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Iron Deficiency (iron + deficiency)
Kinds of Iron Deficiency Terms modified by Iron Deficiency Selected AbstractsChildren of Helicobacter pylori -infected Dyspeptic Mothers are Predisposed to H. pylori Acquisition with Subsequent Iron Deficiency and Growth RetardationHELICOBACTER, Issue 3 2005Yao-Jong Yang Abstract Background., We tested whether Helicobacter pylori -infected dyspeptic mothers had a higher rate of H. pylori infection in their children, and whether such H. pylori -infected children were predisposed to iron deficiency or growth retardation. Materials and methods., A total of 163 children from 106 dyspeptic mothers (58 with and 48 without H. pylori infection) were enrolled to evaluate body weight, height, hemoglobin, serum ferritin, and H. pylori infection using the 13C-urea breath test. A questionnaire was used to evaluate demographic factors of each child. Results., The rate of H. pylori infection in children with H. pylori -infected dyspeptic mothers was higher than that of children with noninfected mothers (20.5% vs. 5.3%; p < .01, OR: 4.6, 95% CI: 1.5,14.2). The rate of H. pylori infection in children elevated as the number of their H. pylori -infected siblings increased (p < .01). For children below 10 years of age, H. pylori infection was closely related to low serum ferritin and body weight growth (p < .05). Conclusion., The children of H. pylori -infected dyspeptic mothers had an increased risk for such infection. The risk further increased once their siblings were infected. H. pylori infection in pre-adolescent children may determine iron deficiency and growth retardation. [source] Bone Structural and Mechanical Properties Are Affected by Hypotransferrinemia But Not by Iron Deficiency in MiceJOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2000Elise A. Malecki Abstract Hypotransferrinemia is a genetic defect in mice resulting in <1% of normal plasma transferrin (Tf) concentrations; heterozygotes for this mutation (+/hpx) have low circulating Tf concentrations. We used this mutant mouse in conjunction with dietary iron deficiency to study the influence of Tf and iron on bone structural and mechanical properties. Twenty-one weanling wild-type BALB/cj +/+ mice and 21 weanling +/hpx mice were fed iron-deficient or iron-adequate diets for 8 weeks. Twelve hpx/hpx mice were fed the iron-adequate diet. Hypotransferrinemia resulted in increased tibia iron and calcium concentrations, lower femur failure load, and extrinsic stiffness. Because the femurs of the hpx/hpx mice were disproportionately small, these bones actually had increased tissue material properties (ultimate stress [US] and modulus of elasticity) than those of wild-type mice. This is the first report on the effect of dietary iron deficiency on bone structural and mechanical properties. Dietary iron deficiency in +/+ and +/hpx mice decreased tibia iron concentrations but had no effect on tibia calcium and phosphorus concentrations or femur structural or mechanical properties. Because the bones of the hpx/hpx mice were small, but had superior tissue mechanical properties, we conclude that Tf is important for normal bone mineralization. (J Bone Miner Res 2000; 15: 271,277) [source] Iron Deficiency in Stabled Dutch Warmblood FoalsJOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 5 2001H. Brommer Forty-three Dutch Warmblood foals were divided at random into 3 rearing groups immediately after birth: a box-rest group, a box-rest with exercise group, and a pasture group. All stabled foals (box-rest and exercise groups) were fed freshly cut grass harvested from the same pastures on which the pasture group foals were grazing. Blood samples were obtained monthly for CBC and biochemical analyses. At 1,3 months of age, the foals at pasture were active but the foals in the box-rest and exercise groups were listless. Mean hemoglobin concentrations, PCVs, blood iron concentrations, and saturation of total iron binding capacity were significantly lower (P < .05) in the box-rest group (11.3 ± 1.2 g/dL, 33 ± 3%, 123 ± 67 ,g/dL, and 18 ± 9%) and the exercise group (11.6 ± 1.5 g/dL, 34 ± 4%, 101 ± 61 ,g/dL, and 15 ± 10%) compared with the pasture group (14.0 ± 0.8 g/dL, 42 ± 3%, 212 ± 67 ,g/dL, and 32 ± 10%). Oral supplementation of iron to all foals resulted in significant increases in the values of these variables in the box-rest group and exercise group at 4,5 months of age, and the stabled foals were as active as the foals at pasture. In the pasture group, no significant changes occurred. Management practices clearly influence the iron state in young growing foals from 1 to 3 months of age, and although not a frequent cause of anemia in the horse, an absolute deficit of body iron may occur in stabled foals fed freshly cut grass. [source] Fortification Strategies to Combat Zinc and Iron DeficiencyNUTRITION REVIEWS, Issue 2 2002Maria Jimena Salgueiro B.Sc. Food fortification is an important strategy to combat iron and zinc deficiency. This review covers the basic concepts of food fortification, as well as its advantages and disadvantages. The main characteristics of the most common zinc and iron compounds used in this procedure are also analyzed. [source] Iron