Nutritional Iron Deficiency Anemia Research Articles

Barriers to and Facilitators of Iron Therapy in Children with Iron Deficiency Anemia

To characterize barriers to and facilitators of successful iron therapy in young children with iron deficiency anemia (IDA) from an in-depth parental perspective. Prospective, mixed methods study of children age 9months to 4years with a diagnosis of nutritional IDA by clinical history and laboratory criteria and their parents. Clinical data were obtained from the electronic health record. Semistructured interviews focused on knowledge of IDA, clinical effects, experience with iron therapies, and motivation were conducted with the parent who identified as the child's primary caregiver. Twenty patient-parent dyads completed the study; 80% (n=16) identified as Hispanic/Latino (white). Patients' median age was 23months (50% male); median initial hemoglobin concentration was 8.2g/dL and duration of oral iron therapy was 3months. Parents' median age was 29years (85% female); 8 interviews (40%) were conducted in Spanish. Barriers included difficulty in administering oral iron owing to side effects and poor taste. Facilitators included provision of specific instructions; support from healthcare providers and additional caregivers at home; motivation to benefit child's health, which was strengthened by strong emotional reactions (ie, stress, anxiety) to therapy and follow-up; and an appreciation of child's improvement with successful completion of therapy. Our findings support the need for interventions designed to promote oral iron adherence in children with IDA. Rather than focusing on knowledge content related to IDA, interventions should aim to increase parental motivation by emphasizing the health benefits of adhering to iron therapy and avoiding more invasive interventions.

The effect of therapy on plasma ghrelin and leptin levels, and appetite in children with iron deficiency anemia.

Background It is known that iron deficiency anemia effects appetite and growth negatively. The aim of this study was to investigate the effect of iron therapy on appetite, growth and plasma ghrelin and leptin levels in children aged between 12 and 24 months with isolated nutritional iron deficiency anemia. Methods Iron deficiency anemia was diagnosed by clinic and laboratory findings. All 19 cases were given 5 mg/kg/day iron therapy for 3 months. Results The mean plasma ghrelin level was 936.7±428.8 pg/mL before therapy and it increased to 1284.7±533.3 pg/mL (p<0.001) while the mean plasma leptin level decreased from 3.4±1.6 ng/mL to 1.9±1.0 ng/mL (p<0.01) after therapy. The amount of daily caloric intake, carbohydrate and protein intake were significantly increased after therapy (p<0.001). Δ body weight was correlated with plasma ghrelin levels before and after therapy significantly. Conclusions In conclusion, the findings of this study indicate that plasma ghrelin level increases and leptin level decreases and growth accelerates because of an increase in appetite and daily calories, carbohydrate and protein amount in children with nutritional iron deficiency anemia after iron therapy. The increase in appetite and acceleration on growth in iron deficiency anemia might result from decreased leptin and increased plasma ghrelin levels. The most important finding of this study is significantly increased plasma ghrelin levels after iron therapy, and this finding might be related to both the improved appetite and catch-up growth.

Correction: Nutritional Iron Deficiency Anemia: Magnitude and Its Predictors among School Age Children, Southwest Ethiopia: A Community Based Cross-Sectional Study.

[This corrects the article DOI: 10.1371/journal.pone.0114059.].

