Detection Of Iron Deficiency Anemia Research Articles

Role of reticulocyte hemoglobin equivalent in early detection of iron deficiency anemia in regular hemodialysis patients

Role of reticulocyte hemoglobin equivalent in early detection of iron deficiency anemia in regular hemodialysis patients

Prevalence of iron deficiency in non-anemic heart failure patients

Background: To study the prevalence of iron deficiency in non-anemic heart failure patients. Materials and methods: This is a single-center cross-sectional study done in the Department of General Medicine at the Institute of Medical Sciences and SUM Hospital, Odisha, between November 2020 and June 2022. The selection of participants was made based on Framingham criteria. An iron profile was used to detect iron deficiency anemia during the study period. According to the WHO, Anemia is defined as having a hemoglobin (Hb) level below 12 gm/dL in females and 13 gm/dL in males. Serum ferritin below 100 ng/mL is considered an absolute iron deficiency, and serum ferritin between 100 and 300 ng/mL with low transferrin saturation (TSAT <20%) is regarded as functional Iron deficiency. Results: A total of 100 individuals with non-anemic heart failure (53% men and 47% women) were included in the study. Most of the individuals were of class IV New York Heart Association (NYHA) (N=39). Iron deficiency was present in 60% of individuals, with 32% having absolute iron deficiency and 28% having functional iron deficiency. Men and women had almost the same prevalence of iron deficiency (62.2% vs 57.44%). The levels of mean Hb, ferritin, and transferrin saturation in the iron deficiency group (i.e., 13.2 gm/dL, 139.7 ng/mL, and 14.4%) were less when compared to the non-iron deficiency group (i.e., 13.3 gm/dL, 391.35 ng/mL and 36.1%). Conclusion: Our research emphasizes the impact of iron deficiency on heart failure patients in India, which is still underappreciated and ignored. This study recommends more in-depth analysis to define this manageable illness correctly and explore habitual testing in upcoming national recommendations.

Diagnostic Accuracy of complete Blood Count versus Serum Ferritin in Diagnosis of iron deficiency Anemia in Pregnant Women

Objective: To determine the frequency of confirmation of iron deficiency anemia in pregnant female on serum Ferritin who are labeled to have iron deficiency anemia on CBC in third trimester. Study Design: Cross-sectional study Study duration: October 2021 to March 2022. Setting: Department of Obstetrics & Gynecology Lady Willingdon Hospital. Patients and Methods: A total of 200 patients who came to OPD were selected. Detailed history was obtained from patients and physical examination performed. CBC and serum ferritin was determined for every patient. All data was entered into the especially designed proforma. Results: Anemia was diagnosed in 74(37%) women. Highest frequency of anemia was seen in women in age group 20-30 years (33.78%), and in women with household income of Rs.15000/- to 50000/- per month. Mean hemoglobin of women was 11.41±1.05 gm. /dl. Mean MCV of women was 83.12±8.45 fl. Minimum and maximum MCV was 68 and 95 fl respectively. Mean serum ferritin level of women was 13.14±2.34 µ/l .Anemia was diagnosed in 75(37.50%) women as per complete blood count criteria. Anemia was diagnosed in 74(37%) women as per serum ferritin level criteria. Practical implication: This study will significantly contribute to the understanding and management of iron deficiency anemia in pregnant women, particularly during the third trimester. By confirming diagnoses through serum Ferritin tests in addition to complete blood count (CBC), the study can enhance the accuracy of diagnosis and treatment. Accurate detection of iron deficiency anemia will allow for more targeted and efficient treatment, thereby improving maternal and fetal health outcomes. Furthermore, this research could inform public health policies and intervention strategies aimed at preventing and managing iron deficiency anemia in pregnancy, ultimately improving the overall well-being of the community. Conclusion: Results of this study revealed that Serum ferritin level is a better diagnostic test for early detection of iron deficiency anemia in pregnant women. Keywords: Confirmation, Iron deficiency, Anemia, Pregnant, Serum Ferritin, Complete blood Count, Third trimester.