homeostasis: new players, newer insightsEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2008Eunice S. Edison Abstract Although iron is a relatively abundant element in the universe, it is estimated that more than 2 billion people worldwide suffer from iron deficiency anemia. Iron deficiency results in impaired production of iron-containing proteins, the most prominent of which is hemoglobin. Cellular iron deficiency inhibits cell growth and subsequently leads to cell death. Hemochromatosis, an inherited disorder results in disproportionate absorption of iron and the extra iron builds up in tissues resulting in organ damage. As both iron deficiency and iron overload have adverse effects, cellular and systemic iron homeostasis is critically important. Recent advances in the field of iron metabolism have led to newer understanding of the pathways involved in iron homeostasis and the diseases which arise from alteration in the regulators. Although insight into this complex regulation of the proteins involved in iron homeostasis has been obtained mainly through animal studies, it is most likely that this knowledge can be directly extrapolated to humans. [source] Iron deficiency and iron repletion in the general populationINTERNAL MEDICINE JOURNAL, Issue 4 2007R. Tampi No abstract is available for this article. [source] Using iron deficiency tests for colorectal cancer screening: a feasibility study in one UK general practiceJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 3 2004Adrian Edwards PhD MRCGP MRCP Abstract Iron deficiency is common at presentation in colorectal cancer. Testing for it may complement other screening tests such as faecal occult blood testing and sigmoidoscopy. We therefore examined the feasibility of offering iron deficiency testing to patients in a primary care setting in the UK, offering testing to all 1240 patients aged 55,74 years in one general practice in South Wales, UK. Patients with abnormal results were assessed and offered further investigations. Five hundred and fifty-one people (44.4%) attended for iron deficiency blood tests, of whom 26 patients (4.7%) were iron deficient and offered endoscopic assessment. This identified two cases of benign neoplasia amenable to treatment and no cases of cancer. Iron deficiency testing in a screening context appeared feasible although uptake may be low. [source] Iron deficiency in minority groups in AustraliaJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 8 2004DR Brewster Prof. No abstract is available for this article. [source] Systematic review: managing anaemia in Crohn's diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11-12 2006S. KULNIGG Summary Background, Anaemia is a serious complication of Crohn's disease that triggers hospitalization and, if not interfered with, may lead to death. Aims, To systematically summarize and compare the literature on anaemia in Crohn's disease. Methods, For this systematic review the literature was searched for English-language articles using anaemia, Crohn* and IBD as key words. 144 articles were identified and sorted according to the following topics: prevalence, aetiology, diagnostic tests and therapy. Results, The reported prevalence of anaemia varied between 6.2% and 73.7%, with higher reported frequencies in older studies and in in-patients. Iron deficiency is the most common underlying condition. Vitamin B12 deficiency is related to the extent of ileal resection but has rarely impact on anaemia. Diagnostic criteria are not established and treatment guidelines are missing. Oral iron supplementation seems effective for short periods but intolerance leads to discontinuation in up to 21%. Eleven of 11 studies show that oral iron enhances intestinal inflammation and colon carcinogenesis in animal models of colitis. Intravenous iron supplementation with iron sucrose has been tested in over 250 Crohn's disease patients, is safe, effective and does not carry such hazards. Conclusions, As disease activity is determining the degree of anaemia in Crohn's disease, implementation of more effective therapy for Crohn's disease will lower its incidence. However, further studies regarding the safety and effectiveness of iron supplementation are needed. [source] Oligodendrogenesis: The role of ironBIOFACTORS, Issue 2 2010Maria Elvira Badaracco Abstract Iron seems to be an essential factor in myelination and oligodendrocyte (OLGc) biology. However, the specific role of iron in these processes remains to be elucidated. Iron deficiency (ID) imposed to developing rats has been a relevant model to understand the role of iron in oligodendrogenesis and myelination. During early development ID causes specific changes in myelin composition, including a lower relative content of cholesterol, proteolipid protein (PLP), and myelin basic protein 21 (MBP21). These changes could be a consequence of the adverse effects of ID on OLGc development and function. We subsenquently studied the possible corrective effect of a single intracranial injection (ICI) of apotransferrin (aTf) on myelin formation in ID rats OLGc migration and differentiation after an ICI of aTf was evaluated at 3 days of age. ID increased the number of proliferating and undifferentiated cells in the corpus callosum (CC), while