Serum ferritin levels among schoolchildren and its correlation with lipid profile and adiposity

To determine the association between serum ferritin levels, lipid profile and adiposity in school-age children. Methods: A cross-sectional study was conducted on obese and non-obese children. Weight, height, waist circumference and blood pressure were measured for all participants. Lipid profile, serum ferritin and glucose were determined and analysed through absorbance. The Spearman correlation was performed for the quantitative variables and a regression analysis was used to determine the interaction between variables. Eighty-nine children were included, with a median age of 9.0 years. Results: When comparing serum ferritin levels in normal weight group, vs. the overweight and obesity group, values were significantly higher in the latter. Serum ferritin correlated positively with BMI (Rho .282, p <0.01), waist circumference (Rho .372, p < 0.01), diastolic blood pressure (Rho .244, p < 0.05), body fat percentage (Rho .375, p < 0.001), insulin (Rho .254, p <.05) and sex (Rho .224, p <.05); and negatively with high-density lipoprotein cholesterol (Rho. -221, p< 0.05). When analysing the significant variables in a multivariate regression model, sex, body mass index, waist circumference, and body fat percentage remained statistically significant (p <0.01). Conclusion: We observed associations between serum ferritin and obesity in Mexican school aged children(AU)

Determinar la asociación entre los niveles de ferritina sérica, el perfil de lípidos y la adiposidad en niños en edad escolar. Metodología: Se realizó un estudio transversal en niños obesos y no obesos. Se midieron el peso, la altura, la circunferencia de cintura y la presión arterial en todos los participantes. El perfil lipídico, la ferritina sérica y la glucosa se determinaron y analizaron mediante absorbancia. Se realizó correlación de Spearman para las variables cuantitativas y se utilizó un análisis de regresión para determinar la interacción entre las variables. Se incluyeron ochenta y nueve niños, con una edad media de 9,0 años. Resultados: Al comparar los niveles de ferritina sérica en el grupo de peso normal, frente al grupo de sobrepeso y obesidad, los valores fueron significativamente más altos en este último. La ferritina sérica se correlacionó positivamente con el IMC (Rho 0,282, p <0,01), la circunferencia de cintura (Rho 0,372, p <0,01), la presión arterial diastólica (Rho 0,244, p <0,05), el porcentaje de grasa corporal (Rho 0,375, p < 0,001), insulina (Rho 0,254, p <0,05) y sexo (Rho 0,224, p < 0,05); y negativamente con colesterol de lipoproteínas de alta densidad (Rho -0,221, p <0,05). Al analizar las variables significativas en un modelo de regresión multivariante, el sexo, el índice de masa corporal, la circunferencia de cintura y el porcentaje de grasa corporal se mantuvieron estadísticamente significativos (p <0,01). Conclusión: Observamos asociaciones entre la ferritina sérica y la obesidad en niños mexicanos en edad escolar(AU)

Acute renal failure in COVID-19 patients on mechanical ventilation / Insuficiencia renal aguda en pacientes COVID-19 en ventilación mecánica

COVID-19 Community acquired pneumonía is a recent and frequent cause of admission in European intensive care units. Currently, there are many open questions regarding the management and prognostic factors of these patients. Among them, its association with acute renal failure in patients on mechanical ventilation. Analysis of acute renal failure in COVID-19 patients on mechanical ventilation. Prognosis and factors related to its development. Retrospective observational study carried out in the intensive care unit of a University Hospital during the COVID-19 pandemic. We analysed patients admitted to the ICU with the diagnosis of Respiratory Failure due to Pneumonia COVID-19 between 6/3/2020 and 21/4/2020. Demographic data (age, sex), APACHE II, comorbidities, analytical data (ferritin, total bilirubin), length of stay, treatments administered (mechanical ventilation, muscle relaxant, vasoactive drugs, prone) and its association to acute renal failure were analysed. 67 patients received complete treatment in our hospital. Length of stay (days) 14.1 ± 10, average age 60 years, APACHE II 14.3 ± 5.2, 67.2% males. Maximum creatinine mean value (mg/dl) 1.48 ± 1.26, Maximum ferritin mean value (ng/ml) 2,310 ± 3,322, Maximum total bilirubin mean value (mg/dl) 2 ± 2.2. 100% of the patients required mechanical ventilation. 65.7% prone positioning, 74.6% neuromuscular blockers and 98.5% required vasoactive drugs. Establishing renal failure as creatinine values greater than 1.2 mg/dl. Patients with maximum creatinine above 1.2 mg/dl presented average values of bilirubin and ferritin higher than those with values under 1.2 mg/dl (P < 0.05). The presence of renal failure was also statistically significantly associated with sex (male), presence of dyslipidaemia, and mortality. In our sample, we have associated acute renal failure with higher ferritin valúes. Likewise, we have observed higher creatinine valúes in the group of non-survivors, those with dyslipidaemia and men, with statistical signification.

