism. Endurance athletes, especially female distance runners, have been identified as being at risk for developing iron deficiency. While iron deficiency is treatable, early diagnosis may be delayed if an adequate medical history and evaluation is not conducted. Objective To describe the evaluation, diagnosis, and comprehensive sports medicine treatment of a collegiate cross-country athlete with a medical diagnosis of iron deficiency with anemia and sports-related musculoskeletal pain. Case Description A 21-year-old female collegiate cross-country athlete experienced a decline in her running performance beginning her freshman year of school. She continued to experience degradation in sports performance despite medical intervention. Two-and-a-half years after initially seeking medical attention she was diagnosed with iron deficiency with anemia by a primary care medical doctor. Additionally, the subject required rehabilitation due to the onset of sports-related musculoskeletal symptoms. Outcomes Comprehensive treatment for this patient consisted of iron supplementation, therapeutic exercises, manual therapy, and modalities. The athlete was able to compete during her entire cross-country season and earn All-American status at the Division-III level. Discussion Sports medicine professionals must consider iron deficiency as a possible differential diagnosis when evaluating endurance athletes. Subtle signs of iron deficiency may, unfortunately, be overlooked ultimately delaying treatment. PMID:21509116

  13. Dissecting iron deficiency-induced proton extrusion in Arabidopsis roots.

    PubMed

    Santi, Simonetta; Schmidt, Wolfgang

    2009-01-01

    Here, we have analysed the H(+)-ATPase-mediated extrusion of protons across the plasma membrane (PM) of rhizodermic cells, a process that is inducible by iron (Fe) deficiency and thought to serve in the mobilization of sparingly soluble Fe sources. The induction and function of Fe-responsive PM H(+)-ATPases in Arabidopsis roots was investigated by gene expression analysis and by using mutants defective in the expression or function of one of the isogenes. In addition, the expression of the most responsive isogenes was investigated in natural Arabidopsis accessions that have been selected for their in vivo proton extrusion activity. Our data suggest that the rhizosphere acidification in response to Fe deficiency is chiefly mediated by AHA2, while AHA1 functions as a housekeeping isoform. The aha7 knock-out mutant plants showed a reduced frequency of root hairs, suggesting an involvement of AHA7 in the differentiation of rhizodermic cells. Acidification capacity varied among Arabidopsis accessions and was associated with a high induction of AHA2 and IRT1, a high relative growth rate and a shoot-root ratio that was unaffected by the external Fe supply. An effective regulation of the Fe-responsive genes and a stable shoot-root ratio may represent important characteristics for the Fe uptake efficiency.

  14. Physicochemical properties and inhibition effect on iron deficiency anemia of a novel polysaccharide-iron complex (LPPC).

    PubMed

    Zhang, Zhong-Shan; Wang, Xiao-Mei; Han, Zhi-Ping; Yin, Li; Zhao, Ming-Xing; Yu, Shu-Chi

    2012-01-01

    Porphyran (P) was extracted from red algae Porphyra by boiling water. A novel polysaccharide-iron complex (LPPC) was prepared under the alkaline condition by adding a ferric chloride solution to the low molecular weight porphyran (LP) solution. Physicochemical properties and inhibition effect on iron deficiency anemia of this complex were studied. The content of iron(III) in the complex is 21.57% determined with iodometry. The results indicate that LPPC was product required. The complex can increase red blood cell count (RBC), hemoglobin (Hb), Serum iron (SI), spleen index, spleen mass and mass of mice with iron deficiency anemia (IDA). Although the structure and deeper mechanisms on hemolytic anemia of LPPC should be further studied, LPPC is hoped to be developed as a late-model iron supplement which has a synergism on anemia. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  15. Increased incidence of iron deficiency anemia secondary to inadequate iron intake in institutionalized, young patients with cerebral palsy.

    PubMed

    Papadopoulos, Athanasios; Ntaios, George; Kaiafa, Georgia; Girtovitis, Fotios; Saouli, Zoi; Kontoninas, Zisis; Diamantidis, Michael D; Savopoulos, Christos; Hatzitolios, Apostolos

    2008-12-01

    We observed high incidence of anemia in patients with cerebral palsy sheltered in a specialized institution in Thessaloniki, Greece. Therefore, we decided to investigate its cause. We studied 108 patients, and assessed complete blood cell count, peripheral blood smear, serum iron, ferritin, folate, B12 and the presence of hemoglobin or parasites in the stools. In all cases, anemia was hypochromic and microcytic. Approximately 33% of patients suffered from hypochromic anemia, whereas 38% were iron deficient. There was no statistical difference in the incidence of iron deficiency between different age groups. All tests for fecal occult blood or intestinal parasites were negative. Folic acid and B12 levels were within normal range in all cases. We also found that 87 and 95.6% of patients on liquid diet were anemic and iron deficient, respectively, compared to only 18.8 and 22.3% of patients on normal diet. The high incidence of anemia was attributed to iron deficiency which was secondary to inadequate iron intake and decreased iron absorption. Thus, it would not be irrational to consider iron supplementation as the first measure in such patients and postpone endoscopic procedures for a later stage, unless there are clinical or laboratory findings (such as fecal occult blood) suggestive of gastrointestinal blood loss.

