Cases Of Iron Deficiency Anemia Research Articles

Quantitative exfoliative cytology of squames obtained from iron defi ciency anemia and healthy individuals

Background: Iron deficiency anemia is the most common nutritional deficiency of world affecting people of all ages and economic groups. Previous studies on the effects of iron deficiency anemia by exfoliative oral cytology have produced conflicting results but application of quantitative parameters such as nuclear diameter (ND) and cytoplasmic diameter (CD) and nuclear to cytoplasmic ratio (N/C) has shown to be significant in the diagnosis of oral lesions. The present study was undertaken to assess the morphometric changes in CD and ND of squames obtained from buccal mucosa of patients with iron deficiency anemia and also to assess the effect of serum ferritin levels on cellular morphometry. Materials and Methods: Thirty cases of iron deficiency anemia and 30 cases of control group were selected for the study. The control group consisted of people without clinical symptoms of anemia, normal hematological and serum ferritin levels. Scrapings were taken from the buccal mucosa of the iron deficiency anemia patients and control groups and stained with Papanicolaou stain. ND and CD were measured using image analyzer. Results: CD and ND values of the control group were found to be in the range of 65.32-75.39 μ and 8.10-9.40 μ respectively. CD values of iron deficiency were 55.05-64.12 μ with the mean CD value of 59.77 μ and ND values were 8.69-11.24 μ with mean ND values of 9.88 μ. On correlating the serum ferritin and red cell parameters with the CD and ND values of iron deficiency anemia showed positive correlation. Conclusions: The decrease in cytoplasmic diameter and increase in ND in iron deficiency anemia and progressive decrease in CD with decrease in serum ferritin levels suggested that iron deficiency causes significant changes in oral exfoliative cells. Cytomorphometric analysis of smears is useful in detecting the changes in iron deficiency anemia.

Сегментация потенциальных потребителей лекарственных препаратов железа на основе данных о распространенности железодефицитной анемии

INTRODUCTION. According to WHO 3.6 billion of people on the planet have latent iron deficiency and another 1.8 billion of people suffer from iron deficiency anemia (IDA). According to the Ministry of Health of Ukraine information the prevalence and the incidence of iron deficiency anemia is 1163.9 and 404.5 per 100 000 persons, respectively. However, this information is only clinically confirmed cases of IDA. The largest share in the structure of morbidity has the latent iron deficiency, which is characterized by less prominent clinical manifestations. Treatment of IDA aimed not only at addressing anemia as a symptom, but also at the elimination of iron deficiency and replenishment of its reserves in the organism, which can be achieved by taking ferric drugs. Today ferric drugs market is characterized by high leveled competition, stable demand and a wide range of products. Therefore, an important issue in the study of the market is to find the best ways to determining its potential capacity to expand the marketing potential and to provide iron supplementation as many consumers who need treatment and prevention of iron deficiency. GOAL OF THE STUDY. the segmentation of the population that needs treatment and prevention of iron deficiency on the basis of the etiological factors that cause development of anemia, based on official statistics on morbidity. MATERIALS AND METODS. According to the standard classification of the iron deficiency we have identified four main groups of etiological factors that lead to the development of IDA: bleeding, iron malabsorption, increased body's need for iron, as well as complicated genesis factors. In order to determine the total number of individual segments we have analyzed the reports of the State Statistics Committee of Ukraine, Health Statistics Centre of Ministry of Health of Ukraine, as well as electronic database of medical statistics “Health for All”. RESULTS AND DISCUSSION. According to the estimates, the total set of potential users of iron supplements was 18,145,268 people, nearly 53% of who were attributed to a group of people who should get therapy, and the other 47% – preventive care. Major consumer segment were children under 18 years old (13.36% in the medical group and 31.17% in preventive group), patients with chronic kidney disease (30.40%), potential customers who have had operating bleeding (10.56%), cancer patients (3.98%), as well as patients with obstetric bleeding (3.57%). The data is much higher than the official information of the prevalence of IDA among the population of Ukraine, which is associated with the severity of the diagnosis of anemia in patients of different age and gender categories, as well as with various pathological conditions. Also the number of people with low incomes need to be determined, because for this category only low-priced drugs can be available, that can significantly affect subsequent calculations of the potential market capacity of ferric drugs, especially in terms of money. CONCLUSION. These data suggest a rather large potential market volume of ferric preparations. In this regard, the main future prospects is study iron supplements consumption, finding the most suitable drugs for the iron deficiency treatment in different segments by interviewing doctors for further calculations of potential capasity and potential market of antianemic drugs.

