Including Iron Deficiency Anemia Research Articles

Iron Deficiency and Overweight in a Child Exposed to Methamphetamine In Utero

Methamphetamine (meth) exposure during fetal development may increase nutritional risk due to both congenital and developmental problems associated with exposure. In this case study, an interdisciplinary team assessed the health and nutrition status of a 5-year-old girl exposed to meth in utero. Significant nutrition-related findings included iron deficiency anemia of nondietary but unknown origin and a body mass index at the 92 percentile. The anemia potentially contributed to or exacerbated the cognitive and behavioral problems identified in her evaluation. The prevalence and origin of iron deficiency anemia in children exposed to meth in utero needs to be investigated further.

HYPOCHROMIC MICROCYTIC ANEMIA IN NORTHWESTERN OF TABRIZ, IRAN

Aim: Hypochromic microcytic anemia included iron Deficiency Anemia (IDA) and thalassemia is a worldwide problem with easy treatment and important unwanted symptoms that widely prevalent in Iran. Methods: Present study was undertaken to find prevalence of hypochromic microcytic anemia in Tabriz, Iran. Citizen of Tabriz were taken up for study after they gave a written consent. Subjects were given a questionnaire to elicit anemia related symptoms. Blood counts were done by electronic counter and serum ferritin was assayed by Elisa ,MCV(Mean Cell Volume),MCH (Mean Cell Hb), hemoglobin electrophoresis and TIBC (Total Iron Binding Capacity) were done . Results: Prevalence of anemia, iron deficiency anemia and minor thalasemia in women was 9.7%, 7%, 1%, respectively, and in men was 9.7%, 2%, 5%. Conclusion: There was not any significant association between MCV and sex. IDA was more common in women and minor thalasemia was more common in men

Seroprevalence of Helicobacter pylori Infection in Children in Northwest Region of Turkey: Relationship with Iron Deficiency Anemia

Helicobacter pylori infection shows worldwide distribution, predominantly in countries or regions with poor socioeconomic conditions [1]. Recently, investigators focused on the role of H. pylori, in the development of extragastrointestinal diseases, including iron deficiency anemia (IDA) [2, 3]. IDA is common in the world and its frequency was reported as 37% in Duzce [4] and 6.5–33% [5] in other regions of Turkey, in children. Despite of studies supporting the role of H. pylori infection in the development of IDA [2, 6–10], some studies from developing countries failed to find such association [11–14] and the development of IDA was explained with malnutrition which leads inadequate iron intake besides reduces in the gastric acid barrier that allows bacterial colonization [15]. This study was designed with the aim of investigating H. pylori seroprevalence in children, in Duzce, the northwest region of Turkey and the association with IDA development. A total of 288 asymptomatic children (aged 6 months to 17 years), were screened for anti-H.pylori IgG with ELISA (IBL, Germany) and for IDA. Children were first applied a questionnaire and venous blood was drawn for antibody testing, complete blood count and biochemical tests. The subjects were divided into three groups based on their ages: Group A (6 months to 6 years, n ¼ 26), Group B (7–12 years, n ¼ 89) and Group C (13–17 years, n ¼ 56). Data was evaluated by � 2 test. From a total of 288 children (125 girls—43.4%, 163 boys—56.6%) with the mean age 11.06 years, overall seropositivity of anti-H. pylori IgG antibodies was 23.9%, increasing with age, 4.4%, 39.1%, 56.5% in Groups A, B and C, respectively (� 2 ¼ 16.27, p 0.05) and seropositivity was inversely related to economic status (p 0.05). H. pylori infection prevalences were increasing with age in both groups, 7.7%, 41.0% and 51.3% in Groups A, B, C, respectively, in IDA groups (� 2 ¼ 18.23, p < 0.001) and 0%, 36.7% and 63.3% Groups A, B, C, respectively in controls (� 2 ¼ 27.3, p < 0.001).

Extraintestinal manifestations of celiac disease

Celiac disease is an autoimmune disorder that occurs in genetically predisposed individuals as the result of an immune response to gluten. It is present in approximately 1% of the population. Diarrhea has become a less common mode of presentation (<50% of cases) than it once was. Other presentations include iron-deficiency anemia, osteoporosis, dermatitis herpetiforme, and neurologic disorders, mainly peripheral neuropathy and ataxia. Arthritis is commonly found in patients with celiac disease when systematically sought. Overall, autoimmune diseases occur more frequently (three to ten times more) in those with celiac disease than in the general population. A gluten-free diet is the standard of treatment, although its effect on some of the extraintestinal manifestations remains to be determined.

Bleeding Disorders in Premenopausal Women: (Another) Public Health Crisis for Hematology?