  16. Prevalence of Iron deficiency anemia in children with liver cirrhosis: A cross-sectional study

    PubMed Central

    Zareifar, Soheila; Dehghani, Seyed Mohsen; Rahanjam, Najmeh; Farahmand Far, Mohammad Reza

    2015-01-01

    Background: Among the many complications reported for cirrhosis, iron deficiency anemia (IDA) has attracted much attention. This type of anemia, in contrast to other types of anemia, is easy to treat prophylactically, but if left untreated can lead to a poor quality of life. The aim of this study was to estimate the hemoglobin and serum iron levels among patients with liver cirrhosis for the early diagnosis of IDA and to avoid unnecessary testing and iron supplementation. Subjects and Methods: In this cross-sectional study, 88 children diagnosed with cirrhosis were included, and the values of hemoglobin, serum iron levels and relationship between serum iron (SI), total iron-binding capacity (TIBC), prothrombine time (PT), international normalization ratio (INR), total and direct bilirubin and hepatic enzymes were estimated using paired t test, Mann-Whitney, Chi-square and Kruskal-Wallis tests. Results: Forty-six (52.3%) of 88 children were girls and 42 (47.7%) were boys. Forty-eight (54.5%) patients had anemia and 8 (9%) had iron deficiency anemia (5 boys, 5.6%, and 3 girls, 3.4%). No relationships were observed between iron deficiency anemia and the patient’s age or gender, whereas there was a relationship between iron deficiency and severity and duration of the disease, although the correlation was not statistically significant. Conclusion: The high frequency of iron deficiency anemia in children with cirrhosis (9%) suggests that timely screening should be used for early diagnosis and treatment. PMID:26261697

  17. Efficacy and safety of iron isomaltoside (Monofer®) in the management of patients with iron deficiency anemia

    PubMed Central

    Kalra, Philip A; Bhandari, Sunil

    2016-01-01

    New intravenous (IV) iron preparations should ideally be capable of delivering a wide dosing range to allow iron correction in a single or low number of visits, a rapid infusion (doses up to 1,000 mg must be administered over more than 15 minutes and doses exceeding 1,000 mg must be administered over 30 minutes or more), and minimal potential side effects including low catalytic/labile iron release with minimal risk of anaphylaxis. Furthermore, they should be convenient for the patient and health-care professional, and cost effective for the health-care system. The intention behind the development of iron isomaltoside (Monofer®) was to fulfill these requirements. Iron isomaltoside has been shown to be effective in treating iron deficiency anemia across multiple therapeutic patient groups and compared to placebo, IV iron sucrose, and oral iron. Iron isomaltoside consists of iron and a carbohydrate moiety where the iron is tightly bound in a matrix structure. It has a low immunogenic potential, a low potential to release labile iron, and does not appear to be associated with clinically significant hypophosphatemia. Due to the structure of iron isomaltoside, it can be administered in high doses with a maximum single dosage of 20 mg/kg body weight. Clinical trials and observational studies of iron isomaltoside show that it is an effective and well-tolerated treatment of anemia across different therapeutic areas with a favorable safety profile. PMID:27022297

  18. Cardiac remodeling in response to chronic iron deficiency: role of the erythropoietin receptor.

    PubMed

    Naito, Yoshiro; Sawada, Hisashi; Oboshi, Makiko; Iwasaku, Toshihiro; Okuhara, Yoshitaka; Morisawa, Daisuke; Eguchi, Akiyo; Hirotani, Shinichi; Mano, Toshiaki; Tsujino, Takeshi; Masuyama, Tohru