SEVERE ANAEMIA

Anaemia is common reason of morbidity and mortality in children especially inthird world countries. 300 million children had anaemia globally in 2011. Nutritional IDA (irondeficiency anemia) is a most common anaemia especially in children as well as women.1Severe anaemia was present in 5.4% of anaemic children (62.1%) in national nutritional survey2011.1 Iron deficiency anaemia (IDA) is also a most common cause of childhood anaemia inPakistan. Factors causing anaemia are multiple including poverty, illiteracy and poor dietaryhabits. Objective: To know about the awareness of severe anaemia in children by their parentsand effect of various risk factors causing severe anaemia. Study Design: Prospective crosssectional study. Setting: Paediatric OPD Islam Teaching Hospital, Sialkot. Period: Jan 2016 toJune 2017. Methods: Children who came to paediatric OPD of Islam Teaching Hospital, havingpallor were investigated for level of haemoglobin (Hb). Those included in this study were havingHb% &lt; 7 gm/dl and parents were interviewed according to a questionnaire. Results: Only23% of parents were aware of anaemia in their children. Inadequate or no weaning was seen in95% of patients. 26% of children were underweight, had weight for age (WAZ) score less than-2 according to WHO standards. 83% of mothers were educated up to matric. All the childrenhad markedly low mean corpuscular volume (MCV). 72% of children were 24 months old orbelow. 80% of children were taking cows/buffalos milk. Conclusion: Age less than 24 months,poor socioeconomic status, lower education qualification of mother, poor weaning habits wereassociated with increased chances of severe anaemia and parents had poor awareness ofpallor/anaemia in children.

AWARENESS AND THE RISK FACTORS OF SEVERE ANAEMIA AMONGST CHILDREN 7 MONTHS - 5 YEARS OF AGE

Anaemia is common reason of morbidity and mortality in children especially inthird world countries. 300 million children had anaemia globally in 2011. Nutritional IDA (irondeficiency anemia) is a most common anaemia especially in children as well as women.1Severe anaemia was present in 5.4% of anaemic children (62.1%) in national nutritional survey2011.1 Iron deficiency anaemia (IDA) is also a most common cause of childhood anaemia inPakistan. Factors causing anaemia are multiple including poverty, illiteracy and poor dietaryhabits. Objective: To know about the awareness of severe anaemia in children by their parentsand effect of various risk factors causing severe anaemia. Study Design: Prospective crosssectional study. Setting: Paediatric OPD Islam Teaching Hospital, Sialkot. Period: Jan 2016 toJune 2017. Methods: Children who came to paediatric OPD of Islam Teaching Hospital, havingpallor were investigated for level of haemoglobin (Hb). Those included in this study were havingHb% &lt; 7 gm/dl and parents were interviewed according to a questionnaire. Results: Only23% of parents were aware of anaemia in their children. Inadequate or no weaning was seen in95% of patients. 26% of children were underweight, had weight for age (WAZ) score less than-2 according to WHO standards. 83% of mothers were educated up to matric. All the childrenhad markedly low mean corpuscular volume (MCV). 72% of children were 24 months old orbelow. 80% of children were taking cows/buffalos milk. Conclusion: Age less than 24 months,poor socioeconomic status, lower education qualification of mother, poor weaning habits wereassociated with increased chances of severe anaemia and parents had poor awareness ofpallor/anaemia in children.

Severe iron deficiency anemia in an infant: A case report

Iron deficiency anemia (IDA) is the most common nutritional deficiency disorder in children and is worldwide in distribution. In fact, iron deficiency is the only micronutrient deficiency that is prevalent in virtually all developed countries. An infant is predominantly fed on milk, bioavailability of breast milk is much better than cow’s milk; although both are deficient in iron content. The peak prevalence of nutritional IDA occurs in late infancy and very rarely seen before the age of 6 months in a term baby who is exclusively breastfed. We report a case of severe IDA in a 6-month-old child in whom no other obvious cause was found.

Effect of Low-Dose Ferrous Sulfate vs Iron Polysaccharide Complex on Hemoglobin Concentration in Young Children With Nutritional Iron-Deficiency Anemia