Discussion on causes of non-gastrointestinal hemorrhagic anemia in patients with viral hepatitis

Objective To explore the causes of non-gastrointestinal hemorrhagic anemia in patients with viral hepatitis.Methods 30 cases of viral hepatitis patients who had anaemia with non-gastrointestinal bleeding in blood routine test were performed bone marrow aspiration and hemolysis tests.Results The results showed there were 3 cases of unexplained hemolytic anemia,3 cases of thalassaemia,2 cases of iron deficiency anemia,9 cases of reduced or obvious reduced hyperosteogeny.Conclusion For the patients with viral hepatitis,bone marrow aspiration and hemolysis tests should be routinely performed. Key words: Viral hepatitis; Anemia; Bone marrow

Safety and efficacy of parenteral iron sucrose complex therapy in iron deficiency anemia in antenatal and postnatal women

Background: Iron deficiency anaemia (IDA) is one of the common medical disorders in pregnancy in the developing world, which affect both the mother and the newborn and subsequent child and later adult. Aims & Objective: This study is undertaken to evaluate the safety and efficacy of parenteral iron sucrose complex therapy in iron deficiency anaemia in antenatal and postnatal women. Material and Methods: 110 consecutive pregnant women between 16-36 weeks of gestation and postnatal women, diagnosed as cases of Iron deficiency anaemia with Hb level 5-8 gm%, who were seen from May 2009 to April 2011 in our Hospital, were included in the study. All the patients received Iron Sucrose Complex in infusion form with the aim to correct the iron deficiency as well as to replenish the iron stores. The aim was to bring her Hb level to 10gm%. Result were analyzed in terms of the safety& efficacy. Results: Intravenous iron sucrose is effective in achieving target Hb of 10g/dl in 80% of patients. It shows that of IV iron sucrose significantly (P

Performance Evaluation of the Automated Morphological Analysis of Erythrocytes by CellaVision DM96

Automated digital morphology systems are utilized for blood cell morphological examination. The aim of this study is to evaluate the accuracy and efficacy of RBC morphological anomaly screening using the CellaVision DM96 (DM96) automated image analysis system. The automated analysis of RBC shape, size, and chromasia abnormalities was conducted on the DM96 using 478 blood samples. A manual microscopic review was independently performed. The DM96 preclassified samples as poikilocytosis-positive for 98% of cases with schistocytosis or echinocytosis, 97% of elliptocytosis, and 92% or 65% of cases that were positive for teardrop cells or for target cells, respectively. The accuracy of the DM96 in the detection of RBC size and chromasia abnormalities of iron deficiency anemia cases was higher than direct microscopic observation. Automated morphological analysis with the DM96 has potential utility in the morphological screening of RBC anomalies that are associated with disease.

Kandidias Oral pada Penderita Anemia Defisiensi Besi (Fe) dan Penetalaksanaannya

Background: Iron deficiency anemia is a microcytic anemia caused by chronic blood loss dueto such problems as excessive menstrual flow, gastrointestinal bleeding, gasterektomi or malabsorption that reduces the absorption of Fe. Predisposing factors that lead to the disruption of the ecology of oral candidiasis or oral microbiological changes can be due to malnutrition (iron deficiency, folic acid, vitamin B12) and the very old age. Objective: To report a case of iron deficiency anemia with oral candidiasis and its management. Case Report: A 69-year man in the reference by peer demonstrated swollen gums, mouth pain and difficulty in swallowing. A moth ago he was hospitalized and boarded for a week but no change, his body weight loss was 25kg. paleconjunctiva and face, droliing, looked weak. The body temperature was 370 C; the BP measurement was: 125/80mmHg; with body weight was 50kg; right and left submandibular lymph nodes become enlarging and soreness palpatiom. Symmetrical face. Right and left lip corners are angular kheilitis, cheek mucosa, palate hyperemia, gingival stipling was disappeared, hyperemia, dorsal surface smooth tongue, hyperemia, depapilasi, OHI: bad; thick saliva, hypersalivation. A lot of dental caries and the remaining roots. Management: Examination of the saliva with KOH solution looked a hyphe. Routine blood tests and profile of fe all within normal limits except RBC was 3,37.106 / uL; HGB: 11.0 g / dl; HCT: 32.2%, Fe 29.00 u g / dl (below normal). Treatment with 3% perhidrol mouthwash, Nyistatin solution 3 x daily. Zegase tablet 2x daily. Paracetamol tablets if necessary. Conclusion sixteen days later the patient recovered.