    2015-06-01

    Anemia is a common comorbidity of patients with heart failure, and iron deficiency is known as one of the causes of anemia in heart failure. Recent studies have shown that iron deficiency alone, without overt anemia, is associated with poor outcomes in patients with heart failure. Thus, to minimize the mortality in patients with heart failure, it is important to understand the link between iron deficiency and cardiac function. Chronic untreated iron deficiency results in cardiac remodeling, and we have previously reported that erythropoietin (Epo) and cardiac Epo receptor (EpoR) signaling may be associated with its remodeling. However, the link between EpoR signaling and its remodeling remains to be elucidated. Herein, we investigated the role of EpoR signaling on cardiac remodeling in response to chronic iron deficiency. Wild-type mice and transgene-rescued EpoR-null mutant mice, which express EpoR only in the hematopoietic lineage (EpoR-restricted mice), were fed with either a normal or an iron-restricted diet, and the molecular mechanisms were investigated. Dietary iron restriction gradually induced anemia, Epo secretion, and cardiac hypertrophy in wild-type mice. In contrast, EpoR-restricted mice fed with an iron-restricted diet exhibited anemia, left ventricular dilatation, and cardiac dysfunction compared with wild-type mice. Interestingly, altered cardiac mitochondrial biogenesis was observed in EpoR-restricted mice following iron deficiency. Moreover, cardiac p53 expression was increased in EpoR-restricted mice compared with wild-type mice following iron deficiency. These data indicate that EpoR signaling is associated with cardiac remodeling following chronic iron deficiency.

  19. Does iron deficiency in pea enhance the activity of the root-plasmalemma iron transport system

    SciTech Connect

    Grusak, M.A.; Welch, R.M.; Kochian, L.V. )

    1990-05-01

    When dicots are subjected to Fe-deficiency stress, the ability of the root system to reduce exogenous Fe is increased. The question remains, however, whether the activity of the root-plasmalemma Fe transport system (which transports Fe{sup 2+}) is similarly enhanced or altered in response to this stress. Since it is currently difficult to supply Fe{sup 2+} to roots in an oxygenated solution, we have indirectly addressed this question by measuring both Fe(III) reduction and short-term Fe{sup 2+} influx (Fe{sup 2+} derived from the reduction of {sup 59}Fe-labelled Fe(III)EDTA) on the same root system. The rate of Fe(III) reduction was used to normalize subsequently determined influx values, such that different treatments could be compared. Measurements at various concentrations of Fe(III)EDTA with excised, primary lateral roots of both iron-deficient and iron-adequate peas (Pisum sativum), showed that the ratio of Fe influx to Fe reduction never exceeded an average value of 0.15 {mu}mol Fe{sup 2+} absorbed/{mu}mol Fe(III) reduced. At high concentrations of Fe(III)EDTA (> 100 {mu}M), the value of this ratio often decreased. Our results suggest that while increased rates of Fe influx can be measured in Fe-deficient peas, this increase is due to an increased production of the transported species Fe{sup 2+}, and the specific activity of the root-plasmalemma Fe transport system is not altered or enhanced in response to Fe-deficiency.

  20. Evaluation of Iron Deficiency As a Nutritional Adaptation to Infectious Disease: An Evolutionary Medicine Perspective

    PubMed Central

    WANDER, KATHERINE; SHELL-DUNCAN, BETTINA; McDADE, THOMAS W.

    2014-01-01

    An evolutionary perspective suggests that iron deficiency may have opposing effects on infectious disease risk, decreasing susceptibility by restricting iron availability to pathogens, and increasing susceptibility by compromising cellular immunocompetence. In some environments, the trade-off between these effects may result in optimal iron intake that is inadequate to fully meet body iron needs. Thus, it has been suggested that moderate iron deficiency may protect against acute infection, and may represent a nutritional adaptation to endemic infectious disease stress. To test this assertion, we examined the association between infection, reflected by C-reactive protein, a biomarker of inflammation, and iron status, reflected by transferrin receptor (TfR) and zinc protoporphyrin to heme ratio (ZPP:H), among school-age Kenyan children, and evaluated the hypothesis that moderate iron deficiency is associated with lower odds of infectious disease. TfR > 5.0 mg/l, with sensitivity and specificity for iron deficiency (ZPP:H > 80 μmol/mol) of 0.807 and 0.815, was selected as the TfR definition of iron deficiency. Controlling for age and triceps skinfold thickness (TSF), the odds ratio (OR) for acute viral or bacterial infection associated with iron deficiency (compared to normal/replete) was 0.50 (P = 0.11). Controlling for age and TSF, the OR for infection associated with an unequivocally iron replete state (compared to all others) was 2.9 (P = 0.01). We conclude that iron deficiency may protect against acute infection in children. PMID:18949769

  1. Evaluation of iron deficiency as a nutritional adaptation to infectious disease: an evolutionary medicine perspective.