Iron-deficiency anemia (IDA) affects millions of persons worldwide, and is associated with impaired neurodevelopment in infants and children. Ferrous sulfate is the most commonly prescribed oral iron despite iron polysaccharide complex possibly being better tolerated. To compare the effect of ferrous sulfate with iron polysaccharide complex on hemoglobin concentration in infants and children with nutritional IDA. Double-blind, superiority randomized clinical trial of infants and children aged 9 to 48 months with nutritional IDA (assessed by history and laboratory criteria) that was conducted in an outpatient hematology clinic at a US tertiary care hospital from September 2013 through November 2015; 12-week follow-up ended in January 2016. Three mg/kg of elemental iron once daily as either ferrous sulfate drops or iron polysaccharide complex drops for 12 weeks. Primary outcome was change in hemoglobin over 12 weeks. Secondary outcomes included complete resolution of IDA (defined as hemoglobin concentration >11 g/dL, mean corpuscular volume >70 fL, reticulocyte hemoglobin equivalent >25 pg, serum ferritin level >15 ng/mL, and total iron-binding capacity <425 μg/dL at the 12-week visit), changes in serum ferritin level and total iron-binding capacity, adverse effects. Of 80 randomized infants and children (median age, 22 months; 55% male; 61% Hispanic white; 40 per group), 59 completed the trial (28 [70%] in ferrous sulfate group; 31 [78%] in iron polysaccharide complex group). From baseline to 12 weeks, mean hemoglobin increased from 7.9 to 11.9 g/dL (ferrous sulfate group) vs 7.7 to 11.1 g/dL (iron complex group), a greater difference of 1.0 g/dL (95% CI, 0.4 to 1.6 g/dL; P < .001) with ferrous sulfate (based on a linear mixed model). Proportion with a complete resolution of IDA was higher in the ferrous sulfate group (29% vs 6%; P = .04). Median serum ferritin level increased from 3.0 to 15.6 ng/mL (ferrous sulfate) vs 2.0 to 7.5 ng/mL (iron complex) over 12 weeks, a greater difference of 10.2 ng/mL (95% CI, 6.2 to 14.1 ng/mL; P < .001) with ferrous sulfate. Mean total iron-binding capacity decreased from 501 to 389 μg/dL (ferrous sulfate) vs 506 to 417 μg/dL (iron complex) (a greater difference of -50 μg/dL [95% CI, -86 to -14 μg/dL] with ferrous sulfate; P < .001). There were more reports of diarrhea in the iron complex group than in the ferrous sulfate group (58% vs 35%, respectively; P = .04). Among infants and children aged 9 to 48 months with nutritional iron-deficiency anemia, ferrous sulfate compared with iron polysaccharide complex resulted in a greater increase in hemoglobin concentration at 12 weeks. Once daily, low-dose ferrous sulfate should be considered for children with nutritional iron-deficiency anemia. clinicaltrials.gov Identifier: NCT01904864.

Iron deficiency in children in Sydney.

Results of prospective studies of over 2,000 children with nutritional iron deficiency anaemia in Sydney are presented. The epidemiological aspects were also investigated in a study of 1500 well children, aged 6 — 36 months, attending Baby Health Centres in Sydney and the incidence of iron deficiency anaemia was found to be low (3%). Iron deficiency anaemia was common in children admitted to hospital with acute infections and diarrhoea (20%) and was clinically unsuspected in two-thirds. Because of inadequate iron prophylaxis the incidence in prematures was high (30%). Another groups recently arrived migrant children, also had a high incidence of anaemia (25%). There was circumstantial evidence linking anaemia and childhood morbidity. Matched patients awaiting elective minor surgery had a low incidence (3%) of iron deficiency anaemia, similar to the data published in out patients in Surabaya.

Deficiencies in the Management of Iron Deficiency Anemia During Childhood.

Limited high-quality evidence supports the management of iron deficiency anemia (IDA). To assess our institutional performance in this area, we retrospectively reviewed IDA treatment practices in 195 consecutive children referred to our center from 2006 to mid-2010. The majority of children were ≤4 years old (64%) and had nutritional IDA (74%). In 11- to 18-year-old patients (31%), the primary etiology was menorrhagia (42%). Many were referred directly to the emergency department and/or prescribed iron doses outside the recommended range. Poor medication adherence and being lost-to-follow-up were common. Substantial improvements are required in the management of IDA.

