Overt Iron Deficiency Research Articles

Serum transferrin receptor for the detection of iron deficiency in pregnancy

Measurements of circulating transferrin receptor provide a sensitive quantitative index of tissue iron deficiency in otherwise healthy subjects. This investigation was undertaken to examine the diagnostic utility of this new iron index in pregnancy. A battery of iron-related measurements, including serum transferrin receptor concentrations, was performed on 176 women in third-trimester pregnancy who were attending a university prenatal clinic. The mean receptor concentration of 5.96 +/- 2.37 mg/L (+/- 1 SD) did not differ significantly from concentrations in nonpregnant individuals and the frequency distributions were likewise comparable. Elevations in serum receptor greater than 8.5 mg/L occurred only in women with depleted iron stores defined by serum ferritin concentrations. Abnormal concentrations were found in 11 of 13 women with overt iron-deficiency anemia. Our findings indicate that serum receptor concentrations are not influenced by pregnancy per se and are a sensitive index of iron deficiency. By combining serum receptor and serum ferritin measurements, the entire spectrum of iron status in pregnancy can be assessed.

Disappearance of iron-deficiency anemia in a high-risk infant population given supplemental iron.

Iron deficiency is the most common single nutrient deficiency in the world. Studies in the United States have shown that the prevalence of overt iron-deficiency anemia is 5 to 15 per cent in American infants and children 9 to 36 months old.1 2 3 Although iron-deficiency anemia is most prevalent among the poor, owing to feeding practices and dietary inadequacy of foods rich in iron, which tend to be expensive, it cuts across socioeconomic barriers. It is particularly frequent during the second year of life because of exhaustion of transplacental iron reserves, rapid growth, and consumption of large amounts of iron-poor milk. . . .

Chronic Experimental Iron Losses in Rats Not Leading to Overt Iron Deficiency: A Model for the Regulation of the Whole-Body Iron Balance in an Iron-Replete Condition

Intestinal iron absorption studies, which include investigation of iron deficiency, increased erythropoiesis, low iron diet and acute bleeding, have been done, but none have reported the regulation of the balance of an iron-replete individual. We bled rats at regular time intervals, such that the experimentally induced iron losses were compensated by iron from storage and nutritional procurement without the onset of anemia. During these experimental periods the hemoglobin and plasma iron concentrations were determined along with repeated histochemical gradings of the bone marrow iron. We determined the intestinal iron absorption at regular intervals after having established its relation to the intragastric ferrous iron dose. The results obtained show that regular bleedings of 15–20% of the total blood volume every 10 days or twice a week, respectively, are compensated completely by storage and nutritional iron procurement without the onset of anemia. The intestinal iron absorption is increased 4 hours after an acute bleeding and was found high during the period that the animals were bled every 10 days. Significant changes of the plasma iron concentration, mostly within the “normal range” are invariably associated with experimental changes in bleeding regimes. The observed increases of the intestinal absorption of a ferrous iron test dose and decreases of the plasma iron concentrations that precede the depletion of the histochemically graded bone marrow iron are interpreted by a modification of a reported model, in which the process of iron release into the plasma from the reticuloendothelial system and the gut mucosa is linked closely to the actual plasma iron concentration.

Overt Iron Deficiency in Sickle Cell Disease

Overt iron deficiency was diagnosed in four patients with sickle cell disease. Three patients had homozygous SS and one had hemoglobin SC disease. The cause in each case was proved or suspected blood loss. Iron repletion was accompanied by increases in the blood hemoglobin and hematocrit levels, erythrocyte mean corpuscular volume, and mean corpuscular hemoglobin concentration (MCHC) and by change in the RBC morphologic characteristics from hypochromic microcytic to normochromic normocytic. The diagnosis of iron deficiency was confirmed by the finding of a low serum ferritin level, a high serum total iron-binding capacity, or both. Two patients who had had no painful crises while they were iron deficient began having crises again, and another patient had painful crises for the first time after the blood values improved. Whether a lowered MCHC is beneficial to patients with sickle cell diseases is an important but unanswered question.

Overt iron deficiency in sickle cell disease

Overt iron deficiency in sickle cell disease

Iron absorption and iron status in patients with chronic uremia on regular peritoneal dialysis.

