Potential interchangeability of erythrocyte hemoglobin content and mean corpuscular hemoglobin for identifying iron deficiency anemia: Comment on the article by van Santen et al

2012 ◽  
Vol 64 (12) ◽  
pp. 4162-4162
Author(s):  
Oscar M. P. Jolobe
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Hemoglobin Content

Investigation of the correlation between immature reticulocyte fraction and reticulocyte hemoglobin content with common tests for iron deficiency anemia

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S12-S13
Author(s):  
Nicholas E Larkey ◽  
Christopher L Rosemark ◽  
Darci R Block
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Mayo Clinic ◽  
Reticulocyte Count ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Hemoglobin Content ◽  
Iron Saturation ◽  
Reticulocyte Hemoglobin Content

Abstract Reticulocyte hemoglobin content (Ret-He, the hemoglobin within reticulocytes or immature red blood cells) and immature reticulocyte fraction (IRF, the immature fraction of the absolute-reticulocyte-count) are tests that provide insight into erythropoiesis and iron status earlier than conventional iron studies offering the added benefit of not being acute-phase-reactants. Studies have shown that Ret-He is a diagnostic marker for iron-deficiency-anemia (IDA), but fewer studies have investigated IRF. Our laboratory is currently planning to report these parameters when reticulocyte is ordered. Since these are new parameters, we wanted to investigate their overall correlation with complete blood count (CBC) and other iron studies to gain a better appreciation of their utility in our patient population. The aim of this study was to compare the overall correlation of Ret-He and IRF with seven tests used in the evaluation of IDA. To our knowledge these parameters have not all been directly correlated within a single study. CBC and reticulocytes were quantified using XN 9000 hematology analyzers (Sysmex Corporation), ferritin (DXI 800, Beckman Coulter Inc.), and % iron-saturation (measured using total iron-binding-capacity (TIBC)=transferrin*1.18 on Cobas 6000, Roche Diagnostics). Two de-identified cohorts of patients undergoing physician-ordered reticulocyte testing were used for this analysis. Dataset 1 (DS1): (N=2026 from Mayo Clinic Florida) had Ret-He and IRF compared to absolute-reticulocyte-count (Ret), ferritin and % iron saturation. Dataset 2 (DS2): (N=3990 from Mayo Clinic Rochester) had Ret-He and IRF compared to the red-cell-indices of the CBC including hemoglobin (Hgb), mean-corpuscular-volume (MCV), mean-corpuscular-hemoglobin (MCH), and mean-corpuscular-hemoglobin-concentration (MCHC). Correlation coefficients were calculated using Spearman rank-order (ρ) wherein values below +/-0.39 are weak, between +/-0.40-0.59 are considered moderate, and values above +/-0.60 are considered strong. For DS1, Ret-He demonstrated the following correlations: Ret (ρ=0.01), ferritin (ρ=0.33), % iron saturation (ρ=0.63). IRF demonstrated: Ret (ρ=0.46), ferritin (ρ=-0.05), % iron saturation (ρ=-0.22). For DS2, Ret-He demonstrated the following correlations: Hgb (ρ=0.17), MCV (ρ=0.64), MCH (ρ=0.74), MCHC (ρ=0.56). IRF demonstrated Hgb (ρ=-0.41), MCV (ρ=0.10), MCH (ρ=0.04), MCHC (ρ=-0.11). Ret-He and IRF demonstrated different correlative profiles suggesting they may have differing uses. Ret-He was strongly positively-correlated with % iron saturation, MCV, MCH and moderately positively-correlated with MCHC. These positive-correlations are consistent with relationships established in the literature. Interestingly, Ret-He was only weakly correlated with ferritin, possibly owing to ferritin being an acute-phase-reactant. IRF had a moderate positive correlation with Ret and moderate inverse correlation with Hgb. Both of these IRF relationships are consistent with other reports, but both relationships have not been shown in the same study before, preventing direct comparison until now. The literature suggests IRF may have more potential in monitoring treatment than in diagnosis. One limitation of these datasets is their lack of clinical correlation such as established iron-deficiency, anemia status, or treatment information.