A study of etiological factors, management, and complications of atrophic rhinitis

Background: Atrophic rhinitis (AR) is a chronic nasal disease that is characterized by progressive atrophy of the nasal mucosa and underlying bone of the turbinates. The etiological factors blamed for its genesis are specific infections, autoimmunity, chronic sinus infection, hormonal imbalance, poor nutritional status, heredity, and iron deficiency anemia. Although its prevalence is in increasing trend, the study of clinical cases of the AR is found very much less. Objectives: To throw light on the etiology and the various modalities of the management and complications. Materials and Methods: A prospective study carried out for 2 years enrolled a total of 41 cases. The detailed study of each case of AR was carried out and data were recorded in the preformed case record form. Participants were grouped in one of the three treatment plan groups. They were followed for 6 months for the response of the treatment and the complications. Result: Maximum incidence of AR was seen in the age group of 41–50 years (24.4%). It was common in women (65.9%) than in men (34.15%). The etiological factors showed 77% idiopathic type, and others were secondary to other diseases such as chronic sinusitis (12.5%), tuberculosis (7.5%), and leprosy (4.9%). The most common symptoms were crusting (100%) and fetor (97.6%). Investigations showed that 73.2% participants had hemoglobin level below 10 g% and 90% had increased erythrocyte sedimentation rate. The majority of the participants managed with injection placentrex and surgery showed good response on follow-up. Conclusion: No specific etiological factor is known for AR but possibly more than one factor is responsible for etiology. More prevalent in the people of lower socioeconomic status. Conservative treatment is acceptable, harmless, cheap, and effective line of treatment and can be taken as most effective approach. Maintenance of hygiene, balanced diet, avoidance of snuff inhalation, and smoking, as well as early diagnosis and prompt treatment of any nasal pathology can prevent the AR.

Low Dose Once Daily Oral Iron Treatment of Young Children with Nutritional Iron Deficiency Anemia