a single aTf injection reverts these effects, increasing the number of mature cells and myelin formation. Overall, results of a series of studies supports the concept that iron may affect OLGc development at early stages of embryogenesis rather than during late development. Myelin composition is altered by a limited iron supply, changes that can be reverted by a single injection of aTf. [source] Impact of daily consumption of iron fortified ready-to-eat cereal and pumpkin seed kernels (Cucurbita pepo) on serum iron in adult womenBIOFACTORS, Issue 1 2007Mohammad Reza Naghii Abstract Iron deficiency, anemia, is the most prevalent nutritional problem in the world today. The objective of this study was to consider the effectiveness of consumption of iron fortified ready-to-eat cereal and pumpkin seed kernels as two sources of dietary iron on status of iron nutrition and response of hematological characteristics of women at reproductive ages. Eight healthy female, single or non pregnant subjects, aged 20,37 y consumed 30 g of iron fortified ready-to-eat cereal (providing 7.1 mg iron/day) plus 30 g of pumpkin seed kernels (providing 4.0 mg iron/day) for four weeks. Blood samples collected on the day 20 of menstrual cycles before and after consumption and indices of iron status such as reticulocyte count, hemoglobin (Hb), hematocrit (Ht), serum ferritin, iron, total iron-binding capacity (TIBC), transferrin and transferrin saturation percent were determined. Better response for iron status was observed after consumption period. The statistical analysis showed a significant difference between the pre and post consumption phase for higher serum iron (60 ± 22 vs. 85 ± 23 ug/dl), higher transferrin saturation percent (16.8 ± 8.0 vs. 25.6 ± 9.0%), and lower TIBC (367 ± 31 vs. 339 ± 31 ug/dl). All individuals had higher serum iron after consumption. A significant positive correlation (r = 0.981, p = 0.000) between the differences in serum iron levels and differences in transferrin saturation percentages and a significant negative correlation (r = ,0.916, p < 0.001) between the differences in serum iron levels and differences in TIBC was found, as well. Fortified foods contribute to maintaining optimal nutritional status and minimizing the likelihood of iron insufficiencies and use of fortified ready-to-eat cereals is a common strategy. The results showed that adding another food source of iron such as pumpkin seed kernels improves the iron status. Additional and longer studies using these two food products are recommended to further determine the effect of iron fortification on iron nutrition and status among the target population, and mainly in young children, adolescents, women of reproductive ages and pregnant women. [source] Autonomic nervous system functions in children with breath-holding spells and effects of iron deficiencyACTA PAEDIATRICA, Issue 9 2005Abdülkerim Kolkiran Abstract Aim: To analyse the activity of the autonomic nervous system during breath-holding spells, we assessed the ECG changes, including ventricular repolarization parameters before and during the spell. We also analysed the effects of iron deficiency on these ECG parameters. Methods: The study group consisted of 37 children with breath-holding spells (30 cyanotic, 7 pallid) (mean age±SD: 12.9±10.8 mo). Twenty-six healthy children (mean age±SD: 14.4±8.6 mo) served as a control group. All patients and controls had standard 12-lead simultaneous surface ECG. All patients had ECG recordings during at least one severe breath-holding spell obtained by "event recorder". Traces obtained by "event recorder" were analysed in terms of mean heart rate and the frequency and duration of asystole during the spell. Results: Respiratory sinus arrhythmia on standard ECGs and asystole frequency during spells were higher in patients with pallid breath-holding spells. Patients with iron deficiency had a lower frequency of respiratory sinus arrhythmia and prolonged asystole time during the spell. There was no difference in terms of ventricular repolarization parameters (QT/QTc intervals and QT/QTc dispersions) between patients and controls and between patient subgroups (cyanotic versus pallid). Conclusion: These results confirmed the presence of autonomic dysregulation in children with breath-holding spells. Iron deficiency may have an impact on this autonomic dysregulation. Ventricular repolarization was unaffected in patients with breath-holding spells. [source] Iron deficiency and iron deficiency anaemia during infancy and childhoodACTA PAEDIATRICA, Issue 4 2004Rolf Zetterströ The present definition of iron deficiency and iron deficiency anaemia is under debate. Our present figures for the prevalence of iron deficiency in infants and toddlers are thus disputed. Conclusion: Better understanding of the regulation of iron metabolism and requirement during the critical early period of growth and development is needed for relevant control of iron deficiency anaemia. [source] Soluble transferrin receptor in the diagnosis of anaemia and iron deficiency in childhoodACTA PAEDIATRICA, Issue 10 2000L Holmberg No abstract is available for this article. [source] Iron availability affects mcyD expression and microcystin-LR synthesis in Microcystis aeruginosa