La neumonía adquirida en la comunidad COVID-19 es una causa reciente y frecuente de ingreso en las unidades de cuidados intensivos europeos. Actualmente, hay muchas preguntas abiertas con respecto al manejo y los factores pronósticos de estos pacientes. Entre ellos, su asociación con insuficiencia renal aguda en pacientes en ventilación mecánica. Análisis de insuficiencia renal aguda en pacientes con COVID-19 en ventilación mecánica. Pronóstico y factores relacionados con su desarrollo. Estudio observacional retrospectivo realizado en la unidad de cuidados intensivos de un Hospital Universitario durante la pandemia de COVID-19. Analizamos los pacientes ingresados en UCI con el diagnóstico de insuficiencia respiratoria por neumonía COVID-19 entre el 3/6/2020 y el 21/4/2020. Se analizaron datos demográficos (edad, sexo), APACHE II, comorbilidades, datos analíticos (ferritina, bilirrubina total), tiempo de estancia, tratamientos administrados (ventilación mecánica, relajante muscular, fármacos vasoactivos, prono) y su asociación con insuficiencia renal aguda. 67 pacientes recibieron tratamiento completo en nuestro hospital. Duración de la estancia (días) 14,1 ± 10, edad media 60 años, APACHE II 14,3 ± 5,2, 67,2% varones. Valor medio máximo de creatinina (mg/dl) 1,48 ± 1,26, valor medio máximo de ferritina (ng/ml) 2.310 ± 3.322, valor medio máximo de bilirrubina total (mg/dl) 2 ± 2,2. El 100% de los pacientes requirió ventilación mecánica. El 65,7% en decúbito prono, el 74,6% bloqueantes neuromusculares y el 98,5% requirieron fármacos vasoactivos. Estableciendo la insuficiencia renal como valores de creatinina superiores a 1,2 mg/dl, los pacientes con creatinina máxima superior a 1,2 mg/dl presentaron valores medios de bilirrubina y ferritina superiores a aquellos con valores menores a 1,2 mg/dl, de forma estadísticamente significativa. La presencia de fallo renal, también se asoció de forma estadísticamente significativa al sexo hombre, la presencia de dislipidemia como antecedente personal de interés y a la mortalidad. En nuestra muestra hemos asociado la insuficiencia renal aguda con valores más elevados de ferritina. Asimismo, hemos observado mayores valores de creatinina en el grupo de no supervivientes, los que presentan dislipidemia y los hombres, con significación estadística.

Hierro intravenoso en la terapia del síndrome de piernas inquietas / Intravenous iron for restless legs syndrome. Report of five cases

Restless legs syndrome (RLS) may severely affect the quality of life of patients. A deficient iron incorporation into the central nervous system has an important role in the pathophysiology of RLS. Severely affected patients may not respond to current therapeutic options. We report a preliminary experience with five patients with severe RLS and low serum ferritin levels who did not improve with oral iron. All were treated with 1 g of intravenous iron carboxymaltose. They experienced a marked improvement in symptoms, evident even during the first week of therapy that had persistent after up to two years of follow-up. A significant change in the RLS severity scale was observed after intravenous iron. Serum ferritin levels increased in all of them. Intravenous iron could be a therapeutic option for patients with severe RLS.

Síndrome de piernas inquietas en niños: caracterización clínica / Characterization of restless leg syndrome in children

El Síndrome de piernas inquietas (SPI) o Enfermedad de Willis­Ekbom, es una condición neurológica que afecta al 2-4% de los niños en edad escolar. Etiológicamente se ha relacionado al metabolismo del hierro y a factores genéticos entre otros. En niños aun es una patología poco diagnosticada. Trabajo observacional descriptivo, en el cual se realiza caracterización clínica, según criterios internacionales, en 14 pacientes menores de 18 años, 9 varones. Edad promedio 8 años. Sintomatología inicial variada, desde resistencia a ir a la cama, hasta dibujar sus molestias. En 10 se comprobó déficit de hierro. En 11 pacientes se realizó un polisomnograma, 10 de ellos con un índice elevado de movimientos periódicos de extremidades. El uso de pregabalina y aporte de hierro fue el tratamiento más utilizado. Dos pacientes tenían padres diagnosticados con SPI.

