scholarly journals Is Erythrocyte Protoporphyrin a Better Single Screening Test for Iron Deficiency Compared to Hemoglobin or Mean Cell Volume in Children and Women?

Nutrients ◽  
2017 ◽  
Vol 9 (6) ◽  
pp. 557 ◽  
Author(s):  
Zuguo Mei ◽  
Rafael Flores-Ayala ◽  
Laurence Grummer-Strawn ◽  
Gary Brittenham
Keyword(s):  
Iron Deficiency ◽  
Cell Volume ◽  
Screening Test ◽  
Mean Cell Volume ◽  
Erythrocyte Protoporphyrin

Hematologic Features of Iron Deficiency Anemia in Llamas

1992 ◽  
Vol 29 (5) ◽  
pp. 400-404 ◽  
Author(s):  
D. E. Morin ◽  
F. B. Garry ◽  
M. G. Weiser ◽  
M. J. Fettman ◽  
L. W. Johnson
Keyword(s):  
Iron Deficiency ◽  
Cell Volume ◽  
Iron Deficiency Anemia ◽  
Hemoglobin Concentration ◽  
Iron Therapy ◽  
Deficiency Anemia ◽  
Mean Corpuscular Hemoglobin ◽  
Volume Distribution ◽  
Mean Cell Volume ◽  
Parenteral Iron

Iron deficiency anemia was identified and characterized in three 14 to 29-month-old male llamas (llama Nos. 1–3) from separate herds in Colorado. The identification of iron deficiency anemia was based on hypoferremia (serum iron = 20–60 μg/dl), erythrocytic features, and hematologic response to iron therapy. The anemia was moderate and nonregenerative and characterized by erythrocyte hypochromia, microcytosis (mean cell volume = 15–18 fl), and decreased mean corpuscular hemoglobin concentration (36.0–41.0 g/dl). Morphologic features unique to llamas with iron deficiency anemia included irregular distribution of hypochromia within erythrocytes and increased folded cells and dacryocytes. The cause of iron deficiency was not determined. The llamas were treated with various doses and schedules of parenteral iron dextran. Two of the llamas were monitored for up to 14 months after the start of iron therapy and experienced increases in hematocrit and mean cell volume values. In one llama, progressive replacement of microcytic cells with normal cells was visualized on sequential erythrocyte volume distribution histograms following iron therapy.

scholarly journals Reference and cut-off values for serum ferritin, mean cell volume, and hemoglobin to diagnose iron deficiency in infants aged 9 to 12 months

Medicina ◽  
2007 ◽  
Vol 43 (9) ◽  
pp. 698 ◽  
Author(s):  
Neve Vendt ◽  
Tiina Talvik ◽  
Pille Kool ◽  
Sirje Leedo ◽  
Karel Tomberg ◽  
...  
Keyword(s):  
Iron Deficiency ◽  
Cell Volume ◽  
Serum Ferritin ◽  
Reference Values ◽  
Mean Cell Volume ◽  
Receiver Operating Characteristic Curves ◽  
Healthy Infants ◽  
Diagnostic Characteristics ◽  
The Mean ◽  
Better Than

Background. The number of different laboratory tests and reference values are used to diagnose iron deficiency, but there is no agreement regarding the diagnostic criteria for infants. Aim of study. To establish reference values for serum ferritin, mean cell volume, and hemoglobin in infants aged from 9 to 12 months in Estonia and to evaluate the diagnostic characteristics of serum ferritin, mean cell volume, and hemoglobin in the diagnosis of iron deficiency. Methods. Altogether 195 healthy infants aged 9–12 months participated in the study. They were randomly selected out of 300 families from seven different counties from all over Estonia. Serum ferritin, hemoglobin, soluble transferrin receptor (sTfR) levels and mean cell volume were measured. The best cut-off values for serum ferritin, mean cell volume, and hemoglobin to diagnose iron deficiency, defined by sTfR>2.45 mg/L (n=25), were determined by receiver operating characteristic curves. Results. The mean and reference values (5th and 95th centiles) for ferritin was 24 µg/L (4– 55), 73 fl (68–80) for mean cell volume, and 112 g/L (101–128) for hemoglobin. The best cut-off values to diagnose iron deficiency were <10.9 µg/L for serum ferritin (sensitivity of 83% and specificity of 80%), <71 fl for mean cell volume (86% and 83%, respectively), and <107 g/L for hemoglobin (67% and 87%, respectively). The sensitivity and specificity of serum ferritin and mean cell volume in the diagnosis of iron deficiency were better than those of hemoglobin. Conclusion. For the diagnosis of iron deficiency in infants aged 9–12 months, the cut-off values of <10.9 µg/L and <71 fl should be used for serum ferritin and mean cell volume, respectively.