PCC7806ENVIRONMENTAL MICROBIOLOGY, Issue 10 2008Emma Sevilla Summary Microcystins are toxins produced by cyanobacteria that entail serious health and environmental problems. They are cyclic heptapeptides synthesized via a mixed polyketide synthase/non-ribosomal peptide synthetase system called microcystin synthetase. Environmental and nutritional factors that trigger microcystin synthesis are still debated and this work deals with the study of the influence of iron nutritional status on the microcystin synthesis. The results indicate that iron deficiency could be one of the inducing factors of the microcystin synthesis. For the first time, increased transcription of an essential mcy gene and correlative microcystin synthesis has been established. Real-time PCR analysis of mcyD, and microcystin-LR synthesis were studied on Microcystis aeruginosa PCC7806 grown in iron-replete and iron-deplete media. Iron starvation causes an increase of mcyD transcription, correlative to the increase of microcystin-LR levels. Four transcription start points were identified for mcyD and two for mcyA, and they are not changed as a consequence of iron deficiency. [source] Impact of parturition on iron status in nonanaemic iron deficiencyEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 10 2003A. Krafft Abstract Background, Iron-deficient nonanaemic parturients risk underdiagnosis as a result of the reliance on postpartum ferritin and haemoglobin as markers of iron status. Ferritin is an acute-phase protein whose levels increase during the inflammatory response, as occurs after delivery. Our aims were to evaluate the impact of parturition on iron status, erythropoiesis and the inflammatory response, and identify the optimal parameters and timing for diagnosing iron deficiency in the presence of postpartum inflammation. Materials and methods, Conventional parameters of iron status, erythropoiesis and the inflammatory response (serum ferritin, serum iron, transferrin saturation, C-reactive protein) were compared with more recent parameters [soluble transferrin receptors (sTfR), hypochromic red cells, reticulocyte indices] within 48 h either side of delivery in 64 iron-deficient nonanaemic women (defined by a prepartum serum ferritin , 15 µg L,1, and a pre- and postpartum haemoglobin of , 11·0 g dL,1 and , 10·0 g dL,1, respectively). Results, Mean sTfR decreased pre to postpartum from 7·3 to 5·8 µg mL,1 (P < 0·01), while mean serum ferritin increased from 9·7 to 16·9 µg L,1 (P < 0·01). Serum ferritin did not correlate with haemoglobin pre or postpartum (r = 0·04, P = 0·7; r = 0·2, P = 0·09), but a correlation persisted postpartum between hypochromic red blood cells and haemoglobin (r = ,0·26; P < 0·05). The percentage of hypochromic red cells remained virtually unchanged pre- and postpartum (4·0% vs. 3·8%; NS). Postpartum mean reticulocyte haemoglobin content (CHr) was 27·1 ± 1·6 pg. Conclusion, Iron status should be tested prepartum, in the absence of an inflammatory response, rather than in the early postpartum. A valuable additional parameter, where available, might be the hypochromic red cell percentage, which is virtually uninfluenced by the inflammatory response. Furthermore, hypochromic red cell percentage, CHr and sTfR can be helpful to differentiate between functional iron deficiency and depleted iron stores. [source] Iron homeostasis: new players, newer insightsEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2008Eunice S. Edison Abstract Although iron is a relatively abundant element in the universe, it is estimated that more than 2 billion people worldwide suffer from iron deficiency anemia. Iron deficiency results in impaired production of iron-containing proteins, the most prominent of which is hemoglobin. Cellular iron deficiency inhibits cell growth and subsequently leads to cell death. Hemochromatosis, an inherited disorder results in disproportionate absorption of iron and the extra iron builds up in tissues resulting in organ damage. As both iron deficiency and iron overload have adverse effects, cellular and systemic iron homeostasis is critically important. Recent advances in the field of iron metabolism have led to newer understanding of the pathways involved in iron homeostasis and the diseases which arise from alteration in the regulators. Although insight into this complex regulation of the proteins involved in iron homeostasis has been obtained mainly through animal studies, it is most likely that this knowledge can be directly extrapolated to humans. [source] Use of advanced red blood cell and reticulocyte indices improves the accuracy in diagnosing iron deficiency in pregnant women at termEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2007Mari Ervasti Abstract Objectives:, Detection of iron deficiency during pregnancy with hemoglobin (Hb) and serum measurements is insignificant as the measurements may be affected by e.g. hemodilution or accelerated erythropoiesis. This study tests whether cell indices will give a more reliable measure of iron deficiency in pregnant women at term. Methods:, The population was 202 pregnant women. Using the ADVIA 120 hematology system, Hb, mean cell volume (MCV), percentage of hypochromic red blood cells (%HYPOm) and reticulocytes (%HYPOr), and cellular hemoglobin in reticulocytes (CHr) were tested. Additionally, transferrin saturation (TfSat), ferritin, and transferrin receptor (TfR) were analyzed. Receiver operating characteristic (ROC) curves and area under the ROC curves (AUC) were used as statistical methods. Results:, When TfSat (,11%) was used as the reference test for iron deficiency, %HYPOm and CHr had a sensitivity of 58.1% and 80.7%, while the specificities were 82.6% and 71.3%, respectively. Additionally, the AUC values were %HYPOr 0.80, CHr 0.79, ferritin 0.77, %HYPOm 0.75, TfR 0.67, MCV 0.63 and Hb 0.64. The results provided by the cell indices alone (%HYPOm or CHr) were in good agreement with the results based on the usage of a combination of three commonly used tests (Hb, MCV, ferritin). Conclusions:, This study suggests that the most practical way to diagnose iron deficiency in pregnant women at term is to use cell indices such as CHr and %HYPOm provided by the automated hematological analyzer. Further studies are needed to determine the usefulness of the cell indices in diagnosing iron deficiency longitudinally during the course of pregnancy. [source] Serum transferrin receptor, ferritin, and reticulocyte maturity indices during the first year of life in ,large' preterm infantsEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 5 2007Vassiliki Schiza Abstract Background:, Preterm infants are at risk of developing iron deficiency; among the iron status and hemopoiesis indices the serum transferrin receptor (sTfr) has been shown to be a useful indicator in assessing iron status, while immature reticulocyte production is regarded as an estimator of erythropoiesis. Objective:, To investigate age-related changes in iron status infants born ,moderately' preterm, with a gestational age (GA) of 32,36 wk, and identify associations between sTfr and other hematological and biochemical iron indices. Design:, Hospital-based prospective, longitudinal study in preterm infants. Methods:, Iron and erythropoiesis parameters were evaluated in 181 formula-fed preterm infants at 2 and 6 wk and 3, 6, 9, and 12 months chronological age. Hemoglobulin (Hb), hematocrit (Hct), mean corpuscular volume (MCV), reticulocytes, serum iron (sFe), serum ferritin (sFer), sTfr, and reticulocyte subpopulations were measured. Results:, A total of 756 measurements were performed. After an initial decline, Hb rose from month 3 to 12 of life. SFe and sFer and immature reticulocyte count decreased from the second week to the third month and remained stable thereafter. STfr was lower up to 6 wk and stable from month 3 to 12. Iron deficiency anemia (IDA) was found in 5.5% of infants. In 76 measurements sFer was <12 ,g/L, implying storage iron deficiency (SID). A negative correlation was observed between sTfr and other indices of iron status such as Hb, Hct, MCV, sFe, and sFer. Infants with sFer <12 ,g/L had lower sTfr than those with sFer >12 ,g/L. Reticulocyte production was positively associated with STfr, but this association was dependent on the chronological age of the infant. Conclusion:, Iron depletion is common in formula-fed preterm (32,36 wk GA) infants between month 3 and 12 of life. STfr appears to be an indicator of iron status in preterm infants during the first year of life. [source] The soluble transferrin receptor in dysplastic erythropoiesis in myelodysplastic syndromeEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 1 2007Georgia Metzgeroth Abstract Objectives:,In individuals without iron deficiency, the soluble transferrin receptor (sTfR) directly reflects the erythropoietic activity. This study investigated sTfR concentrations in ineffective, dysplastic erythropoiesis in myelodysplastic syndrome (MDS). Methods:,To exclude influences of other myeloid cells on sTfR, only patients with refractory anemia (RA), refractory anemia with ringed sideroblasts (RARS) and 5q, syndrome were included. sTfR was measured nephelometrically (normal range 0.81,1.75 mg/L). Results:,Thirty-four untreated MDS patients (RA = 14, RARS = 10, 5q, syndrome = 10) were enrolled and analysed. The mean sTfR value of all MDS patients (1.30 ± 0.8 mg/L, range 0.2,3.8) did not differ from our control group. In 5q, syndrome, the mean sTfR concentration (0.80 ± 0.5 mg/L) was significantly lower than in RA (1.32 ± 0.4 mg/L, P = 0.02) and RARS (1.75 ± 1.1 mg/L, P = 0.03). Subdividing MDS according to their amount of erythroid mass in bone marrow a significant difference of sTfR between patients with decreased (0.70 ± 0.4 mg/L), normal (1.32 ± 0.4 mg/L) and increased (2.06 ± 0.9 mg/L) erythropoiesis was observed. MDS patients with sTfR values below the reference range of 0.81 mg/L required transfusions in 90% of cases and showed higher erythropoietin levels compared to MDS patients with sTfR levels ,0.81 mg/L (P = 0.01). There was a good agreement between sTfR and the amount of polychromatic erythroblasts observed (r = 0.68, P < 0.001). Conclusion:,In conclusion, the serum concentration of sTfR reflects erythropoietic activity in MDS, but it is in particular determined by the degree of erythroid maturation and the severity of ineffective erythropoiesis. Low sTfR values in MDS are associated with a reduced, poorly differentiated erythropoiesis and requirement