Detection of iron deficiency anemia by medical images: a comparative study of machine learning algorithms

BackgroundAnemia is one of the global public health problems that affect children and pregnant women. Anemia occurs when the level of red blood cells within the body decreases or when the structure of the red blood cells is destroyed or when the Hb level in the red blood cell is below the normal threshold, which results from one or more increased red cell destructions, blood loss, defective cell production or a depleted sum of Red Blood Cells.MethodsThe method used in this study is divided into three phases: the datasets were gathered, which is the palm, pre-processed the image, which comprised; Extracted images, and augmented images, segmented the Region of Interest of the images and acquired their various components of the CIE L*a*b* colour space (also referred to as the CIELAB), and finally developed the proposed models for the detection of anemia using the various algorithms, which include CNN, k-NN, Nave Bayes, SVM, and Decision Tree. The experiment utilized 527 initial datasets, rotation, flipping and translation were utilized and augmented the dataset to 2635. We randomly divided the augmented dataset into 70%, 10%, and 20% and trained, validated and tested the models respectively.ResultsThe results of the study justify that the models performed appropriately when the palm is used to detect anemia, with the Naïve Bayes achieving a 99.96% accuracy while the SVM achieved the lowest accuracy of 96.34%, as the CNN also performed better with an accuracy of 99.92% in detecting anemia.ConclusionsThe invasive method of detecting anemia is expensive and time-consuming; however, anemia can be detected through the use of non-invasive methods such as machine learning algorithms which is efficient, cost-effective and takes less time. In this work, we compared machine learning models such as CNN, k-NN, Decision Tree, Naïve Bayes, and SVM to detect anemia using images of the palm. Finally, the study supports other similar studies on the potency of the Machine Learning Algorithm as a non-invasive method in detecting iron deficiency anemia.

Reticulocyte hemoglobin content: a simple parameter for detection of iron deficiency anemia in children with chronic liver disease

BackgroundIron deficiency anemia is common among patients with chronic liver disease. Reticulocyte hemoglobin is a marker for iron availability in the bone marrow that is not affected by inflammation.ObjectiveThe aim of this study is to detect the diagnostic value of reticulocyte hemoglobin (Ret-Hb) in diagnosis of iron deficiency anemia among children with chronic liver disease.MethodsThis is a cross-sectional study that included thirty-three children with chronic liver disease (CLD) and Hb < 11 g/dL, MCV < 77 fl, regularly attending the Pediatric Hepatology Clinic, Cairo University Children Hospitals. Patients underwent full history taking, and full iron profile and reticulocyte Hb were done.ResultsThe median age of our patients was 5.9 years with a median age of onset of CLD was 1.6 years. The mean reticulocytic Hb was 25.52 ± 4.53 pg (N: 28–36 pg). Mean serum ferritin was 89 ± 16.55 ng/ml (N: 7–140 ng/ml). There was a statistically positive significant linear correlation between S-ferritin and Ret. Hb, r = +0.433, p = 0.012. ROC curve analysis of reticulocytic Hb, at cutoff ≤ 29.3 pg for diagnosis of iron deficiency anemia in children with CLD, had an AUC of 0.824 with a sensitivity of 92.59% and a specificity of 83.33%, with p = 0.012.ConclusionReticulocyte Hb is a sensitive and specific marker for detection of iron deficiency anemia in CLD patients. Anemia in CLD was mostly iron deficiency anemia.

Usefulness of Soluble Transferrin Receptor in the Diagnosis of Iron Deficiency Anemia in Rheumatoid Arthritis Patients in Clinical Practice.

Aim We analyzed the added value of sTfR measurement in routine clinical practice to standard parameters (SP) of iron deficiency in the detection of iron deficiency anemia (IDA) in patients with rheumatoid arthritis (RA). Methods Blood samples from 116 patients with RA were analyzed in a prospective study. Based on biochemical parameters, patients were classified as having IDA, anemia of chronic disease (ACD), IDA with concomitant ACD (ACD/IDA), or “other anemia.” Sensitivity, specificity, positive (PPV), and negative predictive values (NPV) of sTfR and SP of iron status alone and in combination were calculated for the diagnosis of IDA in general, i.e., IDA or ACD/IDA. Results In the whole sample, with regard to the diagnosis of iron deficiency (IDA or ACD/IDA), sTfR had a higher sensitivity compared both to the combined use of SP and to the combination of SP with sTfR (80.9% versus 66.7/54.8%). Specificity, PPV and NPV did not differ substantially. When patients were stratified in groups with high (CRP levels above the median, i.e., 24.1 mg/l) and low (CRP levels less or equal to the median) inflammation, the diagnostic superiority of sTfR was restricted to patients with high inflammation. In this group, the diagnostic performance of sTfR was superior both to the combined use of SP and the combination of SP with sTfR with higher sensitivity (100% versus 52.4%) and NPV (100% versus 77.7/76.7%) and comparable specificity and PPV. Conclusion For the detection of iron depletion (IDA or ACD/IDA) in anemic RA patients, sTfR is superior to SP of iron deficiency only in highly inflammatory states.