Intestinal Bacterial Flora that Compete on the Haem Precursor Iron Fumarate in Iron Deficiency Anemia Cases

Intestinal Bacterial Flora that Compete on the Haem Precursor Iron Fumarate in Iron Deficiency Anemia Cases

Blastocystis hominis as a contributing risk factor for development of iron deficiency anemia in pregnant women

Intestinal parasitic infection increases the risk of developing iron deficiency anemia (IDA) during pregnancy. The objective of this study was to assess Blastocystis hominis as a contributing risk factor for development of IDA in pregnant women. A total of 200 fecal specimens from 120 pregnant women with IDA (mean Hb = 9.6 g/dl), and 80 non-anemic controls were examined for Blastocystis. Fecal specimens were examined by the formalin/ethyl-acetate concentration technique, iron hematoxylin staining, modified Ziehl-Neelsen acid-fast staining, and by the in vitro cultivation technique for Blastocystis. Frequency of Blastocystis infection, detected microscopically and by the in vitro culture technique, was significantly higher in IDA study group (n = 48; 40%) compared to non-anemic controls (n = 5; 6.3%; P < 0.0001), and 26.5% (n = 53) in all study subjects. Among the 48 cases, Blastocystis without other intestinal parasitic infections was detected in 41 cases (34.2%), while seven cases (5.8%) with Blastocystis were coinfected with other intestinal parasites which included Giardia and Cryptosporidium (1.7% each), and Entamoeba sp., Ascaris, and Trichuris (0.8% each). The mean Hb level of the 48 Blastocystis-infected cases was 9.2 g/dl (mild anemia). While the other 72 IDA cases with no infection had mean Hb of 10.0 g/dl (mild anemia), with a significant difference in mean Hb level between Blastocystis-infected and the non-infected IDA cases (P < 0.0001). Furthermore, among the 48 Blastocystis-infected IDA cases, the mean Hb of the 41 Blastocystis-infected cases without other intestinal parasitic co-infection was 9.1 g/dl (mild anemia), while the mean Hb level of the 7 Blastocystis-infected cases with other intestinal parasitic co-infection was 8.7 g/dl (moderate anemia). Findings of the current study showed that B. hominis infection contributes to the development of IDA in pregnant women. Hence, parasitological diagnostic tests are recommended in routine examination at all antenatal clinics.

Iron Deficiency Anemia due to Long-time Bloodletting Using Cupping

We report three cases of iron deficiency anemia due to long-time bloodletting using cupping. Case 1 was a 52-year-old man who sought evaluation at the Health Promotion Center in our hospital due to fatigue and dyspnea on exertion (DOE). There were no abnormal findings on his general health examination, except anemia. He has performed self-bloodletting for a long time with cupping on his back and extremities for fatigue, myalgias, or polyarthralgias. Case 2 was a 52-yearold woman with fatigue and DOE. The physical examination revealed a systolic murmur at her left lower anterior chest and pale conjunctiva. The initial hematocrit was 22.4% and the hemoglobin was 6.4 g/dL. She has self-bloodletted using cupping 2 to 3 times a week when she felt tired or had myalgias. Case 3 was a 35-year-old man with sudden onset fatigue and DOE. He had severe DOE during a challenging physical test. He frequently received bloodletting using cuppings on his back and extremities by a doctor of Oriental medicine. There were no abnormal findings on the general health examination, except anemia. All three patients were diagnosed with iron deficiency anemia due to chronic blood loss. We recommended stopping bloodletting using cupping and prescribed oral iron supplements.

Up to which limit can one survive with iron deficiency anemia?

