Hepcidin and iron parameters in children with anemia of chronic disease and iron deficiency anemia

BACKGROUND: Anemia of chronic disease (ACD) and iron deficiency anemia (IDA) are the two most prevalent forms of anemia having interrelated characteristics. Hepcidin, a newly introduced biomarker for assessment of iron status, is a homeostatic regulator of iron metabolism. We investigated the role of hepcidin and other conventional iron parameters to assess iron status among children with ACD and IDA. We also identified children with ACD who developed iron deficiency (ID). METHODS: The study was undertaken in anemic children with 30 cases each of ACD and IDA along with 30 age and sex-matched controls. The ACD cases were subdivided into pure ACD and ACD with coexistent ID. All cases were subjected to following tests: complete blood count with peripheral smear, serum C-reactive protein, serum interleukin-6, iron studies, serum soluble transferrin receptor (sTfR), and serum hepcidin. RESULTS: The mean serum hepcidin concentration was significantly increased in pure ACD patients (143.85±42.76 ng/mL) as compared to those in IDA patients (6.01±2.83 ng/mL, P < 0.001) and controls (24.96±9.09 ng/mL, P <0.001). Also, compared to pure ACD patients [normal sTfR levels (<3 µg/mL)], the serum hepcidin concentration was reduced significantly in ACD patients with ID [high sTfR levels (≥3 µg/mL)] with a mean of 10.0±2.97 ng/mL. CONCLUSION: Hepcidin measurement can provide a useful tool for differentiating ACD from IDA and also help to identify an iron deficiency in ACD patients. This might aid in the appropriate selection of therapy for these patients.

Demographic and clinical profile of children under two years of age with recurrent wheezing

Sixty-seven children less than two years of age with recurrent wheezing were evaluated clinically and demographically by proper history and clinical examinations. The mean age of the study subjects at enrolment and at onset of wheezing was 10.8 +/- 5.24 months and 7.1 +/- 3.857 months, respectively. The male-female ratio was 9:2. The majority of these cases [82%] had onset of wheezing at less than 1 year of age. One-third of the cases were diagnosed as asthma and viral infection associated wheeze. Increasing age in the first 2 years of life was significantly associated with decreasing trend of cases with history suggestive of reflux. The children with wheeze due to causes other than gastroesophageal reflux were more likely to be not exclusively breast fed. The present study did not find any significant difference in the prevalence of various socioeconomic, environmental factors and clinical factors among the various types of the early wheezers