Abstract. The Restless Legs Syndrome (RLS) or Willis-Ekbom Disease is a neurological condition that affects 2-4% of school-age children. Its etiology has been related to the metabolism of iron and genetic factors among others. In children it is still a frequently undiagnosed disorder. This is a descriptive observational report, in which clinical characterization is carried out according to international criteria in 14 patients under 18 years old, 9 boys. Average age is 8 years old. The initial symptomatology was varied, from resistance to comply with bedtime, to drawing their discomfort. In 9, iron deficiency was found. A polysomnogram was performed in 11 patients, 10 of which had a high periodic limb movements index. The use of pregabalin and supplementary iron were the most used treatments. Two patients had parents diagnosed with RLS.

Management of Anemia in Patients with Inflammatory Bowel Disease / 대한소화기학회지

Anemia is one of the commonest extraintestinal manifestations of inflammatory bowel disease (IBD). The pathogenesis of anemia in IBD is complex but iron deficiency combined with inflammation is the most common factor related to the development of anemia. However, other causes such as vitamin B12 and folate deficiency, hemolysis, myelosuppression and drug also should not be overlooked. In addition to ferritin, inflammatory markers and new biochemical parameters such as hepcidin and ferritin index are being tested as diagnostic a tool. First step for treatment is disease activity control and iron supplementation. Although oral iron is widely used, intravenous iron therapy should be considered in patients who are intolerant to oral iron therapy, have severe and refractory anemia or are in active disease state. Recently, new intravenous iron formulations have been introduced and due to their safety and easy usage, they have become the standard treatment modality for managing anemia in IBD. Erythropoietin and transfusion can be considered in specific situations. Vitamin B12 and folate supplementation is also important in patients who are deficient of these micronutrients. Since anemia in IBD patients could significantly influence the disease outcome, further studies and standard guideline for IBD are needed.

Deficiencia subclínica de hierro en niños menores de cuatro años de edad, ciudad de Valencia, Venezuela / Subclinical iron deficiency in children under four years of age, Valencia city, Venezuela / Deficiencia subclinica de ferro em changas menores de quatro anos de idade, cidade de Valencia, Venezuela

La deficiencia de hierro (DH) se considera un problema de salud pública y afecta principalmente a los niños en las etapas de crecimiento rápido y desarrollo psicomotor. El objetivo del estudio fue identificar la deficiencia subclínica de hierro en niños menores de 4 años, mediante el uso de ferritina sérica (FS), receptor soluble de transferrina (RsTf) e índice RsTf-FS como herramientas diagnósticas. El estudio fue descriptivo, transversal, y se realizó en Valencia, Venezuela, en 2006. Se determinaron en 541 niños las concentraciones de hemoglobina (método automatizado), FS (IRMA), RsTf (ELISA), Proteína C Reactiva y alfa glicoproteína (nefelometría). Se realizaron estadísticos descriptivos, prueba de Mann-Whitney y Fisher, con nivel de significancia de p<0,05. El 72,1% de los niños tenían depósitos de hierro agotados, 25,5% eritropoyesis deficiente de hierro y 27,0% anemia. El índice RsTf-FS identificó mayor porcentaje de niños con DH subclínica; mostrando mayor valor diagnóstico frente a la FS y el RsTf por separado. El índice RsTf-FS podría convertirse en una prueba invaluable para distinguir entre agotamiento de los depósitos corporales de hierro y eritropoyesis deficiente de hierro, fases subclínicas de la DH. Se propone una intervención nutricional con base en la suplementación y la educación como estrategia fundamental para disminuir la prevalencia de DH y anemia.