    PubMed

    Wander, Katherine; Shell-Duncan, Bettina; McDade, Thomas W

    2009-01-01

    An evolutionary perspective suggests that iron deficiency may have opposing effects on infectious disease risk, decreasing susceptibility by restricting iron availability to pathogens, and increasing susceptibility by compromising cellular immunocompetence. In some environments, the trade-off between these effects may result in optimal iron intake that is inadequate to fully meet body iron needs. Thus, it has been suggested that moderate iron deficiency may protect against acute infection, and may represent a nutritional adaptation to endemic infectious disease stress. To test this assertion, we examined the association between infection, reflected by C-reactive protein, a biomarker of inflammation, and iron status, reflected by transferrin receptor (TfR) and zinc protoporphyrin to heme ratio (ZPP:H), among school-age Kenyan children, and evaluated the hypothesis that moderate iron deficiency is associated with lower odds of infectious disease. TfR > 5.0 mg/l, with sensitivity and specificity for iron deficiency (ZPP:H > 80 micromol/mol) of 0.807 and 0.815, was selected as the TfR definition of iron deficiency. Controlling for age and triceps skinfold thickness (TSF), the odds ratio (OR) for acute viral or bacterial infection associated with iron deficiency (compared to normal/replete) was 0.50 (P = 0.11). Controlling for age and TSF, the OR for infection associated with an unequivocally iron replete state (compared to all others) was 2.9 (P = 0.01). We conclude that iron deficiency may protect against acute infection in children.

  2. Effects of iron deficiency on attention and learning processes in preschool children: Bandung, Indonesia.

    PubMed

    Soewondo, S; Husaini, M; Pollitt, E

    1989-09-01

    A double-blind clinical trial was conducted in Indonesia to assess effects of iron supplementation on performance of iron-depleted and iron-deficient anemic children in discrimination and oddity learning tasks. Half these children received elemental Fe for 8 wk; the others received a placebo. There were significant changes from pre- to postintervention evaluations in ferritin, transferrin saturation, free erythrocyte protoporphyrin, and hemoglobin among the anemic and iron-depleted children; no changes were observed among the placebos or any of the iron-replete children. The magnitude of hematological changes in anemic children treated with iron was small; yet, after treatment the children's mean ferritin, transferrin saturation, and hemoglobin values were above the cutoff points used for the definition of iron-deficiency anemia (IDA). Pre- and posttreatment psychological test data show that IDA produces alterations in cognitive processes related to visual attention and concept acquisition, alterations reversed with iron treatment.

  3. Tissue distribution of manganese in iron-sufficient or iron-deficient rats after stainless steel welding-fume exposure.

    PubMed

    Park, Jung-Duck; Kim, Ki-Young; Kim, Dong-Won; Choi, Seong-Jin; Choi, Byung-Sun; Chung, Yong Hyun; Han, Jeong Hee; Sung, Jae Hyuck; Kwon, Il Hoon; Mun, Je-Hyeok; Yu, Il Je

    2007-05-01

    Welders can be exposed to high levels of manganese through welding fumes. Although it has already been suggested that excessive manganese exposure causes neurotoxicity, called manganism, the pathway of manganese transport to the brain with welding-fume exposure remains unclear. Iron is an essential metal that maintains a homeostasis in the body. The divalent metal transporter 1 (DMT1) transports iron and other divalent metals, such as manganese, and the depletion of iron is known to upregulate DMT1 expression. Accordingly, this study investigated the tissue distribution of manganese in iron-sufficient and iron-deficient rats after welding-fume exposure. The feeding of an iron-deficient diet for 4 wk produced a depletion of body iron, such as decreased iron levels in the serum and tissues, and upregulated the DMT1 expression in the rat duodenum. The iron-sufficient and iron-deficient rats were then exposed to welding fumes generated from manual metal arc stainless steel at a concentration of 63.5 +/- 2.3 mg/m3 for 2 h per day over a 30-day period. Animals were sacrificed on days 1, 15, and 30. The level of body iron in the iron-deficient rats was restored to the control level after the welding-fume exposure. However, the tissue distributions of manganese after the welding-fume exposure showed similar patterns in both the iron-sufficient and iron-deficient groups. The concentration of manganese increased in the lungs and liver on days 15 and 30, and increased in the olfactory bulb on day 30. Slight and heterogeneous increases of manganese were observed in different brain regions. Consequently, these findings suggest that the presence of Fe in the inhaled welding fumes may not have a significant effect on the uptake of Mn into the brain. Thus, the condition of iron deficiency did not seem to have any apparent effect on the transport of Mn into the brain after the inhalation of welding fumes.