The association between iron deficiency anemia and febrile seizure

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Parviz Karimi ◽  
Koroush Sayehmiri ◽  
Milad Azami ◽  
Zeinab Tardeh
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Febrile Seizure ◽  
Hemoglobin Concentration ◽  
Deficiency Anemia ◽  
Control Group ◽  
Case Group ◽  
Mean Corpuscular Hemoglobin ◽  
Protective Effects ◽  
Corpuscular Hemoglobin

Abstract Objective Different studies have reported contradictory results regarding the relationship between iron deficiency anemia (IDA) and febrile seizure (FS). The present study was conducted to determine the effect of IDA on FS in children. Patients and methods This case-control study was conducted among 52 children with FS (the case group) and 18 children with afebrile seizures and 51 children with fever without seizures in the age range of 6 months to 5 years admitted to the pediatric ward of Imam Khomeini Hospital in Ilam from March 2016 to January 2017. Patients were selected using the convenience sampling method. Red blood cell (RBC) count as well as measurement of hemoglobin (Hb), hematocrit (Hct), ferritin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) levels were performed in all patients. The collected data were analyzed using SPSS16 software. Results A total of 34.6% in the FS group, 66.7% in the afebrile seizure group and 41.2% in the fever without seizure group suffered from IDA, which was not statistically significant between the three groups. Hb, Hct and RBC levels were higher in the case group and MCV, MCH, MCHC levels in the case group were lower than those in the control group. The odds ratio (OR) for FS compared to the febrile group was 0.756 [95% confidence interval (CI) = 0.34–1.68; p = 0.493] and that for FS compared to seizure was 0.265 (95% CI = 0.085–0.823; p = 0.022). Conclusions This study showed that IDA may have protective effects on the onset of FS, and based on the results, IDA is more common in children with afebrile seizures. Further and more comprehensive studies are recommended.

scholarly journals Role of red cell distribution width (RDW) in the detection of iron deficiency anaemia in pregnancy within the first 20 weeks of gestation

1970 ◽  
Vol 37 (3) ◽  
pp. 102-105 ◽  
Author(s):  
GS Sultana ◽  
SA Haque ◽  
T Sultana ◽  
Q Rahman ◽  
ANN Ahmed
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Red Cell Distribution Width ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Red Cell ◽  
Cell Distribution ◽  
Corpuscular Hemoglobin ◽  
Distribution Width ◽  
Iron Deficient

Iron deficiency anemia is common problem during pregnancy. Red cell size variation (anisocytosis) is the earliest morphologic changes in iron deficiency anemia. Red cell distribution width is a quantitative measure of red cell size variation and it can give the idea of early iron deficiency before other test to become positive.190 pregnant women were included in this study. Red cell distribution width was compared between iron deficient & non-iron deficient pregnant women. Red cell distribution width also compared with Hb level, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and peripheral blood film in prelatent iron deficiency, latent iron deficiency, mild and moderate iron deficiency anemia. Red cell distribution width had sensitivity 82.3% and specificity 97.4%. Whereas Hb level, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and peripheral blood film all had 56.6%, 29.2%, 68.1%, 15% and 38.9% sensitivity but specificity was 90.9%, 98.7%, 83.1%, 96.1% and 98.7% in the detection of iron deficiency. Red cell distribution width appears to be a reliable and useful parameter for detection of iron deficiency during pregnancy. DOI: http://dx.doi.org/10.3329/bmrcb.v37i3.9122 BMRCB 2011; 37(3): 102-105

scholarly journals Efficacy of SXN in the Treatment of Iron Deficiency Anemia: A Phase IV Clinical Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Lu Ding ◽  
Lulin Xu ◽  
Yanxia Jin ◽  
Yongchang Wei ◽  
Yunbao Pan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Status ◽  
Deficiency Anemia ◽  
High Dose ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Adults And Children ◽  
Phase Iv