Iron deficiency is considered a public health problem, especially affecting children at ages of fast growth and psychomotor development. The study was aimed to identify subclinical iron deficiency in children below four years of age, through the use of serum ferritin (FS), soluble transferrin receptor (RsTf) and index RsTf-FS as diagnostic tools. It was a descriptive, transversal study performed at Valencia, Venezuela, 2006. Hemoglobin (Hb) by automated method, FS by IRMA, RsTf by ELISA, C Reactive Protein and alpha glycoprotein by nephelometry were assessed in 541 subjects. Descriptives values and Mann-Whitney and Fisher test results are presented. A p value <0.05 was considered significant. 72.1% of children had iron stores depletion, 25.5% had iron deficient erithropoyesis and prevalence of anemia was 27.0%. The index RsTf-FS allowed to identify a higher percentage of children with subclinical iron deficiency, which indicates that the index is better diagnostic indicator than FS or RsTf by separate. Index RsTf-FS could become a invaluable test in order to distinguish between iron body stores depletion and iron-deficient erythropoiesis, subclinical phases of iron deficiency. Nutritional intervention based on supplementation and education as fundamental tool to diminish anemia and iron deficiency prevalence should be initiated.

A deficiencia de ferro (DF) é considerada um problema de saúde pública e afeta principalmente changas em fases de crescimento rápido e desenvolvimento psicomotor. O objetivo do estudo foi identificar a deficiencia de ferro subclinica em criangas menores de 4 anos, através do uso de ferritina sérica (FS), receptor solúvel de transferrina (sTfR) e índice sTfR-FS como ferramentas de diagnóstico. O estudo foi descritivo, transversal, e foi feito em Valencia, Venezuela, em 2006. Foram determinadas em 541 criangas as con-centragoes de hemoglobina (método automatizado), FS (IRMA), sTfR (ELISA), Proteína C reativa e alfa-gli-coproteína (nefelometria). Foram realizados estatísticos descritivos, testes de Mann-Whitney e Fisher, com um nivel de significancia de p<0,05. 72,1% das criangas tinham os depósitos de ferro esgotados, 25,5% eritropoiese deficiente de ferro e 27,0% anemia. O índice sTfR-FS identificou maior percentagem de crian-gas com DF subclínica mostrando assim maior valor diagnóstico em relagáo a FS e sTfR separadamente. O índice sTfR-FS poderia tornar-se um teste de valor inestimável para a distingáo entre deplegáo de reservas corporais de ferro e eritropoiese deficiente de ferro, estágios subclínicos da deficiencia de ferro. Propoe-se uma intervengáo nutricional com base na suplementagáo e educagáo como estratégia fundamental para diminuir a prevalencia de deficiencia de ferro e anemia.

A suplementação de ferro na gravidez: orientações atuais / Iron supplementation in pregnancy: current guidelines

O ferro é um dos minerais mais abundantes na crosta terrestre e nos organismos. Participa da síntese da hemoglobina, mioglobina, além de ser co-fator de uma série de reações enzimáticas. Durante a gravidez, vários processos fisiológicos fazem com que a demanda desse micronutriente tenha um incremento significativo, o que torna necessárias maiores ingestão e absorção de ferro. Sabe-se que, durante a gestação, a quantidade de ferro absorvida nos intestinos aumenta, mas, mesmo assim, a maioria das gestantes não ingere quantidade satisfatória desse mineral, o que torna explicável a suplementação oral da dieta com ferro. Vários autores advogam que essa suplementação não deva ser feita de maneira rotineira, mas individualizada, devido a possíveis efeitos deletérios do ferro durante a gestação, dentre eles o aumento nas taxas de Diabetes Mellitus Gestacional e pré-eclâmpsia. O objetivo desse estudo é realizar uma revisão na literatura médica que versa sobre o assunto, criando uma análise crítica sobre a suplementação oral rotineira de ferro e seus possíveis riscos durante a gestação

Iron is one of the most abundant mineral on the Earth's crust and organisms. It is essential for the synthesis of hemoglobin and myoglobin; besides, it acts as a co-factor in a series of enzymatic reactions. During pregnancy, multiple physiological adaptations cause an increase in the demand of micro-nutrients, which makes further ingestion and absorption of iron necessary. It is known that, during pregnancy, the amount of iron absorbed in the intestines increases, but even so, most pregnant women do not have an adequate iron intake, which makes the oral supplementation of diet with iron a reasonable action. A considerable number of authors advocate that this supplementation should not be made as a routine, but individualized, due to the possible deleterious effects of iron during pregnancy, among them the increased risk of Gestational Diabetes and pre-eclampsia. The aim of this study is to perform a review in the medical literature about the subject, creating a critical analysis of routine iron supplementation and its possible risks during pregnancy