▪BackgroundIron deficiency anemia (IDA) is prevalent in young children whose diet includes prolonged breast feeding without iron supplementation and/or excessive cow milk consumption. Oral iron therapy is recommended to correct the anemia and reconstitute iron stores, but few data exist to guide clinical decision-making. The recommended dosing of elemental iron has been inconsistent in the literature, ranging from 2 to 6 mg/kg/day, given one to three times daily. To address the paucity of treatment data, the BESTIRON study (Clinicaltrials.gov NCT01904864) was initiated to compare two liquid oral iron agents (ferrous sulfate and NovaFerrum, an iron polysaccharide) using a once daily, low-dose regimen.MethodsThis study is a single center, double-blinded, randomized controlled superiority trial. Inclusion criteria include: age 9 months to 4 years with nutritional IDA by history and laboratory indices (Hgb <10 g/dL, MCV <70 fl, reticulocyte hemoglobin equivalent (Ret He) <25 pg, serum ferritin <15 ng/mL and/or TIBC >425 mg/dL). Exclusion criteria include: evidence of blood loss, malabsorption, other cause of anemia, prematurity (gestational age <30 weeks), major co-morbidity, adequate response to prior iron therapy, or previous receipt of intravenous iron.Upon enrollment, subjects are randomized 1:1 to either ferrous sulfate (15 mg/mL) or NovaFerrum (15 mg/mL) dosed at 3 mg/kg elemental iron once daily at bedtime. Follow-up visits occur at 4, 8, and 12 weeks following study initiation. Definition of complete response at study exit is: Hgb >11 g/dL, MCV >70 fl, Ret He >25 pg, serum ferritin >15 ng/mL, and TIBC <425 mg/dL. The primary outcome, rate of change in hemoglobin concentration over 12 weeks, cannot yet be determined as enrollment is ongoing. Here we present the overall combined hematologic response to this "minimalist" treatment regimen for subjects who have completed the study to date.ResultsFrom 9/1/2013 to 8/1/2015, 72 patients (target accrual 80) enrolled in the study. Sixty-two subjects (56% male) completed it and are included in the analysis. Median age was 19 months (range 11 - 41 months). Subjects were predominantly Caucasian/White (Latino) (61%). Median baseline and week 12 laboratory values are shown in the Table. Thirteen patients received a transfusion for severe symptomatic anemia (median Hgb 3.6 g/dL, range 2.2 - 5.3 g/dL) prior to study entry. Forty-six of the 62 subjects (74%) completed all 3 study follow-up visits. Eleven subjects were lost to follow-up or discontinued study participation. Five others were considered treatment failures at 8 weeks (hemoglobin increment <0.5 g/dL above baseline) and removed from the study. Of the 46 subjects who completed all study visits, 20 (43%) met the definition of complete resolution (38% of subjects with baseline hemoglobin <8 g/dL compared to 50% among those with baseline hemoglobin >8 g/dL) and received no further iron therapy.ConclusionThis analysis of children with nutritional IDA receiving a "patient-friendly" regimen of a single daily dose of 3 mg/kg elemental iron for 12 weeks demonstrates a good hematologic response and suggests that higher doses of iron therapy are not necessary to achieve resolution of anemia. While most subjects achieved a normal hemoglobin concentration, some required continued iron therapy to assure repletion of iron stores. Adverse effects ascribed to oral iron treatment may result in part from prescribing higher or more frequent iron doses, which may contribute to poor adherence and treatment failure.We acknowledge Gensavis Pharmaceuticals, LLC for their support of this investigator-initiated study.Table 1Median Laboratory Values at Baseline and Week 12Baseline (N=62) Median (Range)Week 12 (N=46) Median (Range)Hemoglobin concentration (g/dL)8.0 (4.4 - 10.6)11.9 (9.0 - 13.6)Mean cell volume (fl)59.9 (47.3 - 69.8)72.0 (54.7 - 81.9)Red cell distribution width (%) Baseline (n=56), Week 12 (n=46)21.1 (15.5 - 36.5)18.7 (12.5 - 26.4)Reticulocyte count (%) Baseline (n=60), Week 12 (n=45)1.4 (0.3 - 3.9)0.9 (0.4 - 1.8)Reticulocyte hemoglobin equivalent (pg) Baseline (n=41), Week 12 (n=40)17.2 (10.6 - 28.4)29.5 (15.9 - 34.3)Serum iron (mcg/dL)20 (9 - 349)51 (15 - 394)Serum ferritin (ng/mL)2.5 (0.5 - 49.2)11 (2.4 - 46)Total iron binding capacity (mg/dL)513 (236 - 636)394 (287 - 560) DisclosuresPowers:Gensavis Pharmaceuticals, LLC: Research Funding. Mccavit:Gensavis Pharmaceuticals, LLC: Research Funding; Pfizer: Speakers Bureau; Novartis: Speakers Bureau. Adix:Gensavis Pharmaceuticals, LLC: Research Funding. Buchanan:Gensavis Pharmaceuticals, LLC: Research Funding.

Intravenous ferric carboxymaltose for the treatment of iron deficiency anemia.

Nutritional iron deficiency anemia is the most common deficiency disorder, affecting more than two billion people worldwide. Oral iron supplementation is usually the first choice for the treatment of iron deficiency anemia, but in many conditions, oral iron is less than ideal mainly because of gastrointestinal adverse events and the long course needed to treat the disease and replenish body iron stores. Intravenous iron compounds consist of an iron oxyhydroxide core, which is surrounded by a carbohydrate shell made of polymers such as dextran, sucrose or gluconate. The first iron product for intravenous use was the high molecular weight iron dextran. However, dextran-containing intravenous iron preparations are associated with an elevated risk of anaphylactic reactions, which made physicians reluctant to use intravenous iron for the treatment of iron deficiency anemia over many years. Intravenous ferric carboxymaltose is a stable complex with the advantage of being non-dextran-containing and a very low immunogenic potential and therefore not predisposed to anaphylactic reactions. Its properties permit the administration of large doses (15 mg/kg; maximum of 1000 mg/infusion) in a single and rapid session (15-minute infusion) without the requirement of a test dose. The purpose of this review is to discuss some pertinent issues in relation to the history, pharmacology, administration, efficacy, and safety profile of ferric carboxymaltose in the treatment of patients with iron deficiency anemia.