Detection of Iron Deficiency Anaemia in Chronic Obstructive Pulmonary Disease Patients and the Effects of Iron Supplementation

Detection of Iron Deficiency Anaemia in Chronic Obstructive Pulmonary Disease Patients and the Effects of Iron Supplementation

Reticulocyte Haemoglobin Content (CHr) is a Reliable Marker of Iron Deficiency in Pre-dialytic Chronic Kidney Disease (CKD) Patients

Chronic kidney disease (CKD) is a non-communicable epidemic disease. The CKD patients suffer from various types of anemia including iron deficiency anemia. Measurement of reticulocyte hemoglobin content (CHr) has been proposed as a measure of available iron stores. In this study CHr and serum iron profile were compared with stainable iron in the bone marrow to evaluate the CHr as a marker of iron deficiency in pre-dialytic CKD patients. This cross sectional study was conducted at the Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2018 to December 2018. A total of seventy (70) pre-dialytic CKD patients were selected. All participants had undergone bone marrow study for detection of iron deficiency anemia and it was observed that, 60% CKD patients had iron deficiency by bone marrow iron stain. Serum iron profile [serum iron, total iron binding capacity (TIBC), serum ferritin, transferin saturation (TSAT)] and reticulocyte haemoglobin content (CHr) of each patient were determined accordingly. Data analysis reveals that CHr was significantly low in iron deficient group (p<0.001). The sensitivity and specificity of CHr at a cut-off 28 pg/cell was 81% and 75.0% respectively (p<0.001); sensitivity and specificity of serum ferritin at a cut-off 100 ng/ml was 40.6% and 67.9% respectively (p=0.051); while sensitivity and specificity of TSAT at a cut-off 20% was 54.2% and 57.1% respectively (p=0.465). The study proves that reticulocyte haemoglobin content (CHr) is a reliable marker to assess iron status for pre-dialytic CKD patients.

Colorectal cancer and the blood loss paradox

BackgroundFaecal occult blood (FOB) positivity and iron deficiency anaemia (IDA) are common manifestations of colorectal cancer (CRC) and both potentially facilitate diagnosis at an earlier, more treatable stage. It has...

Assessment of serum ferritn level in detection of iron deficiency anaemia in paediatric patients: Prospective analysis

Introduction: Major form in which iron is stored in the body is serum ferritin. It can detect early changes in body iron store. It causes little patient discomfort as compared to bone marrow iron studies. In this study, we used serum ferritin level to assess the level of iron storage in the children less than five years of age. Iron stores are depleted below this value.Materials & Methods: Sample size includes 100 children under the age of 5 years from the opd of the department. The blood was divided into two halves, one was sent for cbc evaluation and from other half the serum was separated through centrifugation for the estimation of serum ferritin level.Results: The range of the serum iron level in the study was 0.2 – 340 ng/ml. The mean serum iron level in the study was 51.8 ng/ml. Out of 100 patients, there were 76 patients with serum level less than 12 ng/ml; they were iron deficient. There were 20 children with iron deficiency in the infants group, there were 34 patients in toddlers group and there were 24 children in preschool group. Discussion & Conclusion: For the early detection of the status of the iron stores in the body is done by serum ferritin concentration. Iron deficiency anemia continues to be a significant public health problem in the world. Serum ferritin level is a good screening test for early detection of iron deficiency anemia in children less than 5 years of age. When it is used in assess with other test for iron status in body, it is considered as more specific indicator for the detection of the iron stores.