Identificación de sujetos a riesgo de deficiencia de hierro mediante el indice receptor soluble de transferrina-log ferritina sérica en hombres afrodescendientes residentes en San Basilio de Palenque, Cartagena de Indias, DTyC., Bolívar, Colombia / Identification of iron deficiency risk by index soluble transferrin receptor-log ferritin in African descent men living at San Basilio de Palenque, Cartagena de Indias, DT and C., Bolivar, Colombia

En el ámbito mundial, sin distingo de raza, edad, género ni procedencia geográfica, la anemia de mayor prevalencia es la anemia ferropénica. De la misma forma, son insuficientes los reportes nacionales e internacionales sobre la prevalencia de los estados subclínicos de hierro, especialmente en comunidad afrodescendiente. El objetivo de la investigación fue caracterizar una población masculina afrodescendiente de 73 hombres sanos con edades comprendidas entre los 16 y 30 años mediante el comportamiento del índice (sTfR- Log F.S.), residentes en San Basilio de Palenque y en Cartagena de Indias DTyC. Se determinaron los índices primarios eritroides: hemoglobina (Hb), hematocrito (Hto), estudio de sangre periférica (E.S.P.); el receptor soluble de transferrina (sTfR), la ferritina sérica (F.S.) y el índice receptor soluble de transferrina – Logaritmo de la ferritina sérica (sTfR-Log F.S.) El análisis estadístico se realizó mediante el software de SPSS versión 17,0. En la población de San Basilio de Palenque el hallazgo hematológico por el algoritmo de mayor frecuencia se asoció a la enfermedad crónica acompañada de deficiencia de hierro en el 41.6%, seguido de deficiencia subclínica de hierro estadio II con un 33.3%. En Cartagena el hallazgo de mayor frecuencia fue la enfermedad crónica con deficiencia de hierro en 49%, seguido de deficiencia subclínica de hierro estadio II 20.41%. Las dos poblaciones evidenciaron un comportamiento hematológico similar en las diferentes variables, constituyéndose estos resultados en pioneros para futuras investigaciones de los estadios subclínicos que anteceden la deficiencia de hierro en afrodescendientes colombianos.

Concentrações de hemoglobina e ferritina sérica em escolares da rede pública municipal de Teresina, Piauí, Nordeste do Brasil / Hemoglobin and serum ferritin concentrations in public school children from Teresina, in the State of Piauí, in Northeast Brazil

OBJETIVOS: avaliar o estado nutricional de ferro em escolares de instituições públicas de ensino de Teresina, Piauí, Brasil. MÉTODOS: corte transversal, envolvendo amostra aleatória, selecionada em duas etapas, de 747 escolares (7-11 anos), de ambos os sexos, no período de agosto / setembro de 2000. A anemia foi rastreada em 747 escolares e para o diagnóstico adotou-se a concentração de hemoglobina (Hb) <11,5g/dL. As reservas corporais de ferro foram estimadas em 207 escolares, mediante análise das concentrações de ferritina sérica (FerS), considerando-se baixas reservas valores <15 µg/L. RESULTADOS: a prevalência de concentrações inadequadas de Hb (< 11,5g/dL) foi de 14,3% (IC95% 12,2-17,4) e de reservas inadequadas de ferro (FerS< 15,0µg/L) de 20,3% (IC95% 15,2-26,6). A prevalência de anemia foi semelhante entre os sexos (p=0,60) e as faixas etárias (p=0,85). Comportamento distributivo similar foi observado no que diz respeito às reservas inadequadas de ferro, frentes às variáveis sexo (p=0,19) e idade (p=0,24). As concentrações de FerS não mostraram correlação (r=0,1; p=0,168) com as de Hb. A prevalência de anemia ferropênica (Hb< 11,5 g/dL e FerS< 15,0 µg/L) foi de 26,3% (IC95% 17,3-37,5). CONCLUSÕES: em Teresina, a deficiência de ferro e a anemia em escolares devem ser consideradas como um problema de saúde pública que requer efetivo programa de prevenção e controle. No entanto, a anemia parece não ser explicada apenas pela deficiência de ferro; outros fatores etiológicos devem, portanto, ser considerados, a exemplo da deficiência de outros micronutrientes, infecções/infestações parasitárias, distúrbios hereditários e exposição a poluentes ambientais.