Premenopausal women with bleeding disorders represent a major public health problem. Estimates suggest up to 20% of women with menorrhagia have an underlying bleeding disorder (corresponding to a prevalence of 1.5-4 million American women). Von Willebrand disease (VWD) is the most common bleeding disorder among women with menorrhagia, affecting up to 20% of such patients. Besides menorrhagia, important consequences of bleeding disorders in premenopausal women include iron deficiency anemia, miscarriage, postpartum bleeding, uterine bleeding and hysterectomy. These patients face many obstacles in achieving optimum care. Recognition is difficult as women may consider their symptoms "normal" and come to attention only after serious bleeding events. Symptoms of VWD may also overlap with benign conditions, primary providers may not suspect the diagnosis, and convenient hematologic input may be unavailable. Diagnosis is difficult as there is no single definitive test for VWD, and test results are variable, often being affected by extragenic factors, including stress, contraceptives, hormones, and pregnancy. Hemostatic treatment is limited by DDAVP tachyphylaxis, the lack of recombinant VWD concentrates, and the ineffectiveness of hormonal therapy, leading to unnecessary procedures and early hysterectomy. Finally, significant controversy exists regarding classification of type 1 VWD as a disease: given the overlap in symptoms and laboratory assays within the normal population, evaluation for those with VWD might be seen as identification of potential bleeding risk rather than detection of a disease. This symposium seeks to explore these issues in greater detail from the combined perspectives of the obstetrician-gynecologist and the hematologist to promote a better public health approach to this problem.

Physostigmine for the Acute Treatment of Restless Legs Syndrome

We present a case report of an acute episode of restless legs syndrome that interfered with the performance of a diagnostic imaging procedure of the cervical spine. The patient had a 19-yr history of restless leg syndrome with periodic limb movements during sleep. Treatment with additional sedation and opioids did not alleviate the leg movements. IV administration of 1 mg of physostigmine eradicated all extraneous leg motion.

Anemias: A Clinical Laboratory Perspective

Anemia is caused by a deficiency in the blood's ability to provide the tissues with adequate oxygen to maintain metabolic functions. There are different types of anemias including iron deficiency anemia, anemia of chronic disease, megaloblastic anemia, hemolytic anemia, and Cooley's anemia. Some of the causes of anemia include iron, folate, or vitamin B 12 deficiency; chronic bacterial infection; malaria; acquired immunodeficiency syndrome; malnutrition; and inherited defects in hemoglobin synthesis. After reading this article, the reader should understand the different types of anemias as well as the pathophysiology of each type and the laboratory tests that are used in diagnosis. Hematology exam 50401 questions and the corresponding answer form are located after the Your Lab Focus section on p. 187.

Gastric histopathology, iron status and iron deficiency anemia in children with Helicobacter pylori infection.

Helicobacter pylori has been established as a major cause of gastritis and peptic ulcer disease in adults and children. H. pylori infection may also have a role in the development of some extra-gastrointestinal diseases, including iron deficiency anemia. The aim of this study is to investigate H. pylori-related changes in gastric physiology and histology and the relationship of these changes to iron deficiency anemia in children. Fifty-two patients with gastrointestinal complaints were studied. Hematologic parameters, 3-day vitamin C and iron consumption, serum gastrin levels, and gastric juice ascorbic acid levels were compared in patients with and without H. pylori infection. Dietary intake of vitamin C and iron, serum gastrin, gastric juice ascorbic acid content, and gastric histology were compared in patients with H. pylori infection and anemia and in patients with H pylori infection and no anemia. The CagA status of the H. pylori organisms was evaluated. Twenty-eight of 52 patients had H. pylori. Thirty-one patients had iron deficiency anemia. H. pylori infection was associated with low serum iron levels. H. pylori gastritis was associated with a decrease in the gastric juice ascorbic acid level. Infection with CagA-positive strains was associated with a greater decrease in gastric juice ascorbic acid than infection with CagA-negative strains. However, the gastric juice ascorbic acid levels of patients with H. pylori and anemia were not different from those of non-anemic patients with H. pylori. Among patients with H. pylori infection, pangastritis was twice as common in those with anemia than in those without anemia. H. pylori infection was associated with a decrease in gastric juice ascorbic acid concentration, and this effect was more pronounced in patients with the CagA-positive strain. Pangastritis was more common in patients whose H. pylori.infection was accompanied by anemia.