of blood transfusions. [source] Hepcidin , central regulator of iron metabolismEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 1 2007Valeriu Atanasiu Abstract The knowledge about mammalian iron metabolism has advanced dramatically over the past decades. Studies of genetics, biochemistry and molecular biology allowed us the identification and characterization of many of the molecules involved in regulation of iron homeostasis. Important progresses were made after the discovery in 2000 of a small peptide , hepcidin , that has been proved to play a central role in orchestration on iron metabolism also providing a link between iron metabolism and inflammation and innate immunity. Hepcidin directly interacts with ferroportin (FPN), the only known mammalian iron exporter, which is expressed by enterocytes, macrophages and hepatocytes. The direct hepcidin,FPN interaction allows an adaptative response from the body in situations that alter normal iron homeostasis (hypoxia, anemia, iron deficiency, iron overload, and inflammation). [source] Iron status in Danish men 1984,94: a cohort comparison of changes in iron stores and the prevalence of iron deficiency and iron overloadEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2002Nils Milman Abstract:,Background and objectives : From 1954 to 1987, flour in Denmark was fortified with 30 mg carbonyl iron per kg. This mandatory fortification was abolished in 1987. The aim of this study was to compare iron status in Danish men before and after abolition of iron fortification. Methods : Iron status (serum ferritin, haemoglobin), was assessed in population surveys in Copenhagen County during 1983,84 comprising 1324 Caucasian men (1024 non-blood-donors, 300 blood donors) and in 1993,94 comprising 1288 Caucasian men (1103 non-blood-donors, 185 donors), equally distributed in age cohorts of 40, 50, 60 and 70 yr. Results : In the 1984 survey median serum ferritin values in the four age cohorts in non-blood-donors were 136, 141, 133 and 111 µg/L, and in the 1994 survey 177, 173, 186 and 148 µg L ,1 , respectively. The difference was significant in all age groups ( P <0.001). There was no significant difference between the two surveys concerning the prevalence of small iron stores (ferritin 16,32 µg L ,1 ), depleted iron stores (ferritin <16 µg L ,1 ) or iron-deficiency anaemia (ferritin <13 µg L ,1 and Hb <5th percentile for iron-replete men). However, from 1984 to 1994, the prevalence of iron overload (ferritin >300 µg L ,1 ) increased from 11.3% to 18.9% ( P <0.0001). During the study period there was an increase in body mass index ( P <0.0001), alcohol consumption ( P <0.03) and use of non-steroid anti-inflammatory drugs (NSAID) ( P <0.0001), and a decrease in the use of vitamin,mineral supplements ( P <0.04) and in the prevalence of tobacco smoking ( P <0.0001). In contrast, median ferritin in blood donors showed a significant fall from 1984 to 1994 (103 vs. 74 µg L ,1 , P <0.02). Conclusion : Abolition of iron fortification reduced the iron content of the Danish diet by an average of 0.24 mg MJ ,1 , and the median dietary iron intake in men from 17 to 12 mg d ,1 . From 1984 to 1994, body iron stores and the prevalence of iron overload in Danish men increased significantly, despite the abolition of food iron fortification. The reason appears to be changes in dietary habits, with a lower consumption of dairy products and eggs, which inhibit iron absorption, and a higher consumption of alcohol, meat, and poultry, containing haem iron and enhancing iron absorption. The high prevalence of iron overload in men may constitute a health risk. [source] Incidence of iron-deficiency anaemia in infants in a prospective study in JordanEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 4 2000Julia Kilbride Abstract: 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 ,g/l or zinc protoporphyrin (ZPP) >35 ,g/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. [source] ORIGINAL ARTICLE Clinical haemophilia: Remission of paroxysmal atrial fibrillation with iron reduction in haemophilia AHAEMOPHILIA, Issue 5 2010L. R. ZACHARSKI Summary., Two male first cousins with mild haemophilia A had baseline factor VIII levels of 12,15% and experienced bleeding requiring coagulation factor infusion therapy with trauma and surgical procedures. Both the patients with haemophilia A also had electrocardiographically documented symptomatic paroxysmal atrial fibrillation (PAF) for several years that had become resistant to pharmacological suppression. Radiofrequency ablation was considered in both the cases but deferred considering refusal of consent by the patients to undergo the procedure. Remission of arrhythmias has been reported in patients with iron-overload syndromes. Body iron stores assessed by serum ferritin levels were elevated in both men but neither had the C282Y or H63D genes for haemochromatosis. Calibrated reduction of iron stores by serial phlebotomy, avoiding iron deficiency, was followed by remission of symptomatic PAF in both cases. Iron reduction may be an effective treatment for arrhythmias apart from the classic iron-overload syndromes and deserves further study particularly in patients with bleeding disorders who might be at risk for arrhythmias and