OBJECTIVES: to assess iron nutritional status of public school children in Teresina, Piauí, Brazil. METHODS: a cross-sectional survey was conducted among 747 school children of both sexes, aged between seven and eleven years, who were randomly selected using a two-step sampling procedure, in August/September 2000. Children with hemoglobin (Hb) concentrations less than 11.5 g/dL were evaluated as anemic and low body iron (Sfer< 15µg/L) was evaluated in 207 children. RESULTS: the prevalence of anemia was 14.3% (95% CI 12.2-17.4) and of low body iron 20.3% (95% CI 15.2-26.6). Anemia and body iron depletion were not correlated with gender (p=0.60; p=0.96, respectively) or age group (p=0.85; p=0.53, respectively). SFer was not correlated (r=0.1; p=0.168) with Hb concentrations. The prevalence of iron deficiency anemia (Hb< 11.5g/dL and SFer< 15.0µg/L) was 26.3% (95% CI 17.3-37.5). CONCLUSIONS: iron deficiency and anemia seem to be a public health problem among school children in Teresina. Concerted action to prevent and control these conditions is strongly recommended. However, all anemia cannot be explained by iron deficiency. Therefore, it may be wise to consider other etiologies, such as micronutrient status, parasite infestation, hereditary disorders and exposure to environmental pollutants.

Iron status and hemoglobin level on chronic renal insufficiency

To correlate the iron status and hemoglobin levels in pre End Stage Renal Disease [ESRE] patients with various degrees of chronic renal insufficiency. A cross sectional analytical study. Department of Physiology, BMSI, JPMC, Karachi, in collaboration with Department of Nephrology, JPMC, Karachi and the above mentioned departments. The study included 120 subjects, distributed into four groups with 30 subjects in each group. There were 15 male and 15 female subjects in each group. First group [control] comprising of normal subjects with Creatinine Clearance above 90 milliliters per minute [Cr. Cl > 90 mI/mm] and remaining three groups i.e., group 11 [Cr. Cl 60-90 mI/mm], group Ill [Cr. Cl 30-59 mI/mm], and group IV [Cr.Cl 15-29 mI/mm] comprising of patients with increasing severity of the renal insufficiency. Their hemoglobin, serum ferritin, serum iron and Total Iron Binding Capacity [TIBC] were analyzed and statistically compaied. As compared to control group. there was a 6.85%, 11.46%, 29.09% decrease in hemoglobin levels in males while 5. 13%, 9.24% and 24.24% decrease in females, when subjects of group II, III, and IV were taken into consideration. Similarly there was 2.82%, 783%, and 12.37% decrease in serum iron, 1.31%, 1.79% and 2.24% rise in Total Iron Binding Capacity [TIBC] and 1.78%, 11.79% and 29.47% decrease in serum ferritin levels in corresponding groups in the same order. The rate of decrease in hemoglobin level corresponds with the rate of deterioration in renal function; however the rate of change in iron profile is by and large within normal limits and hence is not very significant

Intercessory prayer and ferritin and hemoglobin in major thalassemia: a pilot study

Intercessory prayer [IP] is one of the newly recognized holistic treatment methols and its effectiveness has been documented on the mangement of difterent diseases such as coronary heart disease, rheumatoid arthritis, and infertility. This study aims to d etemine its effectiveness on ferritin and blood indices of major thalassemic patients. This was an interventionaI study assessing seven patients attending an outpatient clinic receing IP in addition to their routine treatment. In all IP was performed 5.56 times for each patient as close-Iaying of hands and 6 times as remote IP. Before the study, the mean hemoglobin was 9.7 mg/dI, which increased to 10.8 afterwards [P = 0.028]. Mean serum ferritin was 2246.8 before the intervention which decreased to 1680.8 afterwards. Blood transfusion interval doubled in four patients. Dizziness and fatigue, which were reported by two patients before intervention, disappeared afterwards. Three patienis reporled an improvement in their school penfllrmance after the study. This pilot study showed that intercessory prayer was effectlve in increasing hemoglobin and transfusion interval, decreasing ferritin and improving school performance in patients with major thalassemia. A larger randomized trlal is suggested corfirm the results

Serum ferritin in renal cell carcinoma: effect of tumor size, volume grade, and stage.