  4. Prevalence of anaemia, deficiencies of iron and folic acid and their determinants in Ethiopian women.

    PubMed

    Haidar, Jemal

    2010-08-01

    A cross-sectional community-based study with analytic component was conducted among Ethiopian women during June-July 2005 to assess the magnitude of anaemia and deficiencies of iron and folic acid and to compare the factors responsible for anaemia among anaemic and non-anaemic cases. In total, 970 women, aged 15-19 years, were selected systematically for haematological and other important parameters. The overall prevalence of anaemia, iron deficiency, iron-deficiency anaemia, deficiency of folic acid, and parasitic infestations was 30.4%, 50.1%, 18.1%, 31.3%, and 13.7% respectively. Women who had more children aged less than five years but above two years, open-field toilet habits, chronic illnesses, and having intestinal parasites were positively associated with anaemia. Women who had no formal education and who did not use contraceptives were negatively associated with anaemia. The major determinants identified for anaemia were chronic illnesses [adjusted odds ratio (AOR) = 1.1, 95% confidence interval (CI) 1.15-1.55), deficiency of iron (AOR = 0.4, 95% CI 0.35-0.64), and deficiency of folic acid (AOR = 0.5, 95% CI 0.50-0.90). The odds for developing anaemia was 1.1 times more likely among women with chronic illnesses, 60% more likely in the iron-deficient and 40% more likely in the folic acid-deficient than their counterparts. One in every three women had anaemia and deficiency of folic acid while one in every two had iron deficiency, suggesting that deficiencies of both folic acid and iron constitute the major micronutrient deficiencies in Ethiopian women. The risk imposed by anaemia to the health of women ranging from impediment of daily activities and poor pregnancy outcome calls for effective public-health measures, such as improved nutrient supplementation, health education, and timely treatment of illnesses.

  5. Iron-deficiency anemia and the cycle of poverty among human immunodeficiency virus-infected women in the inner city.

    PubMed

    Semba, Richard D

    2003-01-01

    The prevalence of iron-deficiency anemia appears to be extremely high among female injection drug users in the inner city who have human immunodeficiency virus (HIV) and/or hepatitis C (HCV) infections. Iron deficiency and its associated anemia may contribute to reduced energetic efficiency, lower aerobic capacity, decreased endurance, and fatigue. In practical terms, the functional limitations of iron deficiency and iron-deficiency anemia may affect the ability of women to participate in work, school, social, and family activities. Iron deficiency may contribute to the cycle of poverty in the inner city by limiting the ability of women to work, earn money, and afford iron-rich sources of food. Although iron supplementation may prevent or treat iron deficiency, the use of iron supplements needs to be approached with caution in women with HIV and HCV infections.

  6. Insights into the diagnosis and management of iron deficiency in inflammatory bowel disease.

    PubMed

    Bou-Fakhredin, Rayan; Halawi, Racha; Roumi, Joseph; Taher, Ali

    2017-09-01

    Iron deficiency is a frequent comorbidity of chronic diseases such as inflammatory bowel disease that can severely impact the health and quality of life of affected individuals. It can exist as a silent condition and manifest in non-specific symptoms even in the absence of anemia. Even though iron deficiency anemia is the most common complication and extra-intestinal manifestation of inflammatory bowel disease, the majority of inflammatory bowel disease patients who are diagnosed with iron deficiency anemia are not treated. Areas covered: In this review, we discuss iron deficiency and iron deficiency anemia in patients with inflammatory bowel disease, and review diagnostic and therapeutic options. Expert commentary: We invite international gastroenterological societies and associations to refine the practice guidelines and include iron deficiency as a potential morbidity associated with IBD in analogy to arthritis, uveitis or any other extra intestinal manifestations. There should a more unanimous agreement among different societies on the specific diagnostic cutoff values for C-reactive protein levels, serum ferritin, and transferrin saturation in order to differentiate iron deficiency anemia from anemia of chronic disease.

  7. Pregnancy and maternal iron deficiency stimulate hepatic CRBPII expression in rats.

    PubMed

    Cottin, Sarah C; Gambling, Lorraine; Hayes, Helen E; Stevens, Valerie J; McArdle, Harry J

    2016-06-01

    Iron deficiency impairs vitamin A (VA) metabolism in the rat but the mechanisms involved are unknown and the effect during development has not been investigated. We investigated the effect of pregnancy and maternal iron deficiency on VA metabolism in the mother and fetus. 54 rats were fed either a control or iron deficient diet for 2weeks prior to mating and throughout pregnancy. Another 15 female rats followed the same diet and were used as non-pregnant controls. Maternal liver, placenta and fetal liver were collected at d21 for total VA, retinol and retinyl ester (RE) measurement and VA metabolic gene expression analysis. Iron deficiency increased maternal hepatic RE (P<.05) and total VA (P<.0001), fetal liver RE (P<.05), and decreased placenta total VA (P<.05). Pregnancy increased Cellular Retinol Binding Protein (CRBP)-II gene expression by 7 fold (P=.001), decreased VA levels (P=.0004) and VA metabolic gene expression (P<.0001) in the liver. Iron deficiency increased hepatic CRBPII expression by a further 2 fold (P=.044) and RBP4 by~20% (P=.005), increased RBPR2 and decreased CRBPII, LRAT, and TTR in fetal liver, while it had no effect on VA metabolic gene expression in the placenta. Hepatic CRBPII expression is increased by pregnancy and further increased by iron deficiency, which may play an important role in VA metabolism and homeostasis. Maternal iron deficiency also alters VA metabolism in the fetus, which is likely to have consequences for development. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Effect of Iron Deficiency on the Phenotype of β-Thalassaemia Trait.