Evidence for improved prognosis of colorectal cancer diagnosed following the detection of iron deficiency anaemia

Iron deficiency anaemia (IDA) is common in colorectal cancer (CRC), especially, in right-sided CRC which is known to have an overall worse prognosis. The associations between diagnostic pathway (Bowel Cancer Screening Programme (BCSP), IDA, symptomatic) and tumour side/stage was assessed using logistic regression models in 1138 CRC cases presenting during 2010–2016 at a single secondary-care centre in the UK. In the IDA sub-group, the relationship between CRC stage and the event of having a blood count prior to CRC diagnosis was examined using Bayesian parametric survival model. IDA was found as the only significant predictor of right-sided CRC (OR 10.61, 95% CI 7.02–16.52). Early-stage CRC was associated with both the IDA (OR 1.65, 95% CI 1.18–2.29) and BCSP pathway (OR 2.42, 95% CI 1.75–3.37). At any age, the risk of detecting CRC at late-stage was higher in those without a previous blood count check (hazard ratio 1.53, 95% credibility interval 1.08–2.14). The findings of this retrospective observational study suggest a benefit from diagnosing CRC through the detection of IDA, and warrant further research into the prognosis benefit of systematic approach to blood count monitoring of the at-risk population.

Reticulocyte Haemoglobin Content and Soluble Transferrin Receptor Concentration as Markers of Iron Stores in Chronic Kidney Disease in Egyptian Patients

Background: Chronic kidney disease (CKD), also known as chronic renal disease, is progressive loss in kidney function over a period of months or years. It is an internationally recognized public health problem affecting 5–10% of the world population. Objective: To evaluate the role of reticulocyte hemoglobin content and soluble transferrin receptor concentration for detection of iron deficiency anemia in chronic kidney disease in Egyptian patients compared to conventional markers. Patients and Methods: This is a cross–sectional study that had been done on 177 Chronic Kidney Disease Egyptian patients with iron deficiency anemia. Patients had been selected from the Outpatient Clinics and Hemodialysis Unit of the Internal Medicine Department, Menoufia University Hospital. Subjects had been divided into three groups: group 1 (Hemodialysis group): A number of 49 chronic hemodialysis patients (more than 3 months), group 2 (CKD group): A number of 88 patients with chronic kidney disease stages 3-5 and group 3 (Controls): Included 40 healthy subjects as a control group and had been matched with other groups regarding age and gender. Results: There was statistically significant difference between the studied groups regarding serum iron, serum transferrin and serum ferritin. There was statistically significant difference between group I, II compared to control regarding total iron binding capacity (TIBC), Hb, reticulocyte hemoglobin content and serum soluble transferrin receptors (sTfR). Conclusion: This study concluded that sTfR, and TfR-F index proved to be important tools to determine iron deficiency anaemia (IDA) in RH anemic patients and TFR index has superior accuracy than sTfR.

Iron Deficiency Anemia as a Risk Factor for First Febrile Seizures a Case Control Study

Background: Febrile seizures in children are a common problem. Iron deficiency anaemia is known, among other contributing factors, to be an aggravating factor in febrile seizures. Iron deficiency anaemia is a condition that can be avoided and managed. The study goal was to identify iron deficiency anaemia as a trigger factor for febrile seizures (FS). To determine the association between Iron Deficiency Anemia (IDA) and the first episode of febrile seizures (FFS). Subjects and Methods: Investigation like hemoglobin, blood indices (MCV, MCH), and serum iron and serum ferritin are done for detection of iron deficiency anaemia and their relationship with the first episode of febrile seizure was observed. Results: In our study comprising 50 cases and 50 controls, 58% (29) of cases were diagnosed as IDA with FS, 18% (9) of controls were diagnosed as IDA with Febrile Illness (FI). This suggests IDA as a risk factor for febrile seizures with a significant P value of &lt;0.001. Among 50 cases 42% (21) cases have FS without IDA and among 50 controls 82% (41) controls have FI without IDA were present in the current study. Conclusion: IDA was more common in children with FS than in those with febrile illness (FI) disease alone. The result suggests that the IDA can be a contributing factor to the FFS. Screening of IDA of children with FFS should be regarded. Fever can worsen the negative effects of anaemia or iron deficiency on the brain, which can lead to seizures.