Iron deficiency anemia is an important public health problem worldwide. In this case report we presented an unusual case of iron deficiency anemia manifesting with extremely low hemoglobin (Hb) level of 1.7 g/dl. This case was challenging because, the cause of anemia in this patient was insufficient intake, which is an unusual cause of iron deficiency anemia. Secondly, the degree of Hb level that the patient had might not be compatible with life. On the other hand, by means of this case we wanted to present the adaptive capability of human body to chronic long-standing anemia. Therefore, the question of when and how much transfusion will be given should be queried.

An interesting case of iron deficiency anemia

An interesting case of iron deficiency anemia

鉄欠乏性貧血とHelicobacter pylori感染―除菌療法により鉄吸収の増加を示した1例

鉄欠乏性貧血とHelicobacter pylori感染―除菌療法により鉄吸収の増加を示した1例

Separating Thalassemia Trait and Iron Deficiency by Even Simpler Inspection

I read with interest the correspondence relating to recent articles published in the Journal describing mathematical approaches to the differentiation of thalassemia trait (TT) and iron deficiency anemia (IDA).1–3 I found this and the accompanying authors’ responses to be thoughtful and informative. There has been a clear revival of interest in the application of discriminant functions to these areas as demonstrated by the increasing number of publications in recent years. Doubtless this reflects the interest in population screening, and from a UK perspective, in the antenatal and newborn screening programs. Ntaios2 admirably summarizes the key issue in that mathematical formulas and simple examination of indices work extremely well only in classical cases of TT and IDA. The biologic variability seen in both conditions, and especially when TT is complicated by coexisting IDA, as is common in some populations …

Once Weekly Low-dose Iron Supplementation Effectively Improved Iron Status in Adolescent Girls

Iron supplementation has been suggested as a strategy for prevention and treatment of iron deficiency (ID) and iron deficiency anemia (IDA) in many countries, but non-compliance of daily regimens and common dosage remain as major challenges. The aim of this study was to investigate the effects of low dose once weekly iron supplementation in adolescent girls. The study was designed as a community-based, randomized, supplementation trial. The initial sample consisted of 200 female high school students, aged 14-16 years old, of whom 193 students concluded the study. They were randomly selected and assigned into either iron-supplemented group (ISG) or iron-unsupplemented group (IUG). The ISG received 150 mg ferrous sulfate once weekly for 16 weeks, whereas the IUG received nothing. Weight, height, and hematological parameters were measured and compared between the two groups before and after the intervention. There was no significant difference between the initial measures of the two groups before the intervention. After 16 weeks of intervention, mean of hemoglobin and serum ferritin improved significantly in ISG compared to IUG. At the beginning of the study, percent of anemia, IDA, and ID in ISG were 12.5%, 8.3%, and 30.2%, whereas these figures for IUG in this period of study were 14.4, 10.3, and 38.2, respectively, which were not significantly different between the two groups. However, percentages of the above items at the end of study in ISG were 2.1%, 0%, and 21.9%, respectively. In contrast to IUG, all cases of IDA were abolished in the ISG. Our study showed that once weekly supplementation of 150 mg ferrous sulfate for 16 weeks significantly improved iron status in female adolescents and effectively treated IDA. There is no need for higher dosage of iron for supplementation that may cause adverse effects and bear higher costs.

Red Cell Indices and Functions Differentiating Patients with the β-Thalassaemia Trait from those with Iron Deficiency Anaemia

This study examined the diagnostic accuracy of nine indices to discriminate between patients with mild-to-moderate (haemoglobin 8.5 - 11 g/dl) or moderate-to-severe (haemoglobin < 8.5 g/dl) iron deficiency anaemia (IDA) from those with beta-thalassaemia (beta-TT) (n = 100 per group). Indices examined were red blood cell (RBC) count, RBC distribution width (RDW), Mentzer index (MI), Shine and Lal index (S&L), England and Fraser index (E&F), Srivastava index (S), Green and King index (G&K), RDW index (RDWI), and Ricerca index (R). Index sensitivity, specificity, and positive and negative prognostic values were examined. Youden's indices were calculated and showed: S&L > G&K > E&F > RBC = RDWI > MI > S > R > RDW to differentiate between beta-TT and mild-to-moderate IDA; and S&L > G&K > E&F = RDWI > RBC > R > MI > S > RDW to differentiate between beta-TT or moderate-to-severe IDA. For both groups, S&L and G&K offered the best discrimination and RDW the worst. S&L showed the highest Youden index for beta-TT and IDA discrimination, but sensitivity and specificity were not 100%. In both mild and severe IDA, the S&L index may be used to differentiate cases of beta-TT from IDA cases, but large clinical trials are needed to explore this further.