    PubMed

    Arshad, Maham; Ahmed, Suhaib; Ali, Nadir

    2016-03-01

    The objective of this study was to determine the effect of iron deficiency on Hb-A2 level in β-thalassaemia trait and to determine the frequency of individuals with β-thalassaemia trait who could be missed due to concomitant iron deficiency. A total of 120 patients were studied, out of which 23 were iron deficient (serum ferritin < 20 ng/ml). Mean Hb-A2 in the iron deficient individuals was 4.1 ± 0.47% as compared to 5.1 ± 0.58% in the remaining 97 individuals without iron deficiency (p < 0.001). In the 120 individuals with β-thalassaemia trait, mean Hb-A2 was 5.8% with range 3 - 6.8% and confidence interval was 95%. In 2 individuals with β-thalassaemia trait, Iron deficiency was observed and showed Hb-A2 less than 3.5%. These could have been missed while screening by Hb-A2 estimation alone. Co-existence of Iron deficiency and β-thalassaemia trait may mask the diagnosis of beta thalassaemia trait and such individuals can be missed during screening by Hb-A2 estimation alone.

  9. Iron-deficiency anemia as a subclinical celiac disease presentation in an Argentinian population.

    PubMed

    Lasa, J S; Olivera, P; Soifer, L; Moore, R

    There is a wide heterogeneity in the reports of celiac disease prevalence in iron-deficiency anemia patients. To determine the prevalence of celiac disease in patients with iron-deficiency anemia. Adult patients with a diagnosis of iron-deficiency anemia were enrolled for upper endoscopy with duodenal biopsies. Healthy volunteers that underwent upper endoscopy were enrolled as controls. A total of 135 patients with iron-deficiency anemia and 133 controls were enrolled. Celiac disease prevalence was higher in the iron-deficiency anemia group [11.11 vs. 1.51%, OR: 8.18 (1.83-36.55), P=.001). Of the celiac disease patients in the iron-deficiency anemia group, 73.3% had at least one endoscopic sign suggesting villous atrophy, whereas 100% of the celiac disease patients in the control group presented with at least one endoscopic sign. Patients with iron-deficiency anemia have an increased risk for celiac disease. Up to 25% of these patients may not present any endoscopic sign suggesting villous atrophy. Copyright © 2017 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  10. Increased gastric IL-1β concentration and iron deficiency parameters in H. pylori infected children.

    PubMed

    Queiroz, Dulciene Maria Magalhaes; Rocha, Andreia Maria Camargos; Melo, Fabricio Freire; Rocha, Gifone Aguiar; Teixeira, Kádima Nayara; Carvalho, Simone Diniz; Bittencourt, Paulo Fernando Souto; Castro, Lucia Porto Fonseca; Crabtree, Jean E

    2013-01-01

    Association between H. pylori infection, iron deficiency and iron deficiency anaemia has been described, but the mechanisms involved have not been established. We hypothesized that in H. pylori infected children increased gastric concentrations of IL-1β and/or TNF-α, both potent inhibitors of gastric acid secretion that is essential for iron absorption, are predictors for low blood concentrations of ferritin and haemoglobin, markers of early depletion of iron stores and anaemia, respectively. We evaluated 125 children undergoing endoscopy to clarify the origin of gastrointestinal symptoms. Gastric specimens were obtained for H. pylori status and cytokine evaluation and blood samples for determination of iron deficiency/iron deficiency anaemia parameters and IL1 cluster and TNFA polymorphisms that are associated with increased cytokine secretions. Higher IL-1β and TNF-α gastric concentrations were observed in H. pylori-positive (n = 47) than in -negative (n = 78) children. Multiple linear regression models revealed gastric IL-1β, but not TNF-α, as a significant predictor of low ferritin and haemoglobin concentrations; results were reproduced in young children in whom IL1RN polymorphic genotypes associated with higher gastric IL-1β expression and lower blood ferritin and haemoglobin concentrations. In conclusion, high gastric levels of IL-1β can be the link between H. pylori infection and iron deficiency/iron deficiency anaemia in childhood.

  11. High-dose intravenously administered iron versus orally administered iron in blood donors with iron deficiency: study protocol for a randomised, controlled trial.