AIM: To study the levels of serum ferritin in patients of renal cell carcinoma (RCC). PATIENTS AND METHODS: Serum ferritin levels were measured preoperatively in 32 patients with radiological evidence of RCC using an enzyme immunoassay. The largest diameter of the primary tumor was measured in the pathological specimens in patients undergoing radical nephrectomy while in patients with non-operable tumor maximum tumor dimension was taken from CT scan. Pathological staging was done according TNM-1997. RESULTS: Mean serum ferritin value in patients of RCC was 283.23+/-77.38 ng/ml while in controls the mean value was 79.98+/-32.96 ng/ml (P CONCLUSIONS: Serum ferritin levels are elevated in patients with RCC although its actual source is unclear. Further studies are needed to establish the role of ferritin in RCC.

Estrategias diagnósticas utilizadas para detectar deficiencias de hierro subclínicas y asociadas a enfermedades crónicas / Diagnostic strategies for detecting subclinical iron deficiencies and associated to chronic diseases

La homeostasis y las variaciones fisiológicas horarias en el metabolismo del hierro se constituyen en verdaderos desafíos para los expertos, quienes intentan diseñar pruebas altamente sensibles y específicas que cuantifiquen los niveles circulantes y de depósito de este elemento, su repercusión en la eritropoyesis,cuantificación de las proteínas, transportadores y receptores involucrados en el proceso, a fin de descartar la presencia de estados carenciales. Las deficiencias de hierro pasan por tres fases; las dos primeras son lasmás difíciles de identificar porque son subclínicas, más aún, cuando pueden cursar simultáneamente con enfermedades crónicas inflamatorias, infecciosas y neoplásicas que de por sí son anemizantes. En este trabajose revisarán las principales pruebas de laboratorio utilizadas para la identificación de deficiencias de hierro, sensibilidad, especificidad, ventajas y limitaciones para su uso.

Expected value of serum soluble transferrin receptor, erythropoietin and ferritin and their correlation among healthy non-anemic Thai children.

Transferrin receptor (TfR) is a glycoprotein which mediates the entry of ferric transferrin from the extracellular compartment into the cells. The measurement of sTfR has become a widely used tool in assessing erythropoiesis but its use has mainly been restricted to research laboratory settings. In Thailand, there are only a few reports concerning the sTfR. The authors studied the expected value of sTFR as well as other basic parameters for monitoring of erythropoiesis as erythropoietin (EPO) and ferritin among a sample of non-anemic healthy Thai children. In addition, correlation was done between each pair of studied parameters. Expected range for sTfR level for the healthy controls in this study was 1.761 to 2.034 mg/L. Expected range for serum EPO level for the healthy controls in this study was 19.445 to 34.176 mU/ml. Expected range for serum ferritin level for the healthy control from this study was 67.895 to 96.692 ng/ml. Of interest, poor correlation among the three studied parameters, sTfR, serum EPO and serum ferritin was observed in this study.

Cambios en los valores de hemoglobina y reserva de hierro en los primeros dos meses de vida / Hemoblobin and iron stores modifications during the first two months of life

Introducción. El objetivo del estudio fue evaluar los cambios en la reserva de hierro (Fe) y hemoglobina (Hb) en el recién nacido y describir su efecto sobre la concentración de Fe a los 2 meses de edad. Material y métodos. Se incluyeron neonatos de término sanos, determinándose los valores Hb y ferritina sérica (Fs) en muestras obtenidas al nacimiento, 1 y 2 meses de edad. El protocolo fue aprobado por los Comités de Investigación y Bioética del Instituto. Resultados. Se estudiaron 128 casos; los valores promedio de Hb fueron de 19.3, 13.9 y 11.8 g/dL y de Fe de 337, 290 y 206 µg/L (P< 0.001). A los 2 meses de edad 13.3 por ciento de los lactantes fueron deficientes de Fe (Fs<20 µg/L), hubo diferencias entre ambos grupos a partir de los valores de Fs al mes de edad (P=0.01), en la caída de Hb entre el primer y segundo mes (P=0.01), en la caída de Fs entre el nacimiento y segundo mes (P< 0.001) y entre el primero al segundo mes (P< 0.001). Conclusiones: Los neonatos de término muestran caída paralela en los valores de Hb y Fs durante los dos primeros meses de edad. Los lactantes deficientes de Fe muestran una caída menor en los valores de Hb entre el primero y segundo mes. La destrucción eritrocitaria normal representa un ahorro o mayor acúmulo de Fe, como un mecanismo adaptativo a esta edad