Discrimination indices as screening tests for beta-thalassemia trait

Dear Editor,We have read with great interest the study by Ntaios et al.[1], which was published online in your journal. The reasonfor our interest is the recent publication of our studyevaluating the predictive value of discrimination indicesused in patients with iron deficiency anaemia (IDA) andbeta-thalassemia trait (B-TT) [2]. In this paper, we thinkthat evaluating the results of both studies as a whole is veryimportant in understanding the predictive value of thesediscrimination indices used in differential diagnosis of suchpatients. Besides Mentzer index (MI), Green and Kingindex (G&K), RDW index (RDWI), England and Fraserindex (E&F), red cell distribution width (RDW), and redblood cell (RBC) count evaluated in their study, we haveadditionally evaluated Shine and Lal index, Srivastataindex, and Ricerca index in our study, and we have foundthat these indices, similar to others, also do not have enoughpredictive value in discriminating these two entities. An-other difference between two studies is the exclusion ofIDA cases with hemoglobin (Hb) value <8.7 g/dl in ourstudy. Hb values of patients with B-TTusually range from 9to 11 g/dl [3]. Demir et al. [4] had excluded IDA cases withHb value <8.7 g/dl in their study performed in paediatricpopulation, because these cases are not confused with B-TTcases in practice. Our study was performed to establish thestatus in adult cases with inspiration from the results of thisstudy [2]. If such an exclusion has not been done, it isobvious that IDA cases with much lower Hb and hematocritvalues than B-TT cases would be included in studypopulation, and in this case, statistical homogeneity ofcompared populations would deteriorate. As a result, therewould be unexpected deviations in indices such as E&F inwhich Hb and hematocrit values play a substantial role.Evaluation of the results of the study published in yourjournal with exclusion of IDA cases having Hb value<8.7 g/dl could give rise to different results. A superiorityof the study by Ntaios et al. [1] is the inclusion of largernumber of cases compared to our study (while we have 45IDA and 66 B-TT cases in our study, they have included120 IDA and 373 B-TT cases in their study). G&K wasfound to have the highest reliability in their study, whilethis index had the second highest predictive value afterRBC count in our study (according to Youden’s index70.86 and 65.5, respectively). Investigators found thatRDW was extremely insufficient in discriminating caseswith IDA and B-TT, and this finding is similar in bothstudies (according to Youden’s index

Predictive value of discrimination indices in differential diagnosis of iron deficiency anemia and beta‐thalassemia trait

Iron deficiency anemia (IDA) and beta-thalassemia trait (B-TT) are the most common causes of hypochromic microcytic anemias. Many indices have been defined to quickly discriminate these similar entities via parameters obtained from automated blood count analyzers. The purpose of the study was to evaluate the predictive value of these indices in differential diagnosis of IDA and B-TT in adult cases. This study consists of 45 IDA cases, 36 women and nine men, whose mean age is 33.87 +/- 11.59 (mean +/- SD) (range 17-57 yr) and 66 B-TT cases, 41 women and 25 men, whose mean age is 33.26 +/- 13.36 (mean +/- SD) (range 14-74 yr). IDA cases with Hb value <8.7 g/dL have been excluded because these cases are not confused with B-TT cases in practice. Patient groups have been evaluated according to red blood cell (RBC), red blood cell distribution width (RDW), Mentzer index, Shine and Lal indices, England and Fraser indices, Srivastava index, Green and King indices, RDW index and Ricerca index. Sensitivity, specificity, positive and negative predictive values and Youden's index have been calculated. Finally, none of these different formulations are superior to RBC value obtained from automated analyzers in adult cases with IDA and B-TT. Total body iron status and hemoglobin A(2) level should be obtained for accurate differential diagnosis of IDA and B-TT until more efficient tools develop.

