ABSTRACT
Serum transferrin receptor [STfR] is a reliable tool for assessing functional iron status and erythropoietic activity in adults, but little is known about its role in children. The aim of this study was to evaluate STfR concentrations in healthy newborns, infants, and children and to show age and sex-related variations. A further aim was to investigate the value of STfR in children with iron deficiency anemia [IDA], and its response to oral iron therapy. We studied 3 groups. Group I included 26 healthy newborns, they were 70 preterm and 16 term babies. Group II included 22 healthy infants and children. Group III included 27 children with IDA. Complete blood count, serum iron, total iron binding capacity [TIBC], serum ferritin [SF], and STfR levels were measured. STfR/log ferritin index [STfR-F index] was calculated. Cord blood samples were obtained from the studied newborns just after delivery. Children with IDA were treated for 3 months with oral iron to evaluate its effects on parameters reflecting iron status. The results showed that: in group I, serum iron, SF, and TIBC were highest at term, whereas reticulocytes were highest in the preterm babies. STfR levels were not influenced by gestation. STfR in healthy newborns correlated negatively with hemoglobin [r = -0.779; P 0.005], with iron[r -0.25; P = 0.03] and with SF [r = -0.273; P= 0.071, and positively with reticulocytes [r = 0.838; P = 0.007]. In-group II, a negative correlation was found between STfR and age among healthy infants and children [r = -0.595; P = 0.001]. There was no significant difference in STfR between male and female subjects in-group I and II [P = 0.113, and P = 0.456]. STfR concentration was significantly higher in children with IDA compared to healthy children [P = 0.001]. After oral iron therapy, STfR level was significantly decreased compared to that before iron therapy [P 0.006]. STfR-F index was significantly decreased in children with IDA after oral iron therapy compared to that before iron therapy [P = 0.0001]. In children with IDA before treatment, STfR correlated negatively with hemoglobin [r = -0.798; P 0.001], with serum iron [r = -0.485; P =0.02], and with SF [r = -0.447; P = 0.03], and positively with TIBC [r = 0.503; P=0.02]
Conclusions: STfR levels in cord blood are not directly influenced by gestation. STfR concentrations show age-,but not sex-related changes. STfR is a reliable indicator for identifying IDA, and STfR and STfR-F index are useful parameters for assessing the effect of iron therapy in these children
ABSTRACT
Liver diseases in children represent a major and complicated health problem especially in developing countries. Early detection of liver disease is helpful in arresting the disease progress and anticipating the prognosis and risk of recurrence in the family. Neopterin, which is released from human macrophages, is an indicator for the activation of the cellular immune system. Increased concentrations were reported in viral and bacterial infections, allograft rejection, malignant diseases, HIV and autoimmune disease. In all these cases, enhanced concentrations of neopterin have been shown to have prognostic significance. The objective of this work was to define whether neopterin can be used as a marker to determine differences in liver diseases according to etiology and stages of diseases, and whether neopterin concentrations could be correlated with other laboratory investigations. The present study was conducted at the Pediatric Hepatology Unit, Children Hospital, Cairo University. The study included 60 children [34 males and 26 females] representing a broad etiological spectrum of acute and chronic liver diseases. Their age ranged from 2 months to 10 years with a mean of 5.5 years. Thirty age- and sex-matched healthy children served as controls. Routine as well as specific investigations were done to all studied cases and serum neopterin concentrations were measured by enzyme-linked immunoassay. The results showed that increased serum neopterin concentration were found in 63% of alI patients with various liver diseases [n = 60]. Patients with liver abscess had appreciably the highest neopterin values [mean +/- SD, 150 +/- 3.45 nmol/g and the lowest were found in patients with glycogen storage disease [1.98 2 0.52 nmol/l]. Patients with acute liver disease have significantly higher mean neopterin [25.35 +/- 55.32 nmol/l, p = 0,025] than patients with chronic cirrhotic [3.24 +/- 2.29 nmol/l, p = 0.017] and chronic non- cirrhotic liver diseases [4.28 +/- 2.99 nmol/l, p = 0.003]. Neopterin tended to be higher in patients with non- cirrhotic liver disease in comparison to those with cirrhotic liver disease. However, the difference between the two groups was insignificant [p = 0.222]. In all patients, most of the diagnostic parameters of liver function tests were significantly elevated when compared to controls but they did not correlate with serum neopterin concentrations. Similar insignificant correlations were found between serum neopterin concentrations and blood indices
Conclusion: our study showed that serum neopterin increases in certain liver diseases and can help in diagnosis of certain hepatic disorders, but we did not find the proof of its benefit in the assessment of the etiology or stage of these disorders