Shengxuening (SXN) tablet is extracted from the excrement of the silkworm and has effects on hematopoiesis. The main components of SXN are chlorophyll derivatives and sodium iron chlorophyllin (SIC). The present study aims to investigate the efficiency and safety of SXN on iron deficiency anemia. This phase IV, multicenter, open-label, randomized clinical trial was conducted in 31 hospitals in China from June 2001 to April 2002. Adults and children were randomly divided into low-dose (L-SXN), medium-dose (M-SXN), and high-dose (H-SXN) groups, respectively. The course of treatment was 1 month. Peripheral hemogram levels and iron status were examined before and after treatment. Adults in all three dose groups demonstrated a significant increase in hemoglobin (HGB) concentration. Children who received SXN treatment in medium and high doses also demonstrated increased HGB concentration. Reticulocyte counts increased at the end of treatment in the M-SXN and H-SXN adult groups and in the M-SXN child group. For both children and adults, SXN in the three dose groups was found to significantly elevate red blood cell level, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. The total effective rate in the SXN-treated group reached 84.8%. The incidence of adverse events was 4.07%. The most common side effects were nausea (2.83%), diarrhea (0.74%), and rash (0.25%). SXN was proved to be efficient and safe for adults and children with iron deficiency anemia.

scholarly journals Evaluation of Iron Deficiency Anemia Frequency as a Risk Factor in Glaucoma

Anemia ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Penpe Gul Firat ◽  
Ersan Ersin Demirel ◽  
Seyhan Dikci ◽  
Irfan Kuku ◽  
Oguzhan Genc
Keyword(s):  
Risk Factor ◽  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Iron Status ◽  
Normal Subjects ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Significant Difference ◽  
Group 2

Purpose. Iron deficiency anemia is an important public health problem. Also it is considered to be a risk factor for many diseases. The study demonstrates the iron deficiency anemia frequency in glaucoma patients and compares with the normal subjects. We aimed to determine the iron deficiency anemia frequency in glaucoma patients.Methods. Prospective, controlled study in a single university hospital setting. A total of 130 normal subjects (Group 1) and 131 glaucoma patients (Group 2) were included. The erythrocytes parameters, hemoglobin, red blood cell, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, mean corpuscular hemoglobin, and red blood cell distribution width, and iron status indicators, Fe (iron), total iron binding capacity, and ferritin of the cases, in normal subjects and glaucoma patients were compared.Results. There was no statistically significant difference for the erythrocyte parameters between the groups (p≥0.05). The number of the patients with iron deficiency anemia in both groups was similar. No statistically significant difference was found in the comparison of erythrocyte parameters and iron status indicators values according to the number of antiglaucomatous agents and visual field changes according to the presence of anemia in Group 2 (p≥0.05). A statistically significant difference was found only in MCH when the erythrocyte parameters and iron status indicators values of the cases in glaucoma patients were compared with the glaucoma duration (p<0.05).Conclusion. The iron deficiency anemia frequency was like the normal population in glaucoma patients.

scholarly journals RELATIONSHIP BETWEEN RECURRENT APHTHOUS STOMATITIS WITH IRON DEFICIENCY ANEMIA

2018 ◽  
Vol 21 (2) ◽  
pp. 41-46
Author(s):  
Nurdiana Nurdiana ◽  
Pocut Astari
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Recurrent Aphthous Stomatitis ◽  
Aphthous Stomatitis ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Iron Level ◽  
Corpuscular Hemoglobin ◽  
Serum Iron Level ◽  
Significant Difference