    PubMed

    Macher, Susanne; Drexler, Camilla; Lindenau, Ines; Sareban, Nazanin; Schlenke, Peter; Amrein, Karin

    2016-10-28

    About 2-3 % of the population participates in blood donation programmes. Each whole blood donation or ten apheresis donations cause a loss of 200-250 mg of iron. As a result, one of the most common risks of regular blood donors is iron deficiency. Although this has been known for decades, in most countries, iron status is currently not assessed or treated in this population. Premenopausal women are particularly affected, as they have lower iron reserves and higher daily requirements. Besides anaemia, iron deficiency may lead to fatigue and impaired cognitive and physical performance. Current iron preparations for intravenous administration are well tolerated and allow for application of large doses up to 1 g in one visit. Our hypothesis is that in blood donors with iron deficiency, intravenously administered iron is more efficient and as safe as oral iron supplementation. Since anaemia is one of the most frequent reasons for permanent or intermittent donor deferral, maintaining an iron-replete donor pool may help to prevent shortages in blood supply and to avoid iron deficiency-related comorbidities. In this randomised clinical trial we include male and female blood donors aged ≥18 and ≤65 years with a ferritin value of ≤30 ng/ml. Stratified by gender, participants are randomized with a web-based randomisation tool in a 1:1 ratio to either 1 g of intravenously administered ferric carboxymaltose or 10 g of iron fumarate supplements at one to two daily doses of 100 mg each. Eight to 12 weeks after the first visit, iron status, blood count and symptoms are assessed in both groups. The primary endpoint is the difference in transferrin saturation (%) following the intervention between both groups. Secondary endpoints include other parameters of iron metabolism and red blood cell count, the number of patients with drug-related adverse events, and subjective symptoms including those of the restless legs syndrome, quality of life, and fatigue. Iron

  12. Gastric Helicobacter Infection Induces Iron Deficiency in the INS-GAS Mouse

    PubMed Central

    Thomson, Melanie J.; Pritchard, D. Mark; Boxall, Sally A.; Abuderman, Abdul A.; Williams, Jonathan M.; Varro, Andrea; Crabtree, Jean E.

    2012-01-01

    There is increasing evidence from clinical and population studies for a role of H. pylori infection in the aetiology of iron deficiency. Rodent models of Helicobacter infection are helpful for investigating any causal links and mechanisms of iron deficiency in the host. The aim of this study was to investigate the effects of gastric Helicobacter infection on iron deficiency and host iron metabolism/transport gene expression in hypergastrinemic INS-GAS mice. INS-GAS mice were infected with Helicobacter felis for 3, 6 and 9 months. At post mortem, blood was taken for assessment of iron status and gastric mucosa for pathology, immunohistology and analysis of gene expression. Chronic Helicobacter infection of INS- GAS mice resulted in decreased serum iron, transferrin saturation and hypoferritinemia and increased Total iron binding capacity (TIBC). Decreased serum iron concentrations were associated with a concomitant reduction in the number of parietal cells, strengthening the association between hypochlorhydria and gastric Helicobacter-induced iron deficiency. Infection with H. felis for nine months was associated with decreased gastric expression of iron metabolism regulators hepcidin, Bmp4 and Bmp6 but increased expression of Ferroportin 1, the iron efflux protein, iron absorption genes such as Divalent metal transporter 1, Transferrin receptor 1 and also Lcn2 a siderophore-binding protein. The INS-GAS mouse is therefore a useful model for studying Helicobacter-induced iron deficiency. Furthermore, the marked changes in expression of gastric iron transporters following Helicobacter infection may be relevant to the more rapid development of carcinogenesis in the Helicobacter infected INS-GAS model. PMID:23185574

  13. Duodenal expression of iron transport molecules in patients with hereditary hemochromatosis or iron deficiency

    PubMed Central

    Dostalikova-Cimburova, Marketa; Kratka, Karolina; Balusikova, Kamila; Chmelikova, Jitka; Hejda, Vaclav; Hnanicek, Jan; Neubauerova, Jitka; Vranova, Jana; Kovar, Jan; Horak, Jiri

    2012-01-01

    Abstract Disturbances of iron metabolism are observed in chronic liver diseases. In the present study, we examined gene expression of duodenal iron transport molecules and hepcidin in patients with hereditary hemochromatosis (HHC) (treated and untreated), involving various genotypes (genotypes which represent risk for HHC were examined), and in patients with iron deficiency anaemia (IDA). Gene expressions of DMT1, ferroportin, Dcytb, hephaestin, HFE and TFR1 were measured in duodenal biopsies using real-time PCR and Western blot. Serum hepcidin levels were measured using ELISA. DMT1, ferroportin and TFR1 mRNA levels were significantly increased in post-phlebotomized hemochromatics relative to controls. mRNAs of all tested molecules were significantly increased in patients with IDA compared to controls. The protein expression of ferroportin was increased in both groups of patients but not significantly. Spearman rank correlations showed that DMT1 versus ferroportin, Dcytb versus hephaestin and DMT1 versus TFR1 mRNAs were positively correlated regardless of the underlying cause, similarly to protein levels of ferroportin versus Dcytb and ferroportin versus hephaestin. Serum ferritin was negatively correlated with DMT1 mRNA in investigated groups of patients, except for HHC group. A decrease of serum hepcidin was observed in IDA patients, but this was not statistically significant. Our data showed that although untreated HHC patients do not have increased mRNA levels of iron transport molecules when compared to normal subjects, the expression is relatively increased in relation to body iron stores. On the other hand, post-phlebotomized HHC patients had increased DMT1 and ferroportin mRNA levels possibly due to stimulated erythropoiesis after phlebotomy. PMID:21973163