other diseases of ageing. [source] Helicobacter pylori Infection and Iron Stores: A Systematic Review and Meta-analysisHELICOBACTER, Issue 5 2008Khitam Muhsen Abstract Background and Aims:, We carried out a systematic literature review and meta-analysis to evaluate the existing evidence on the association between Helicobacter pylori infection and iron stores. Methods:, Twelve case reports and case series, 19 observational epidemiologic studies and six intervention trials were included in the review. Results:, Although only few studies controlled for multiple potential confounders, most studies reported a positive association, linking between H. pylori and decreased body iron stores in symptomatic and asymptomatic H. pylori -infected subjects. H. pylori infection may be regarded as a risk factor for reduction in body iron stores and also for iron deficiency or iron deficiency anemia, especially in high-risk groups. The results of the meta-analysis of thoroughly designed and analyzed studies revealed an increased risk for iron deficiency anemia; pooled odds ratio (OR) 2.8 (95% confidence interval (CI) 1.9, 4.2) and also for iron deficiency; pooled OR 1.38 (95%CI 1.16,1.65) among H. pylori -infected subjects. The biologic mechanism by which H. pylori induces the alteration in the iron stores is not fully understood, but it seems to involve several pathways, including gastrointestinal blood loss, decrease in the absorption of dietary iron, and enhanced uptake of the iron by the bacterium. Conclusions:,H. pylori is associated with reduced iron stores. Future research is needed to determine whether this relationship is a causal association and to better understand its biologic mechanism. The impact of anti- H. pylori therapy on improvement of iron stores needs to be further evaluated in large and well-controlled trials. [source] Children of Helicobacter pylori -infected Dyspeptic Mothers are Predisposed to H. pylori Acquisition with Subsequent Iron Deficiency and Growth RetardationHELICOBACTER, Issue 3 2005Yao-Jong Yang Abstract Background., We tested whether Helicobacter pylori -infected dyspeptic mothers had a higher rate of H. pylori infection in their children, and whether such H. pylori -infected children were predisposed to iron deficiency or growth retardation. Materials and methods., A total of 163 children from 106 dyspeptic mothers (58 with and 48 without H. pylori infection) were enrolled to evaluate body weight, height, hemoglobin, serum ferritin, and H. pylori infection using the 13C-urea breath test. A questionnaire was used to evaluate demographic factors of each child. Results., The rate of H. pylori infection in children with H. pylori -infected dyspeptic mothers was higher than that of children with noninfected mothers (20.5% vs. 5.3%; p < .01, OR: 4.6, 95% CI: 1.5,14.2). The rate of H. pylori infection in children elevated as the number of their H. pylori -infected siblings increased (p < .01). For children below 10 years of age, H. pylori infection was closely related to low serum ferritin and body weight growth (p < .05). Conclusion., The children of H. pylori -infected dyspeptic mothers had an increased risk for such infection. The risk further increased once their siblings were infected. H. pylori infection in pre-adolescent children may determine iron deficiency and growth retardation. [source] Un-promoted issues in inflammatory bowel disease: opportunities to optimize careINTERNAL MEDICINE JOURNAL, Issue 3 2010J. M. Andrews Abstract Inflammatory bowel diseases (IBD), comprising Crohn's disease (CD) and ulcerative colitis (UC), are chronic inflammatory disorders of the gut, which lead to significant morbidity and impaired quality of life (QoL) in sufferers, without generally affecting mortality. Despite CD and UC being chronic, life-long illnesses, most medical management is directed at acute flares of disease. Moreover, with more intensive medical therapy and the development of biological therapy, there is a risk that management will become even more narrowly focused on acute care, and be directed only at those with more severe disease, rather than encompassing all sufferers and addressing important non-acute issues. This imbalance of concentration of medical attention on ,high-end' care is in part driven by the need to perform and publish randomized clinical trials of newer therapies to obtain registration and licensing for these agents, which thus occupy a large proportion of the recent IBD treatment literature. This leads to less attention on relatively ,low-technology' issues including: (i) the psychosocial burden of chronic disease, QoL and specific psychological comorbidities; (ii) comorbidity with functional gastrointestinal disorders (FGIDs); (iii) maintenance therapy, monitoring and compliance; (iv) smoking (with regard to CD); (v) sexuality, fertility, family planning and pregnancy; and (vi) iron deficiency and anaemia. We propose these to be the ,Un-promoted Issues' in IBD and review the importance and treatment of each of these in the current management of IBD. [source] Quantification of blood intake of the head louse: Pediculus humanus capitisINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 5 2006Rick Speare MB Although head lice, Pediculus humanus