Recurrent aphtous stomatitisis a recurrent oral ulcer. Clinically recurrent aphtous stomatitis is easy to diagnose, but its etiology and pathogenesis remain unclear because it has no single or specific cause. The main predisposing factors associated with recurrent aphtous stomatitis are genetic factors, hematological and immunologic abnormalities, local factors such as trauma, and smoking cessation. Several studies have shown that hematological abnormalities can affect the oral mucosa and cause recurrent aphtous stomatitis. The purpose of this study was to examine the relationship between recurrent aphthous stomatitis and iron deficiency anemia, as well as the relationship between recurrent aphthous stomatitis and hematological status. The subjects consist of 59 recurrent aphtous stomatitis patients and 60 control patients. A full blood examination was carried out for all subjects. Hemoglobin level, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and serum iron level are determined for each subject.The result of this study showed that there is no significant difference in hemoglobin level, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, and serum iron level with p-value of 0.714, 0.395, 0.809, 0.497, and 0.368, respectively. The result also showed that there is no significant difference in iron deficiency anemia status between the recurrent aphtous stomatitis and control group (p = 0,7). Therefore, it can be concluded that there is no relationship between iron deficiency anemia and recurrent aphtous stomatitis incidence.

scholarly journals Prevalence, profile of malnutrition and iron deficiency anemia in children with cyanotic congenital heart defects: a case control observational study in a tertiary care hospital in North India

2019 ◽  
Vol 6 (3) ◽  
pp. 1303
Author(s):  
Amber B. Mir ◽  
Jehangir A. Shah ◽  
Sheikh Mushtaq ◽  
Muzafar Jan
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Congenital Heart ◽  
Binding Capacity ◽  
Case Control ◽  
Total Iron ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Iron Binding Capacity

Background: Children with congenital heart disease (CHD) are prone to malnutrition. Children with cyanotic CHD [CCHD] are specifically affected due to chronic hypoxia and iron deficiency anemia which is overlooked by pediatrician. This can have a significant effect on the outcome of surgery. Our objective was to determine the burden and determinant of malnutrition in children with several types of cyanotic congenital heart disease (CCHD).Methods: This case-control study included 80 children with symptomatic CCHD, and 40 healthy children matched for age and sex as a control group. Clinical evaluation and laboratory assessment of nutritional status were documented. Anthropometric measurements were recorded and Z scores for weight for age (WAZ), weight for height (WHZ), and height for age (HAZ) have been calculated. Haemoglobin, red cell indices and serum iron, total iron binding capacity and serum ferritin was done in cases and controls.Results: The overall prevalence of malnutrition was 72.5% in patients with CCHD and 22.5% in controls. Severe malnutrition was diagnosed in 68.9% of cases. All anthropometric measurements which markers of nutritional state are were significantly lower in the patients group compared to controls. The prevalence of iron deficiency anemia (IDA) was 47.5% in the study population. The study also showed that hemoglobin and hematocrit levels, RBC count were paradoxically higher in the cyanotic CHD as compared to the healthy controls though the iron studies revealed the iron deficiency. The mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) mean corpuscular hemoglobin concentration (MCHC), serum ferritin, serum iron, total iron binding capacity (TIBC), values were the parameters, which were found to be statistically significant to differentiate the study groups.Conclusions: Malnutrition is a very common problem in children with symptomatic CCHD, the prevalence of IDA in children with CCHD was found to be high.

scholarly journals Clinical Features and Outcomes of Iron Deficiency Anemia in Patients with Gastrectomy

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2171-2171
Author(s):  
Hyewon Ryu ◽  
Deog-Yeon Jo ◽  
Kyu-Seop Lee ◽  
Ik Chan Song ◽  
Yoon Seok Choi ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Total Gastrectomy ◽  
Clinical Features ◽  
Iron Deficiency Anemia ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Control Group ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Parenteral Iron