Clinical usefulness of the reticulocyte hemoglobin equivalent in children on hemodialysis.

Iron-deficiency anemia is common in hemodialysis patients. Serum ferritin and transferrin saturation (TS) are used for its detection. The reticulocyte hemoglobin equivalent (RET-He) is a marker that is not altered by inflammatory conditions and directly reflects iron availability in the bone marrow. To explore the diagnostic capability of RET-He to detect absolute iron deficiency and assess its correlation with traditional markers of iron deficiency. Retrospective study comparing RET-He with ferritin and TS in children on hemodialysis seen at Hospital Garrahan between July 2016 and July 2019. In 164 observations carried out in 40 children, a weak positive correlation was found between hemoglobin and RETHe (r = 0.35, p < 0.001), a significant positive correlation between TS and RET-He (r = 0.52, p < 0.001), a low negative correlation between hemoglobin and ferritin (r = -0.19, p = 0.02), and a lack of correlation between hemoglobin and TS (r = 0.05, p = 0.5). Anemia was observed in 50 %; iron-deficiency anemia was detected by traditional markers in 13 % and by RET-He in 44 %. RET-He showed a sensitivity of 90.9 % (95 % CI: 57.1-99.5 %), a specificity of 74.5 % (95 % CI: 66.7-81 %), a negative predictive value of 99.1 % (95 % CI: 94.5-99.9 %), and a positive predictive value of 20.4 % (95 % CI: 10.7-34.7 %) to detect iron-deficiency anemia with a cut-off value of 29 pg. Despite its limited capability, the use of RET-He as a biomarker of iron deficiency increases the detection of iron-deficiency anemia in children on hemodialysis.

Computer-Aided Diagnosis for Detection of Iron Deficiency Anemia Based On Capsule Endoscopy

Computer-Aided Diagnosis for Detection of Iron Deficiency Anemia Based On Capsule Endoscopy

The validity of reticulocyte hemoglobin content and percentage of hypochromic red blood cells for screening iron-deficiency anemia among patients with end-stage renal disease: a retrospective analysis

BackgroundEarly detection of iron-deficiency anemia (IDA) can enhance the efficiency and effectiveness of clinical treatment and quality of life for end-stage renal disease (ESRD) patients. This study aimed to evaluate the validity of CHr and %Hypo in screening IDA among ESRD patients and compare their performance with screening IDA among non-ESRD patients.MethodA retrospective analysis of 312 participants was conducted at Cho Ray Hospital, Vietnam, including healthy control participants and ESRD patients. Receiver operator characteristics curves and the area under the curve (AUC) of models were used to evaluate the performance of CHr, %Hypo. Optimal cut-off values were determined using Youden’s index.ResultsDetecting IDA in ESRD patients is more complicated, as the screening performance of CHr and %Hypo in predicting IDA among ESRD patients were lower than non ESRD group, but still reasonable with AUC = 0.748 (95% CI: 0.656–0.840, power = 0.997) and 0.740 (95% CI: 0.647–0.833, power = 0.996), respectively. Cut-off values of CHr < 31.5 pg and %Hypo> 10.0 pg are recommended to obtain optimal screening ability for Vietnamese ESRD patients.ConclusionCHr and %Hypo appears to be useful tools for screening IDA among both non ESRD and ESRD patients. The low cost and accessible of the two markers encourage their utility as effective screening tools in clinical practice.

Role of Soluble Transferrin Receptor and Transferrin Receptor-Ferritin Index to Detect Iron Deficiency Anemia in Regular Hemodialysis Patients.