EFFICIENCY OF HAEMOGLOBIN REGENERATION IN THE NUTRITIONAL FERROPENIC ANAEMIA RECOVERY WITH GOAT MILK-BASED DIETS

in spite of the high incidence/prevalence of iron deficiency anemia (IDA) and the beneficial effects derived from the consumption of goat milk, scarce is known about the recovery of the anemia following a balanced diet accompanied by the intake of goat milk of goat. The aim of the current study is to assess, in rats with experimentally induced nutritional iron deficiency anemia, the effects of goat or cow milk-based diets, supplied during 30 days, on the recovery of the anemia and the efficiency of regeneration of the hemoglobin. 40 male Wistar albino rats newly weaned were divided at random in two experimental groups and they were fed ad libitum for 40 days with AIN-93G diet, either with normal iron content (control group, 45 mg/kg diet), or low iron content (anaemic group, 5 mg/kg diet). Samples of blood form the caudal vein were collected for the hematologic control of the anemia. Later, both experimental groups (control and iron deficient) were fed for 30 days with goat or cow milk- based diets. After finishing the experimental period and previous anesthesia the animals were withdrawn by canulation of the abdominal aorta, and the obtained blood was gathered in tubes with EDTA as anticoagulant for the later determination of hematologic parameters and the efficiency of regeneration of the hemoglobin. after the consumption of a diet with low iron content during 40 days, the rats were anaemic, with a concentration of hemoglobin, hematocrit, serum iron, mean corpuscular volume (MCV), serum ferritin and low transferrin (p < 0.001), whereas the levels of platelets and the total iron binding capacity (TIBC) were raised (p < 0.001), findings consistent with the anemia induced experimentally in the animals. The efficiency of regeneration of the hemoglobin was higher in control and anaemic rats fed goat milk-based diet in comparison with those fed cow milk-based diet (p < 0.001) due to, partly, to the major levels of serum iron and hemoglobin, and to the best nutritive utilization of iron in the animals that consumed the goat milk-based diet thanks to the excellent nutritional characteristics of this type of milk. the consumption during 30 days of goat or cow milk-based diets favors the recovery of the iron deficiency anemia, especially with the goat milk, due to the major efficiency of regeneration of the hemoglobin, index that shows the quantity of iron of the diet used for the synthesis of hemoglobin. Therefore, it would be recommendable the consumption of goat milk in the context of a balanced diet in healthy populations and, especially in those at risk of suffering iron deficiency.

Management of iron deficiency anemia: a survey of pediatric hematology/oncology specialists.

Iron deficiency anemia (IDA) is the most common hematologic condition in children and adolescents in the United States (US). No prior reports have described the management of IDA by a large cohort of pediatric hematology/oncology specialists. A 20-question electronic survey that solicited responses to two hypothetical cases of IDA was sent to active members of the American Society of Pediatric Hematology/Oncology (ASPHO) in the US. Of 1,217 recipients, 398 (32.7%) reported regularly treating IDA and completed the survey. In a toddler with nutritional IDA, 15% (N = 61) of respondents reported ordering no diagnostic test beyond a complete blood count. Otherwise, wide variability in laboratory testing was reported. For treatment, most respondents would prescribe ferrous sulfate (N = 335, 84%) dosed at 6 mg/kg/day (N = 248, 62%) divided twice daily (N = 272, 68%). The recommended duration of iron treatment after resolution of anemia and normalized serum ferritin varied widely from 0 to 3 months. For an adolescent with heavy menstrual bleeding and IDA, most respondents recommended ferrous sulfate (N = 327, 83%), with dosing based on the number of tablets daily. For IDA refractory to oral treatment, intravenous iron therapy was recommended most frequently, 48% (N = 188) using iron sucrose, 17% (N = 68) ferric gluconate, and 15% (N = 60) low molecular weight iron dextran. The approach to diagnosis and treatment of IDA in childhood was widely variable among responding ASPHO members. Given the lack of an evidence base to guide clinical decision making, further research investigating IDA management is needed.