  14. [Prevalence of anemia and iron deficiency in 12 year old school children from Jujuy].

    PubMed

    Buys, María C; Guerra, Lidia N; Martín, Beatriz; Miranda, Carmen E; Torrejón, Irma; Garrot, Teresa

    2005-01-01

    Iron deficiency is highly frequent among adolescents. Its early detection can prevent the development of a ferropenic anemia, a serious condition. The problem has not been well studied in our country. The purpose of this work was to determine the frequency of iron deficiency and anemia in adolescents. The criteria considered were: hematocrit below 38%, b) saturation transferrin below 16%, c) ferritin below 15 ng/ml. The study was carried out in 2265 schoolchildren, 12 years old, of both sexes, in urban and periurban areas in the city of San Salvador de Jujuy (1250 a.s.l.). The following parameters were measured: hematocrit as well as serum iron and total iron binding capacity, both by colorimetric method. Ferritin was measured by ELISA. Anemia was not found. Iron deficiency as estimated by the iron functional component, was found in 25% of girls and 21% of boys and, through iron stores, in 28% of girls and 18% of boys. Iron deficiency stores in both sexes is the more relevant alteration, indicating that the population sample here studied constitutes a highly vulnerable group. The early detection of iron deficiency will help physical and intellectual development so that adequate sanitary policies are necessary for its prevention.

  15. [Iron deficiency and anemia in female athletes--causes and risks].

    PubMed

    Portal, Shawn; Epstein, Muli; Dubnov, Gal

    2003-10-01

    Iron deficiency is probably the most common nutrient deficiency in the western world. Low levels of iron in the body are caused by several mechanisms, and become symptomatic with the onset of iron deficiency anemia. Athletes are a special group with additional reasons for iron or blood loss, such as plasma expansion, increase perspiration, 'foot strike hemolysis, and occasionally--malnutrition. Female athletes have yet another source of blood loss--menstruation. However, the most common cause for low hemoglobin levels in an athlete is dilutional pseudoanemia, which is caused by exercise-induced fluid retention. Athletes are more sensitive to the effects of anemia and iron deficiency, as exercise performance depends on maximal oxygen carrying capacity to the active muscle, and efficient oxygen utilization. Iron deficiency without anemia can also reduce athletic performance. Diagnosis is ultimately made by a blood count and red blood cell parameters, with ferritin serving as an index of body iron stores. Treatment requires iron supplements, as it is nearly impossible to refill the iron stores through diet alone.

  16. Early gestation screening of pregnant women for iodine deficiency disorders and iron deficiency in urban centre in Vadodara, Gujarat, India.

    PubMed

    Joshi, K; Nair, S; Khade, C; Rajan, M G R

    2014-02-01

    Pregnancy is a special condition where many metabolic changes may occur because of increased requirement of essential micronutrients such as iron and iodine. Foetal thyroid starts producing its own thyroid hormones after 12 weeks of gestation. Therefore, the first trimester is very crucial for meeting thyroid hormone requirements of the mother and foetus. Iodine deficiency and iron deficiency may affect mental and physical growth of the foetus. Hence, it is very important to establish a programme on the screening of pregnant women for thyroid dysfunction tests along with established iron status assessment. Thus, the study was aimed to screen the pregnant women for iodine deficiency disorders and iron deficiency during early gestation, situational analysis on thyroid insufficiency and iron deficiency in pregnant women (gestational age <15 weeks) in urban Vadodara, Gujarat. n = 256 healthy pregnant women with uncomplicated singleton pregnancy were selected. The thyroid hormone was estimated by RIA, UIE using simple microplate technique and haemoglobin (Hb) concentration by acid hematin method. Median thyrotropin (TSH), free thyroxine (FT4), total thyroxine (TT4) and UIE concentrations were 1.88 μIU/ml, 0.83 ng/dl, 10.24 μg/dl and 297.14 mcg/l, respectively. There was a significant correlation between TSH, FT4 and month of gestation. Mean Hb concentration was 9.27 ± 1.09 g/dl. The prevalence of iodine insufficiency (based on UI) was 16.79% and ir