Gastrointestinal iron absorption was measured by whole body counting in 18 patients on regular peritoneal dialysis. Ten patients received regular oral iron treatment prior to the study (iron treated group), 8 patients did not receive iron treatment (non-iron treated group). Whole body retention 14 days after oral administration of 10 microCi 59Fe together with a carrier dose of 10 mg Fe2+ was used as an estimate of absorption. The erythrocyte iron incorporation, i.e. the percentage of administered 59Fe incorporated into the total erythrocyte mass, was measured. Geometric mean iron absorption in the non-iron treated groups was 7.4+/-3.3 (S.D.) % and in the iron treated group 2.8+/-2.5% (p less than 0.01). Absorption in the non-iron treated group did not differ significantly from the value in a normal control group (p greater than 0.3). Absorption in the iron treated group was distinctly lower than in the controls (p less than 0.01), due to the high iron supplementation. Several patients in the non-iron treated group had latent or overt iron deficiency, while patients in the iron treated group had satisfactory iron status. The correlation between iron absorption and erythrocyte iron incorporation was highly significant (r=0.95, p less than 0.001). Peritoneal dialysis patients on the whole have a normally functioning iron absorption. However, due to increased iron losses and insufficient dietary iron intake, the maintenance of a satisfactory iron balance implies an adequate oral iron supplementation.

Developmental change in red blood cell volume: Implication in screening infants and children for iron deficiency and thalassemia trait

The mean corpuscular volumen when determined by electronic counter is an accurate tool for identification of children with microcytosis due to either iron deficiency or thalassemia trait. The purpose of this report is to describe the normal developmental changes in MCV that occur in children afler 6 months of age. In 211 healthy infants and children screened to exclude those with borderline or overt iron deficiency, thalassemia trait, or hemoglobinopathy, we found that the lower limit of normal for MCV is 70 ft between 10 and 17 months of age and that there is a gradual increase of MCV with age; the lower limit is 74 between 1 1/2 and 4 years and 76 between 4 and 7 years. All of these values are well below the minimum adult level of 80 fl.

Nonheme iron mobilization from the liver in piglets.

An experiment was conducted with 38 piglets to clarify relationships ofhepatic xanthine oxidase and plasma ferroxidase to storage iron mobilization. In conjunc-tion with the result of hypotransferremia, hepatic xanthine oxidase and plasma ferroxidasewere extremely low at birth. Accordingly, it seems likely that due to these enzymatic andprotein deficits, the rate of iron storage cells to plasma iron transfer may be quite limited, if at all. When there were sudden increases in plasma transferrin, ferroxidase activity andhepatic xanthine oxidase after piglets had utilized colostrum, a corresponding increase iniron release from the liver was observed. It is possible that the ferrous to ferric cycles inthe liver and plasma are activated by the increase in iron-releasing enzymes and plasmatransferrin, and that thereafter the rate of transport of iron from storage cell to erythro-poietic organ is accelerated still more.Eventually, as a result of storage iron depletion, plasma iron and hemoglobin levelsdecreased and overt iron deficiency appeared markedly from 3 days of age onward.. Milkferroxidase and transferrin showed a high level at farrowing and decreased progressivelyto 10 days postpartum. Although plasma ferroxidase increased intensively after pigletshad absorbed colostrum, the amount of colostral ferroxidase absorbed by piglets was verysmall, as compared with that derived from endogenous sources after the cessation of theabsorption of colostral protein by the piglets.

IRON deficiency in children without anaemia: a method in diagnosis

Iron deficiency anaemia in children is commonly encountered in paediatric institutions. It is easily diagnosed from the morphology of erythrocytes, provided that the haemoglobin value is below 10.0 g. /lo0 ml. The recognition of developing iron deficiency anaemia in the absence of low haemoglobin values is a continuous and challenging problem. It is well known that serum iron studies, bone marrow iron, and the determination of absolute indices are usually not helpful in such cases. With this in mind, a method was developed to provide more information about impending or overt iron deficiency in children aged between 6 mth. and 3 yr. A fragiligraph was used in a study of haematologically normal children and another group with blood films showing excessive microcytosis and hypochromia, with and without anaemia. Two systems of analysis were used. In the first, samples of blood diluted with saline were haemolyzed by dialysing them against a distilled water gradient for a set period of time. In the second series of experiments, identical samples were tested against buffered 0.2% saline. In both instances, use was made of continuous recordings showing point-to-point lysis of cells at specified time intervals. The results indicate that significant microcytosis may be recognized, even without anaemia, under the second set of experimental conditions. The test is rapid, reproducible and requires only a single drop of blood. It is capable of being performed by means of any photo-electric recording instrument (for instance standard haemoglobinometers) which has had home-made modifications. It was suggested that this test would be particularly suitable for field studies of iron deficiency anaemia.