Nutritional iron deficiency anemia: magnitude and its predictors among school age children, southwest Ethiopia: a community based cross-sectional study.

BackgroundIron deficiency anemia (IDA) is a global public health problem among school age children, which retards psychomotor development and impairs cognitive performance. There is limited data on prevalence and risk factors for IDA.ObjectiveThe aim of this study was to determine the prevalence, severity, and predictors of nutritional IDA in school age children in Southwest Ethiopia.MethodologyA community based cross-sectional study was conducted in Jimma Town, Southwest Ethiopia from April to July 2013. A total of 616 school children aged 6 to 12 years were included in the study using multistage sampling technique. A structured questionnaire was used to collect sociodemographic data. Five milliliter venous blood was collected from each child for hematological examinations. Anemia was defined as a hemoglobin level lower than 11.5 g/dl and 12 g/dl for age group of 5–11 years and 12–15 years, respectively. Iron deficiency anemia was defined when serum iron and ferritin levels are below 10 µmol/l and 15 µg/dl, respectively. Moreover, fresh stool specimen was collected for diagnosis of intestinal parasitic infection. Stained thick and thin blood films were examined for detection of Plasmodium infection and study of red blood cell morphology. Dietary patterns of the study subjects were assessed using food frequency questionnaire and anthropometric measurements were done. Data were analyzed using SPSS V-20.0 for windows.ResultOverall, prevalence of anemia was 43.7%, and that of IDA was 37.4%. Not-consuming protein source foods [AOR = 2.30, 95%CI(1.04,5.14)], not-consuming dairy products [AOR = 1.83, 95%CI(1.14,5.14)], not-consuming discretionary calories [AOR = 2.77, 95%CI(1.42,5.40)], low family income [AOR = 6.14, 95%CI(2.90,12.9)] and intestinal parasitic infections [AOR = 1.45, 95%CI(1.23, 5. 27)] were predictors of IDA.ConclusionIron deficiency anemia is a moderate public health problem in the study site. Dietary deficiencies and intestinal parasitic infections were predictors of IDA. Therefore, emphasis should be given to the strategies for the prevention of risk factors for IDA.

The role of hepcidin, ferroportin, HCP1, and DMT1 protein in iron absorption in the human digestive tract.

Iron is found in almost all foods, so dietary iron intake is related to energy intake. However, its availability for absorption is quite variable, and poor bioavailability is a major reason for the high prevalence of nutritional iron deficiency anaemia. Absorption occurs primarily in the proximal small intestine through mature enterocytes located at the tips of the duodenal villi. Two transporters: Hem Carrier Protein 1 (HCP1) and Divalent Metal Transporter 1 (DMT1) appear to mediate the entry of most if not all dietary iron into these mucosal cells. Absorption is regulated according to the body's needs. The results of studies suggest that iron absorption is regulated by the control of iron export from duodenal enterocytes to the circulating transferrin pool by ferroportin. Hepcidin, a 25-amino acid polypeptide, which is synthesised primarily in hepatocytes, reduces the iron absorption from the intestine by binding to the only known cellular iron exporter, ferroportin, causing it to be degraded. Therefore, hepcidin is now considered to be the most important factor controlling iron absorption.