An assessment of the incidence of iron deficiency in paediatric otolaryngology inpatients

1991 ◽  
Vol 105 (12) ◽  
pp. 1021-1024 ◽  
Author(s):  
Judith M. Heaton ◽  
Robin L. Blair ◽  
Clemency Shadbolt ◽  
Helen Christmas
Keyword(s):  
Regression Analysis ◽  
Iron Deficiency ◽  
Haemoglobin Level ◽  
Cell Volume ◽  
Surgical Procedures ◽  
Ferritin Level ◽  
Preoperative Screening ◽  
Mean Cell Volume ◽  
Economic Class ◽  
The Mean

AbstractThe aims of this study were: to determine whether there is an increased incidence of iron deficiency in paediatric otolaryngology inpatients compared with other surgical controls; and to establish whether preoperative screening of haemoglobin level is warranted in such patients.Children aged 1–10 years admitted electively for ENT surgery or for general surgical procedures had blood taken for haemoglobin level, mean cell volume and serum ferritin. Their age, weight, socio-economic class and ethnic background were recorded.A total of 100 patients entered the study, in a six-month period. The mean ages and weights for the two groups were statistically different, so allowance was made for this in calculations. Social class was not significantly different. No relationship could be established between haemoglobin level and ferritin level for individual patients. Multiple regression analysis for haemoglobin level, mean cell volume and for ferritin level showed that allowing for the age and weight differences these variables were not significantly different for the two groups.This study has therefore shown no increased incidence of iron deficiency in paediatric ENT inpatients. Each Department should formulate its own policy on pre-operative haemoglobin screening, based on local considerations.

Transferrin Saturation (TS) Is a Surrogate Marker for Iron Deficiency Anemia (IDA),

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3175-3175
Author(s):  
Mohammed Najeeb Al Hallak ◽  
William Newman ◽  
Aref Al-Kali
Keyword(s):  
Iron Deficiency ◽  
Confidence Intervals ◽  
Iron Deficiency Anemia ◽  
Transferrin Saturation ◽  
Deficiency Anemia ◽  
Likelihood Ratios ◽  
Mean Cell Volume ◽  
Erythrocyte Protoporphyrin ◽  
Sensitivity Specificity ◽  
Log Ratio

Abstract Abstract 3175 Background: Iron deficiency anemia (IDA) is an important entity in clinical practice. Distinguishing between IDA and other kinds of anemia is challenging in many situations. Various laboratory indices have been studied in relation to IDA including red cell distribution width (RDW), mean cell volume (MCV), transferrin saturation (TS), total iron binding capacity (TIBC), serum ferritin and erythrocyte protoporphyrin (EPP). Methods: We chose 8015 subjects in the National Health and Nutrition Examination Survey (NHANES) database between 2003–2008 who had the required hematologic values. After applying the Centers for Disease Control (CDC) definition for anemia, the number of anemic subjects became 627 (8%). After applying the IDA model as suggested by Cogswell et al using the log ratio of transferrin receptor to ferritin, 46.1% of the anemic subjects had IDA. Then we developed receiver operator (ROC) curves for MCV, RDW, erythrocyte protoporphyrin, TIBC, and percent transferrin saturation for those anemic subjects with and without iron deficiency. From these variables, the area under the curves (AUC), sensitivity, specificity, positive likelihood ratios (LR+), and negative likelihood ratios (LR-) along with their confidence intervals (CI) were calculated. Furthermore we investigated the performance of each available measure by sub-setting the subject group into variables. Data analysis was done using SAS (version 9.2), R version 9.2 with the ROCR library, and MedCalc (version 11.2; MedCalc Software, Mariakerke, Belgium). ROCR and MedCalc have slightly different but individually valuable approaches to ROC curve analysis. Confidence intervals for sensitivity, specificity, and the likelihood ratios were calculated. Results: For the 627 anemic subjects, median age was 26.1 year with 95% being females. Fifty four percent were African American (AA). The MCV showed an AUC of 0.666, sensitivity of 73.7, specificity of 58.8, LR(+) of 1.79, LR(−) of 0.45 with a criterion of <81.6. RDW showed an AUC of 0.803, sensitivity of 77.2, specificity of 69.2, LR(+) of 2.51, LR(−) of 0.33 with a criterion >13.9. For 535 subjects with anemia the EPP showed an AUC of 0.831, sensitivity of 66.4, specificity of 84.9, LR(+) of 4.41, LR(−) of 0.40 with a criterion >93. For 542 subjects with anemia the TIBC showed an AUC of 0.756, sensitivity of 80.3, specificity of 61.5, LR(+) of 2.09, LR(−) of 0.32 with a criterion >406. Finally for the same 542 subjects the TS showed an AUC of 0.869, sensitivity of 80.3, specificity of 78.8, LR(+) of 3.79, LR(−) of 0.25 with a criterion <10.4 [Figure 1]. Comparing the LR(+) and LR(−) between the indices in the setting of inflammation showed that the EPP is the least affected but all indicators are, to some extent, affected by inflammation. Comparing the LR(+) and LR(−) between the indices in the setting of pregnancy showed that TS is the strongest performer. Finally; comparing the LR(+) and LR(−) between the indices in the AA versus non-AA showed that AA ethnicity has a small impact on the LR(−) but reduces the clinical utility of the LR(+) somewhat. Conclusion: Alternative hematologic indices have diagnostic value in the diagnosis of IDA. Transferrin saturation (TS) is the most efficient alternative to ferritin in most circumstances. Erythrocyte proto-porphyrin (EPP) should be considered as an alternative tool in inflammatory conditions. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Erythrocyte protoporphyrin or hemoglobin: which is a better screening test for iron deficiency in children and women?