BACKGROUND:Several iron indicators can be used to detect iron deficiency anaemia (IDA) where confounding comorbidities occurred such as patients with regular hemodialysis.AIM:This study was aimed to determine the diagnostic value of serum transferrin receptor (sTfR) and transferrin receptor-transferrin index (TfR-F index) and to combine these two markers in detecting IDA in regular hemodialysis anaemic patients.METHODS:There were 70 patients recruited consecutively. IDA was diagnosed based on TS < 20% and ferritin level < 200 ng/L and functional iron deficiency when TS < 20% and ferritin > 200 ng/L. TfR-F index calculated as sTfR/log ferritin.RESULTS:Correlation of ferritin to iron level was changed when its correlation adjusted by confounding inflammation (CRP level > 10). The correlation strength of ferritin to iron serum before adjusted was r = 0.37 with p = 0.02 but became r = 0.65 with p = 0.023 after adjusted to CRP > 10. In inflammation (CRP > 10), ferritin mild-moderately correlated with iron but became moderately strong when there was no inflammation (CRP < 10). AUC for sTfR was 0.77 with p = 0.028 (95% CI 0.55-0.99), and for TfR-F index has larger AUC 0.85% with p = 0.004 (95%CI 0.69-1.00), hence TfR-F index more superior than sTfR. sTfR and sTfR-F index were not correlated with CRP with p > 0.05, and sTfR and TfR-F index mean level was different between IDA and ACD patients although not statistically significant.CONCLUSION:When sTfR and the TfR-F index used in combination to detect IDA, we found the largest AUC on ROC 0.98 (95% CI 0.94-1.00).

Red Cell Distribution Width (RDW) and Hb% in the Detection of Iron Deficiency Anemia in Pregnant Women

Background: Detection of iron deficiency early during pregnancy is essential for correct management. Red cell distribution width (RDW) is a new routine parameter in fully automated hematology analyzer that can give the idea of early iron deficiency before Hb%. This study was aimed to see the role of red cell distribution width and Hb% in determining early iron deficiency in pregnant women.Methods: In this study 190 pregnant women were included. CBC including Hb% and RDW and iron profile were done. RDW were compared with Hb% in various stages of iron deficiency.Results: RDW was more significant than Hb level in latent iron deficiency when Hb level was normal (p&lt;0.05). In mild and moderate iron deficiency anemia, RDW was increased progressively though Hb level was reduced. In this study RDW had sensitivity 82.3% and specificity 97.4%. Whereas Hb level had sensitivity 56.6% and specificity 90.9% for iron deficiency.Conclusion: Latent iron deficiency without other complicating disease could be screened out early by increased RDW when Hb% was normal.Anwer Khan Modern Medical College Journal Vol. 9, No. 2: Jul 2018, P 137-141

Red Cell Distribution Width is Early Marker for Detection of Iron Deficiency Anemia during Pregnancy

Red Cell Distribution Width is Early Marker for Detection of Iron Deficiency Anemia during Pregnancy

Optimizing diagnostic biomarkers of iron deficiency anemia in community-dwelling Indian women and preschool children.

The detection of iron deficiency anemia is challenged by the paucity of diagnostic tests demonstrating high sensitivity and specificity. Using two biomarkers, zinc-protoporphyrin/heme and hepcidin, we established the diagnostic cut-off values for iron deficiency anemia in preschool children and women. We randomly selected non-anemic individuals (n=190; women=90, children=100) and individuals with iron deficiency anemia (n=200; women=100, children=100) from a preexisting cohort of healthy preschool children and their mothers. The diagnostic performance of these biomarkers was estimated by analyzing receiver operating characteristic curves. Diagnostic cut-offs with a high predictive value for iron deficiency anemia were selected. Median zinc-protoporphyrin/heme and hepcidin values in non-anemic children were 49 μmol/mol heme and 42 ng/mL, respectively, and in non-anemic women these values were 66 μmol/mol heme and 17.7ng/mL, respectively. Children and women with iron deficiency anemia had higher zinc-protoporphyrin/heme ratios (children=151 μmol/mol heme and women=155 μmol/mol heme) and lower hepcidin levels (children=1.2ng/mL and women=0.6ng/mL). A zinc-protoporphyrin/heme ratio cut-off >90 μmole/mole heme in children and >107 μmole/mole heme in women was associated with a high diagnostic likelihood for iron deficiency anemia (children, likelihood ratio=20.2: women, likelihood ratio=10.8). Hepcidin cut-off values of ≤6.8ng/mL in children and ≤4.5ng/mL in women were associated with a high diagnostic likelihood for iron deficiency anemia (children, likelihood ratio=14.3: women, likelihood ratio=16.2). The reference ranges and cut-off values identified in this study provide clinicians with guidance for applying these tests to detect iron deficiency anemia. Erythrocyte zinc-protoporphyrin/heme ratio is a valid point-of-care biomarker to diagnose iron deficiency anemia.