Abstract Background: Iron deficiency anemia (IDA) is common in patients with partial or total gastrectomy; however, clinical features and appropriate therapy in these patients have not been well described. We compared clinical features and outcomes in IDA patients with and without gastrectomy. Methods: We retrospectively analyzed clinical features at the time of diagnosis and response to iron therapy in IDA patients with partial or total gastrectomy (gastrectomy group) and in age- and gender-matched IDA patients without gastrectomy (control group) who were diagnosed between 2002 and 2010 at Chungnam National University Hospital. Results: A total of 2,072 patients were diagnosed with IDA during the study period. Thirty-seven and 40 patients were enrolled in the gastrectomy and control groups, respectively. The median ages were 58.8 years (range, 19–84 years) and 52.7 years (range, 25–84 years), respectively. At initial presentation, the hemoglobin levels, mean corpuscular volume (MCV), mean corpuscular hemoglobin levels, mean corpuscular hemoglobin concentration, serum iron levels, total iron binding capacity, ferritin levels as well as endoscopic findings did not differ between the two groups. After 2 weeks, 6 weeks, and 3 months of oral iron therapy, hemoglobin levels were significantly lower in the gastrectomy group than in the control group (8.3 vs. 9.6 g/dL, P=0.012; 9.7 vs. 12.0 g/dL, P=0.000; 11.9 vs. 13.3 g/dL, P=0.016, respectively). After 2 weeks and 6 weeks of treatment, the increase in the hemoglobin level and that in the MCV were significantly slower in the gastrectomy group than in the control group (hemoglobin: 0.6 vs. 2.3 g/dL, P=0.000; 2.1 vs. 4.7 g/dL, P=0.000, respectively) (MCV: 2.6 vs. 6.2 fL, P=0.005; 7.2 vs. 12.7 fL, P=0.008). Parenteral iron was required in nine (23.4%) patients in the gastrectomy group, but not in the control group. The follow-up duration was much longer in the gastrectomy group (23.2 vs. 5.2 months, P=0.008), and 11 (29.7%) patients in this group needed long-term maintenance iron therapy. To normalize hemoglobin levels, longer treatment was required in the gastrectomy group (0.8 vs. 2.8 months, respectively; P=0.013). Conclusion: The response to oral iron therapy in IDA patients with gastrectomy is slower than in those without gastrectomy. Parenteral iron therapy is needed in one-fourth of these patients to normalize hemoglobin levels. Disclosures No relevant conflicts of interest to declare.

scholarly journals Plant-based Diet and Iron Deficiency Anemia in Sundanese Adolescent Girls at Islamic Boarding Schools in Indonesia

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Mohammad Zen Rahfiludin ◽  
Septo Pawelas Arso ◽  
Tri Joko ◽  
Alfa Fairuz Asna ◽  
Retno Murwani ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Iron Deficiency Anemia ◽  
Adolescent Girls ◽  
Hemoglobin Concentration ◽  
Boarding Schools ◽  
Heme Iron ◽  
Molar Ratio ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin

Background. Adolescent girls are at risk for iron deficiency anemia (IDA) due to the higher demand of iron for growth and the loss of blood during menstruation. Consumption of foods containing iron that have higher bioavailability can reduce the risk of IDA although diets that are largely plant-based, like those consumed by many Sundanese people, may not contain sufficient bioavailable iron. Here, we investigated the correlation between plant-based diets and IDA in adolescent Sundanese girls who were students at Islamic boarding schools in Indonesia. Methods. A total of 176 girls from seven Islamic boarding schools in Tasikmalaya were recruited. Nutritional intake data were obtained using 24-hr dietary recall. Blood samples were analyzed with a Sysmex-XNL instrument to measure several parameters including hemoglobin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). Results. The prevalence of IDA in the study population was 22.2%. Iron intake was 6.59 mg/day, which was lower than the recommended amount. The molar ratio of phytic acid to iron and vitamin C to iron was 8.72 and 0.03, respectively. There was a correlation between heme iron and both hemoglobin ( p = 0.009 ) and hematocrit ( p = 0.018 ). Iron from meat, fish, and poultry was correlated with hemoglobin ( p = 0.009 ) and hematocrit ( p = 0.011 ). Conclusion. The Sundanese plant-based diet did not affect the IDA status. Instead, IDA was associated with consumption of less animal-based foods that have iron with higher bioavailability. Increased access to an animal-based menu at the school cafeteria could be an approach to prevent IDA in students at Islamic boarding schools in Indonesia.

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