2003 ◽  
Vol 77 (5) ◽  
pp. 1229-1233 ◽  
Author(s):  
Zuguo Mei ◽  
Ibrahim Parvanta ◽  
Mary E Cogswell ◽  
Elaine W Gunter ◽  
Laurence M Grummer-Strawn
Keyword(s):  
Iron Deficiency ◽  
Screening Test ◽  
Erythrocyte Protoporphyrin

scholarly journals 891 ERYTHROCYTE PROTOPORPHYRIN (EP) AS A SCREENING TEST FOR IRON DEFICIENCY IN AN URBAN PEDIATRIC CLINIC

1981 ◽  
Vol 15 ◽  
pp. 591-591 ◽  
Author(s):  
Ray Yip ◽  
Thomas N Norris ◽  
Arnold S Anderson ◽  
Peter R Dallman
Keyword(s):  
Iron Deficiency ◽  
Screening Test ◽  
Pediatric Clinic ◽  
Erythrocyte Protoporphyrin

Does Cell Size Matter?: Utilizing Mean Cell Volume in Hospitalized Patients As a Screen to Determine Common Causes of Anemia Including Iron Deficiency Anemia, Vitamin B12 and Folate Deficiency

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2338-2338 ◽  
Author(s):  
Manika Gupta ◽  
Kathleen Copley ◽  
Michael Keeney ◽  
Ian Chin-Yee
Keyword(s):  
Iron Deficiency ◽  
Vitamin B12 ◽  
Cell Volume ◽  
Iron Deficiency Anemia ◽  
Vitamin B12 Deficiency ◽  
Folate Deficiency ◽  
Deficiency Anemia ◽  
Mean Cell Volume ◽  
Common Causes ◽  
B12 Deficiency

Abstract Background: The approach to anemia is traditionally based on the Mean Cell Volume. Based on this approach anemia is subdivided into microcytic, normocytic and macrocytic causes. This approach may not accurately discern common causes of anemia in hospitalized patients. Previous studies suggest the MCV may not be a sensitive measurement to differentiate iron deficiency anemia (IDA) and megaloblastic anemia due to vitamin B12 or folate deficiency. Methods: In a retrospective, single-centre study at London Health Sciences Center, all adult patients (age 18 years or older) with confirmed IDA, vitamin B12 and folate deficiency and their associated MCV and RDW values at LHSC over a one year period were reviewed. IDA was defined as hemoglobin less than 115 g/l and ferritin less than 30 (M) and 10 (F). Vitamin B12 deficiency was defined as a value of less than 145. Results: 1119 patients were identified with confirmed IDA, B12 or Folate deficiency. 894 patients had IDA of which 564 patients had low MCV (sensitivity 63.1%) and 797 patients had low MCV or high RDW (sensitivity 89.1%). Of the 96 patients with vitamin B12 deficiency anemia, 12 patients had high MCV (sensitivity 12.5%) and 70 patients had high MCV or high RDW (72.9%). Only one of 2244 patients who had RBC folate measured had an actual folate deficiency. Conclusion: Our results confirm that a normal MCV does not exclude IDA or vitamin B12 deficiency. Clinicians need to be aware of the low sensitivity of the MCV as a screen. The sensitivity of MCV for IDA or vitamin B12 deficiency is improved with indices such as RDW. Folate deficiency is rare in North America and should not be routinely ordered for assessment of nutritional anemia. Disclosures No relevant conflicts of interest to declare.

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