The Detection Of The Immunophenotyping Of Plasma Cells In Patients With Multiple Myeloma

ObjectivesTo study the immunophenotyping of plasma cells in patients with Multiple Myeloma(MM). To explore the antigen combination used to identify benign plasma cells from malignant plasma cells. MethodFour-color flow cytometry (BD FACSCalibur )was respectively used to detect antigens expression rate of 44 diagnosed patients with MM and 25 normal controls (14 patients with nutritional iron deficiency anemia and 11 healthy bone marrow donators). The results were analyzed by the software of CellQuest. The positive expression rate of clusters of differentiation in cells surface is greater than twenty percent. ResultsThe frequency of expression rate of clusters of differentiation among patients with MM are as fellows:CD138+(97.72%) ACD38+(100.00%) ACD56+(63.64%) ACD19-(84.09%) ACD20+(11.63%) ACD200+(77.27%) ACD28+(38.64%) ACD86+(54.55%). The frequency of expression rate among normal plasma cells of controls are CD138+(100.00%) ACD38+(100.00%) ACD56-(0.00%) ACD19+(96.00%) ACD20-(0.00%) ACD200+(0%) ACD28+(0.00%) ACD86+(4.00%). ConclusionsUsing the antigen combination of CD138 ACD38 ACD56 ACD19 ACD20 ACD200 ACD28 ACD86 is availably conducive to detect the phenotype of the malignant plasma cells of the patients with MM. Disclosures:No relevant conflicts of interest to declare.

G187(P) Causes of Severe Anaemia (Hb

Severe childhood anaemia risks significant morbidity and mortality though may have different benign or malignant aetiologies. We set out to define the characteristics of this group of patients at our...

The Role of Diet in Predicting: Iron Deficiency Anemia in HIV-Positive Women

The association between medical, social, and nutritional factors and iron deficiency anemia was examined in adult women who had tested positive for human immunodeficiency virus (HIV) and were living in the Greater Vancouver Area. This was a cross-sectional observational study of 102 HIV-positive women, aged 19 or older, who were patients of one of three chosen community health clinics in Vancouver, British Columbia. Information on usual dietary intake and other nutrition-related factors was collected with a short diet survey, while medical information and laboratory data were obtained from each participant's medical chart. Of the predictors studied, a CD4 cell count below 200 cells/µL, a regular menstrual pattern, and African ethnicity were associated with an increased risk of iron deficiency anemia. Dietary intake was not independently associated with iron status. Iron deficiency anemia in HIV-positive women has multifactorial and complicated causation, but is strongly associated with poorer immune status and greater menstrual losses. Health disparities in Aboriginal and African women may lead to a higher risk for iron deficiency anemia. Routine screening and ongoing nutrition education are necessary for the prevention and management of iron deficiency anemia. Further research into factors associated with iron deficiency anemia is essential to improve prevention and management efforts.

Iron deficiency anaemia in pregnancy and postpartum: pathophysiology and effect of oral versus intravenous iron therapy.

Nutritional iron-deficiency anaemia (IDA) is the most common disorder in the world, affecting more than two billion people. The World Health Organization's global database on anaemia has estimated a prevalence of 14% based on a regression-based analysis. Recent data show that the prevalence of IDA in pregnant women in industrialized countries is 17.4% while the incidence of IDA in developing countries increases significantly up to 56%. Although oral iron supplementation is widely used for the treatment of IDA, not all patients respond adequately to oral iron therapy. This is due to several factors including the side effects of oral iron which lead to poor compliance and lack of efficacy. The side effects, predominantly gastrointestinal discomfort, occur in a large cohort of patients taking oral iron preparations. Previously, the use of intravenous iron had been associated with undesirable and sometimes serious side effects and therefore was underutilised. However, in recent years, new type II and III iron complexes have been developed, which offer better compliance and toleration as well as high efficacy with a good safety profile. In summary, intravenous iron can be used safely for a rapid repletion of iron stores and correction of anaemia during and after pregnancy.