capitis, are globally prevalent blood-sucking ectoparasites, the amount of blood imbibed by head lice has not been determined. This study investigated this parameter, as regular loss of a small quantity of blood may lead to an iron deficiency and anaemia. Adult female lice (66), adult males (46), and nymphs (152) were weighed before and after feeding in groups of 17,109 lice. The average amounts of blood imbibed at a single feed were: adult female louse (0.0001579 ml), adult male (0.0000657 ml) and nymph (0.0000387 ml). Assuming three feeds per day by an average infection of 30 lice (10 females, 10 males, and 10 nymphs), the average child with active pediculosis would loose 0.008 ml of blood per day. This amount of blood loss is of no clinical significance even in iron-deficient children. The most heavily infected child observed with 2657 lice could be expected to loose 0.7 ml/day or 20.8 ml/month, which may be of clinical importance in a child on an adequate diet, and would be significant in an iron-deficient child. However, if head lice feed more often than three times a day, a heavy infestation would have a greater potential to lead to iron deficiency. The frequency of feeding of head lice on the head of the human host needs to be determined. [source] Chronic telogen effluvium or early androgenetic alopecia?INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2004Rodney Sinclair MBBS A 16-year-old girl presented with a 12-month history of generalized hair shedding from the scalp. The onset of shedding coincided with the development of Hashimoto's thyroiditis and iron deficiency. At the time of initial presentation, the Hashimoto's thyroiditis had been treated with Neo-Mercazole and she was euthyroid. Her iron stores were low, with a ferritin level of 13 µg/L. As she was vegetarian, oral iron replacement therapy was commenced without further investigation. On follow-up 6 months later, her iron stores were normal (ferritin, 36 µg/L), but the hair shedding had continued. On examination, there was a positive hair pull test from both the vertex of the scalp and the occipital scalp. There was mild bitemporal recession, but no widening of the central part, and she appeared to have a full, thick head of hair (Fig. 1). Additional investigations at that time revealed normal thyroid function and negative antinuclear antibody (ANA) and syphilis serology. She was on no medication other than Neo-Mercazole. Serum testosterone, dihydroepiandosterone sulphate (DHEAS) and sex hormone binding globulin (SHBG) were normal. Two 4-mm punch biopsies were taken from the vertex of the scalp; one was sectioned horizontally and the other vertically. The vertical section was unremarkable. On the horizontal section, there were 32 hair follicles in total, 30 of which were terminal hairs and two of which were vellus hairs. One hair was in telogen. The ratio of terminal to vellus hairs was 15 : 1. Figure 1. Initial presentation A diagnosis of chronic telogen effluvium was made. The condition was explained to the patient and she was reassured that chronic telogen effluvium is not a progressive condition and does not lead to baldness. No treatment was recommended. At follow-up 12 months later, the hair loss had obviously progressed and the patient was assessed as having Ludwig Stage 1 androgenetic alopecia with widening of the central part (Fig. 2). Repeat blood tests showed normal iron studies, thyroid function, and hormone parameters. Three 4-mm punch biopsies were taken from the vertex of the scalp and all were sectioned horizontally. The terminal to vellus hair ratios were 1 : 1, 2.6 : 1, and 1.9 : 1. A diagnosis of androgenetic alopecia was made and she was commenced on oral spironolactone, 200 mg/day. Figure 2. Presentation after 12 months [source] Relationships of serum free thyroxine and erythrocyte measures in euthyroid HFE C282Y homozygotes and control subjects: the HEIRS StudyINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 3 2010J. C. BARTON Summary Hemoglobin (Hb) levels and mean corpuscular volume (MCV) are abnormal in some persons with hemochromatosis or thyroid disorders. We sought to determine whether serum free thyroxine (T4) affects erythrocyte measures in euthyroid adults with or without C282Y homozygosity. We evaluated 488 white HFE C282Y homozygotes and controls (no HFE C282Y or H63D; normal serum iron measures) identified in screening; we excluded those with thyroid disorders, anemia, erythrocytosis, or serum ferritin (SF) <34 pmol/l. In the remaining 141 C282Y homozygotes and 243 controls, we evaluated correlations of log10 free T4 with Hb, RBC, MCV, and red blood cell distribution width (RDW). C282Y homozygotes had lower mean age, higher mean Hb, MCV, and log10 SF, and lower mean RBC and RDW than controls; mean log10 free T4 did not differ significantly. In HFE C282Y homozygotes, there was no significant correlation of log10 T4 with erythrocyte measures. In controls, there was a positive correlation of log10 T4 with Hb (P = 0.0096) and a negative correlation with RDW (P = 0.0286). Among euthyroid white adults without iron deficiency, there are significant correlations of log10 free T4 with Hb and RDW in controls, but not in HFE C282Y homozygotes. [source] | ||||||||||||||||||||||||||||||||||