Gastric Histopathology, Iron Status and Iron Deficiency Anemia in Children with Helicobacter pylori Infection

ABSTRACTObjectivesHelicobacter pylori has been established as a major cause of gastritis and peptic ulcer disease in adults and children. H. pylori infection may also have a role in the development of some extragastrointestinal diseases, including iron deficiency anemia. The aim of this study is to investigate H. pylori‐related changes in gastric physiology and histology and the relationship of these changes to iron deficiency anemia in children.MethodsFifty‐two patients with gastrointestinal complaints were studied. Hematologic parameters, 3‐day vitamin C and iron consumption, serum gastrin levels, and gastric juice ascorbic acid levels were compared in patients with and without H. pylori infection. Dietary intake of vitamin C and iron, serum gastrin, gastric juice ascorbic acid content, and gastric histology were compared in patients with H. pylori infection and anemia and in patients with H pylori infection and no anemia. The CagA status of the H. pylori organisms was evaluated.ResultsTwenty‐eight of 52 patients had H. pylori. Thirty‐one patients had iron deficiency anemia. H. pylori infection was associated with low serum iron levels. H. pylori gastritis was associated with a decrease in the gastric juice ascorbic acid level. Infection with CagA‐positive strains was associated with a greater decrease in gastric juice ascorbic acid than infection with CagA‐negative strains. However, the gastric juice ascorbic acid levels of patients with H. pylori and anemia were not different from those of non‐anemic patients with H. pylori. Among patients with H. pylori infection, pangastritis was twice as common in those with anemia than in those without anemia.ConclusionsH. pylori infection was associated with a decrease in gastric juice ascorbic acid concentration, and this effect was more pronounced in patients with the CagA‐positive strain. Pangastritis was more common in patients whose H. pylori. infection was accompanied by anemia.

Pica: common but commonly missed.

Pica is the compulsive eating of nonnutritive substances and can have serious medical implications. Although it has been described since antiquity, there has been no single agreed-upon explanation of the cause of such behavior. Databases from MEDLINE and PSYCH-Lit were searched from 1964 to the present to find relevant sources of information using the key words "pica," "obsessive-compulsive disorder," "iron-deficiency anemia," and "nutrition." Pica is observed most commonly in areas of low socioeconomic status and is more common in women (especially pregnant women) and in children. To our knowledge, the prevalence of pica is not known. Numerous complications of the disorder have been described, including iron-deficiency anemia, lead poisoning, and helminthic infestations. Pica is probably a behavior pattern driven by multiple factors. Some recent evidence supports including pica with the obsessive-compulsive spectrum of disorders. Many different treatment regimens have been described, with variable responses. It is important to be aware of this common, but commonly missed, condition.

The Epidemic of Severe Obesity: The Value of Surgical Treatment

The Epidemic of Severe Obesity: The Value of Surgical Treatment

Skeletal evidence of health and disease in pre-contact Alaskan Eskimos and Aleuts.

There have been relatively few paleopathological studies of arctic populations to date, compared to other regions of North America. Studies aimed at elucidating patterns of health and disease in arctic peoples prior to contact and assessing inter- and intraregional differences in disease patterns have been particularly few. In the present study, five pre-contact skeletal samples (N = 193), representing 4 Eskimo populations from northern coastal Alaska and 1 Aleut population from the eastern Aleutian Islands, were examined macroscopically for the following indicators of health status: cribra orbitalia, porotic hyperostosis, trauma, infection, dental caries, abscesses, antemortem tooth loss, periodontal disease, and dental attrition. In addition, archeological and epidemiological data were used to help reconstruct the health of these populations. The goals of the analysis were 2-fold: 1) to assess the pre-contact health of North Alaskan Eskimos and Aleuts in order to provide a baseline comparison for the post-contact health of these groups, and 2) to determine if any differences in disease patterns exist between the Eskimos and Aleuts that might be related to differences in their physical environment, subsistence patterns, and cultural practices. The analysis revealed that both groups suffered from a variety of health problems prior to contact, including iron deficiency anemia, trauma, infection, and various forms of dental pathology. Statistical comparisons of the 2 groups revealed that Eskimos and Aleuts had different patterns of health and disease prior to contact. Most notably, the Aleuts had a significantly higher frequency of cranial trauma and infracranial infection than the Eskimos, while the latter had a significantly higher frequency of enamel hypoplasia. An examination of the physical and cultural environment of the 2 groups reveals several possible explanations for these differences, including warfare, subsistence pursuits, and housing practices. The documentation of these differences indicates that variability in pre-contact disease patterns can be identified between hunter-gatherer populations living in similar environments and exhibiting similar general lifestyles.