Vulvite par carence en fer

Many mucocutaneous signs associated with iron deficiency are described in the current dermatologic and haematologic literature but genital mucosa involvement has never been reported. We report a case of iron deficiency anaemia revealed by psoriasis-like vulvar dermatitis. The vulvar involvement dramatically improved after iron therapy. In the case reported herein, iron deficiency resulted from three mechanisms: increased loss (menorrhagia), inadequate dietary iron intake (vegetarian diet) and inadequate absorption (iron absorption inhibitors such as tea). Iron deficiency may be responsible for genital mucosa involvement. Iron deficiency investigation must determine the presence of blood loss and dietary habits (assessment of iron levels and ingestion of iron absorption inhibitors). Certain dietary recommendations are essential to avoid the failure of iron supplementation.

Validity Assessment of Nine Discriminant Functions Used for the Differentiation between Iron Deficiency Anemia and Thalassemia Minor

Iron deficiency anemia (IDA) and thalassemia minor are two of the most common causes of microcytic anemias worldwide. Because of similar red blood cell count parameters and blood picture, it was imperative to develop other measures that would differentially and correctly diagnose these two anemias. Several mathematical formulas and simple RBC indices have been introduced as simple, fast and inexpensive means of providing differential diagnosis for IDA and thalassemia minor. The Objective of this study was to apply and compare nine well-documented discriminant functions on a population of 153 confirmed cases of microcytic anemias (IDA n = 56, beta-thalassemia minor n = 47 and alpha-thalassemia n = 50) and to measure validity using Youden's Index. The results show that England and Fraser (E & F) Index had the highest Youden's Index value (98.2) in correctly differentiating between IDA and alpha- and beta-thalassemia minor, while Shine and Lal Index was found ineffective in differentiating between microcytic anemias in our population. E & F Index showed with great sensitivity and specificity to be the best discriminant function to differentiate between IDA and thalassemia minor cases.

Iron Deficiency and Vitamin B12/Folate Levels. A Case-Control Study.

A number of cases with iron deficiency anemia (IDA) are associated with low vitamin B12 (LB12). However, LB12 is not synonymous with B12 deficiency. An increase in homocysteine (Hcy) or methylmalonic acid can differentiate cases with a real deficiency from those with apparently innocuous LB12. Our aim was to study LB12 and low red cell folate (LRCF) prevalence in IDA cases and to determine the existence of B12/folate deficiency. A prospective case-control study was carried out in patients with anemia consecutively admitted to our Hospital. The case group included 506 IDA patients (Hb <115g/l, MCV <98fl, serum ferritin <20microg/l or soluble transferrin receptor >5mg/l). The control group was made up of 117 patients with anemia of chronic disorders (ACD) (Hb <115g/l, MCV 80-98fl, iron <10micromol/l, total iron binding capacity <40micromol/l, serum ferritin >100microg/l and soluble transferrin receptor <4mg/l). Serum B12 and RCF were evaluated in all cases and controls. Serum homocysteine was determined in those with B12 and/or RCF below percentile 10 (B12 <200pmol/l, RCF <590nmol/l). HyperHcy was considered when Hcy exceeded >17micromol/l. Several variables were included in a multiple regression analysis to build a predictive model for IDA with LB12 and hyperHcy. LB12 was observed in 17.8% of IDA cases (87 cases), including 8.2% with B12<150pmol/l (percentile 2.5). Interestingly, 60% of patients with B12 <150pmol/l had hyperHcy and 48% of those with B12 between 150 and 200pmol/l. Low RCF was found in 6.3% (13 cases). All cases with RCF <500nmol/l (percentile 2.5) showed hyperHcy and 50% of cases with RCF between 500 and 590nmol/l. LB12 was observed in 7 patients in the control group (5.4%) and LRCF in 10%. LB12 was more frequent in IDA than in ACD (p<0.0001). The best predictive variable for IDA and LB12 with hyperHcy was age and the cut-off was 60 years (sensitivity: 91%). In summary, in our study 18% of cases with IDA showed LB12, and a high percentage had a real vitamin deficiency. Age was the main predictive factor. Thus, serum B12 should be determined in IDA patients over 60 years