Determinação da ferritina sérica por dois métodos imunológicos automatizados / Ferritin determination performed by two immunologic automated methods

A concentração de ferritina sérica está diretamente relacionada às reservas de ferro do organismo. A proposta de nosso trabalho foi comparar os resultados obtidos na determinação da ferritina sérica por dois métodos imunológicos automatizados, uma vez que os resultados obtidos podem implicar ou não em condutas terapêuticas. Foram analisadas 206 amostras de soro por nefelometria usando o kit N-Látex-Ferritin da Behring e por enzimaimunoensaio em micropartículas usando o kit IMx Abbott. O coeficiente de correlação entre os dois métodos foi de r² = 0,94. No entanto, quando o método de enzimaimunoensaio foi utilizado, a média dos resultados obtidos foi significativamente mais altos que a média dos resultados do método de nefelometria (p < 0,001). A seguinte equação de regressão foi obtida: y = 0,83x + 1,172, onde y é o resultado da nefelometria e x é o resultado do método IMx Abbott. A despeito da alta correlação obtida, os resultados confirmam a importância de se especificar a metodologia aplicada nos resultados reportados

Ferritina sérica en diferentes grupos de población en Honduras / Serum ferritin in differents groups in Honduran population

Con el propósito de conocer valores normales en Honduras, hemos investigado la concentración de ferritina sérica en cuatro grupos de población. De 283 voluntarios estudiados, 13 fueron mujeres no embarazadas, 73 niños, 98 mujeres embarazadas y 99 hombres. El valor medio de ferritina y el rango encontrado fue de la siguiente manera: mujeres no embarazadas 32 ng/dl (5.5 ng/dl- 200 ng/dl), niños 24.8 ng/dl (3.7 ng/dl - 18 ng/dl), mujeres embarazadas 10.6 ng/dL (3.1 ng/dL- 163 ng/dL) y hombres 73.6 ng/dL (21.8 ng/dL- 422.7 ng/dL). Se determinó la concentración de hemoglobina y hematocrito y se estableció la relación entre hemoglobina y ferritina, encontrandose que en los cuatro grupos existió una relación directamente proporcional entre los niveles de hemoglobina y de ferritina sérica

Dosis semanal única de eritropoyetina recombinante en niños con insuficiencia renal crónica / Recombinant human erhytropoietin once a week in the treatment of anemia in children whit end stage renal failure

Objetivo: Estudiar el resultado de la aplicación de una dosis semanal de eritropoyetina humana recombinante (EPO) por vía subcutánea en el tratamiento de la anemia de niños con insuficiencia renal terminal (IRT). Diseño. Se estudiaron 19 pacientes de 6 a 17 años de edad con IRT del programa de dialisis peritoneal crónica ambulatoria (DPCA) del Centro Médico Nacional de la ciudad de León. Los enfermos habían requerido previamente un promedio 2.8 transfusiones sanguíneas en 18.2 meses. Los requisitos de inclusión fueron: anemia normocrómica severa (Hto > 20 por ciento), ausencia de procesos infecciosos y otras enfermedades sistémicas, cifras tensionales por debajo de la percential 97 para su edad, función hepática normal, y ausencia de crisis convulsivas. La EPO se administró por vía subcutánea una vez por semana a razón de 130 ñ (DE) 15 U/kg de peso. Todos los pacientes recibieron diariamente los requerimientos mínimos de sulfato ferroso y ácido fólico. Resultados. Los valores iniciales promedio fueron de 6.6 ñ 0.9 g/dL y 20.6 ñ 3.3 por ciento para la hemoglobina y el hematocrito respectivamente, elevándose a 9.4 ñ 0.9 g/dL y 28.8 ñ 2.5 por ciento a las doce semanas (p< 0.05). Los pacientes no recibieron hemotransfusiones durante el periodo de estudio. La presión arterial no mostró cambios significativos. Conclusiones. La administración subcutánea de EPO en nuestro estudio fue suficiente para obtener un aumento en los valores de Hb y Hto en los pacientes estudiados. Adicionalmente se obtuvo una disminución en la aparición de efectos secundarios y en el costo del tratamiento