High Third-Trimester Ferritin Concentration: Associations With Very Preterm Delivery, Infection, and Maternal Nutritional Status

Objective: To determine whether a high concentration of serum ferritin during the third trimester is a marker of subclinical maternal infection and very preterm delivery and is associated with maternal nutritional status. Methods: A total of 1162 gravidas was followed prospectively from entry to prenatal care (15.0 ± 4.9 completed weeks’ gestation) in Camden, New Jersey, between 1985 and 1995. Multiple logistic regression and analysis of covariance were used to examine the influence of serum ferritin on the outcomes of interest. Results: High concentrations of serum ferritin (at or above the 90th percentile) at week 28, but not at entry to prenatal care, increased risk of preterm and very preterm delivery, but the risk changed if the concentration of ferritin declined from entry. If the concentration declined as expected, high ferritin concentration had no influence on outcome. If the concentration increased, then high ferritin concentration at week 28 was associated with very preterm delivery (adjusted odds ratio [AOR] 8.77; 95% confidence interval [CI] 3.90, 19.72), preterm delivery (AOR 3.81; 95% CI 1.93, 7.52), low birth weight (AOR 5.15; 95% CI 2.47, 10.72), clinical chorioamnionitis (AOR 2.56; 95% CI 1.01, 6.52), and symptoms of “flu” as an index of unmeasured infection (AOR 6.02; 95% CI 1.16, 31.17). Factors associated with failure of the ferritin concentration to decline included iron deficiency anemia earlier in pregnancy (AOR 3.98; 95% CI 1.17, 8.98) and lower levels of serum and red cell folate. Conclusion: High serum ferritin concentration in the third trimester, resulting from a failure of ferritin to decline, is associated with very preterm delivery and markers of maternal infection. Iron deficiency anemia and other indicators reflecting poor maternal nutritional status earlier in pregnancy underlie this relationship.

Symptoms and disease associations in idiopathic intracranial hypertension (pseudotumor cerebri)

To identify the symptoms and coexisting medical conditions associated with idiopathic intracranial hypertension (IIH), we administered an 83-item questionnaire at the time of diagnosis to 50 IIH patients and 100 aged-matched controls. Ninety percent of the IIH patients were women; the mean age was 33. Obesity and recent weight gain were much more common among patients than controls. Symptoms most commonly reported by IIH patients were headache (94%), transient visual obscurations (TVO) (68%), and intracranial noises (ICN) (58%). Daily occurrence of these symptoms was much more common among patients than controls. Controls also reported these and other IIH symptoms, but at lower frequencies. Several conditions previously associated with IIH were no more common in patients than controls including iron deficiency anemia, thyroid disease, pregnancy, antibiotic intake, and use of oral contraceptives. We conclude that previous studies of IIH, mostly uncontrolled and retrospective, have underestimated the frequency of symptoms in IIH patients and reported chance and spurious associations with common medical conditions and medications. The profile of a young obese woman with headaches and either TVO or ICN should alert the clinician to the diagnosis of IIH, especially when the symptoms occur daily.

Increased incidence of acute promyelocytic leukemia in patients with ulcerative colitis.

Brief Reports1 December 1982Increased Incidence of Acute Promyelocytic Leukemia in Patients with Ulcerative ColitisJANET CUTTNER, M.D.JANET CUTTNER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-6-864 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptUlcerative colitis is an inflammatory disease of unknown origin. Immune mechanisms are now considered important in the etiology of this disease (1-3). Recognized hematologic complications in this disorder include iron deficiency anemia related to bleeding, and Coombs' positive hemolytic anemia associated with the drug salicylazosulfapyridine (Azulfidine, Pharmacia Laboratories, Piscataway, New Jersey). Thrombocytosis and leukocytosis can occur in the active phase of the disease. We report six patients with a long-standing history of ulcerative colitis who developed acute leukemia; five cases of which were of a specific subtype, acute promyelocytic leukemia.From 1974 through 1981, 227 patients newly diagnosed as having...

4 - Nutritional Anaemias: Part 1: Tropical Africa

A review of nutritional anaemia in Africa is presented above. It has been noted that nutritional anaemia, including iron-deficiency anaemia, megaloblastic anaemia due to folate deficiency or vitamin B12 deficiency, or both, and protein deficiency-anaemia, is widespread throughout Africa. It is particularly common in growing children, women of child-bearing age, pregnant women and lactating mothers. The anaemia is also especially common during the second half of the dry season and the first Half of the wet season, when food supplies are limited. In all cases the anaemia is caused either by limited dietary intake, excessive loss of nutrients or excessive utilization. The anaemia is associated with a number of sequelae including both structural changes, like mitochondrial swelling and mucosal atrophy, and functional abnormalities, such as cardiac failure, decreased work output, increased pregnancy risks and increased susceptibility to infections. The evidence in favour of increased susceptibility to infections in megaloblastic anaemia and protein-deficiency anaemia is overwhelming, but in iron-deficiency anaemia the available information argues in favour of reduced susceptibility to infections, except after initiation of iron therapy. The treatment of nutritional anaemia includes replacement of the deficient nutrients (and blood transfusion in severe cases), prevention of further nutrient losses and treatment of associated complications.