Evaluación biológica de la exposición laboral al plomo / Biological assessment of the work-related exposure to lead

Introducción: El plomo, por su amplio uso causa una gran contaminación ambiental y problemas de salud en muchas partes del mundo. La Organización Mundial de la Salud incluyó el plomo dentro de una lista de diez productos químicos causantes de graves efectos sobre la salud. Objetivo: Evaluar los niveles de plomo en sangre y de protoporfirina libre eritrocitaria en un grupo de trabajadores expuestos a plomo inorgánico. Métodos: Estudio descriptivo de corte transversal donde se evaluaron 776 casos que acudieron a los laboratorios del Instituto Nacional de Salud de los Trabajadores en el año 2018, provenientes de diferentes sectores industriales. Se les realizó la determinación de plomo en sangre a 288 y la de protoporfirina a 488, según métodos establecidos en el laboratorio. Los datos obtenidos fueron procesados utilizando Microsoft Excel® y el paquete estadístico Statgraphics Centurion XVI.II. Resultados: El 92 por ciento de los pacientes fue del sexo masculino. La concentración de plomo en sangre osciló entre 5 µg/dL y 89 µg/dL para un promedio en hombres de 24 µg/dL ± 21 µg/dL y en las mujeres de 11 µg/dL ± 9 µg/dL. Para la protoporfirina, esta fluctuó entre 21 µg/dL y 274 µg/dL, con un promedio de 47 µg/dL ± 22 µg/dL en hombres y 66 µg/dL ± 32 µg/dL en las mujeres. El 8 por ciento de los casos evaluados tuvo valores de plomo en sangre mayores de 60 µg/dL y para la protoporfirina el 5 por ciento de los casos presentaron valores por encima de 85 μg/dL. Conclusiones: Algunos casos evaluados presentaron niveles elevados de plomo que superan los límites permitidos, lo que pone en evidencia la necesidad de reforzar las medidas de protección aplicadas a los trabajadores y la importancia de detectar precozmente el problema en el ámbito laboral, antes de que aparezcan repercusiones derivadas de una intoxicación por plomo(AU)

Introduction: Lead, due to its large use, causes a major environmental pollution and health problems in many places around the world. The World Health Organization included lead in a list of ten chemical products causing severe effects in health. Objective: To assess lead levels in blood and free-erythtocyte protoporphyrin (FEP) levels in groups of workers exposed to inorganic lead. Methods: Descriptive. cross-sectional study where 776 cases coming from different industrial sectors were assessed in the laboratories of the National Institute of Workers Health in the year 2018. It was conducted to 288 of the cases a test to determine if there was lead in blood and a test for FEP to 488 cases, according to the methods established in the laboratory. The data collected were processed using Microsoft Excel® and the statistical program called Statgraphics Centurion XVI.II. Results: 92 percent of the patients were males. Lead concentration in blood ranged from 5 µg/dL and 89 µg/dL, for an average in men of 24 µg/dL ± 21 µg/dL, and in women of 11 µg/dL ± µg/dL. FEP concentration swung from 21 µg/dL to 274 µg/dL, with an average of 47 µg/dL ± 22 µg/dL in men, and 66 µg/dL ± 32 µg/dL in women. 8 percent of the assessed cases presented values of lead in blood higher than 60 µg/dL and for FEP, 5 percent of the cases presented values higher than 85 µg/dL. Conclusions: Some of the assessed cases presented high levels of lead which exceed the permitted levels; so, this demonstrates the need of reinforzing the protection measures applied to the workers and the importance of early detecting this problem in work-related environments prior to the onset of repercutions derived from lead poisoning(AU)

Iron deficiency anaemia in sickle cell disorders in India.

BACKGROUND & OBJECTIVE: Iron deficiency anaemia (IDA) is uncommon in individuals with sickle cell disease (SCD) because of availability of an adequate iron source potentially from increased red cell turnover and from blood transfusions. Also, iron deficiency anaemia can often go unnoticed because the sickle cell disease patients are already anaemic. Iron deficiency in sickle cell patients may result in lowering the intracellular haemoglobin concentration and this may ameliorate sickling. The present study was undertaken to determine the prevalence of iron deficiency anaemia and the response of iron supplementation in sickle cell disorders in tribal population of the four States viz. Maharashtra, Gujarat, Orissa and Tamil Nadu. METHODS: A total of 8434 individuals (7105 AA, 1267 AS and 62 SS) were tested for zinc protoporphyrin/haem (ZPP/H) ratio and haemoglobin levels. Twenty two sickle cell anaemia (SS), 47 sickle cell trait (AS) and 150 normal control (AA) individuals who were iron deficient, were given iron therapy for a period of 12 wk and the laboratory investigations were repeated at the 13th wk. RESULTS: Sixty seven per cent of subjects with sickle cell anaemia and 26 per cent with sickle cell trait had elevated ZPP/H ratios (>80 micromol/mol) as against 22.8 per cent of normal individuals. The elevated ZPP/H ratios is an indicator of microcytic anaemia of iron deficiency. Following iron therapy, an improvement in the Hb levels and ZPP/H ratios was observed in both sickle cell disorders and normal individual cases. INTERPRETATION & CONCLUSION: This study suggests that iron deficiency anaemia is an important problem in Indian sickle cell anaemia patients and iron supplementation should be given only in proven cases of iron deficiency anaemia.

Evaluation of iron status: zinc protoporphyrin vis-a-vis bone marrow iron stores.

Zinc protoporphyrin (ZPP) in the red cells is an indicator of iron status in the bone marrow (BM) and can be easily measured by Protofluor-Z Hematofluorometer from Helena Laboratories. It is well known that bone marrow iron is a gold standard for the diagnosis of iron deficiency anemia (IDA) even in the pre-latent phase. Hence, it was considered pertinent to evaluate the diagnostic utility of ZPP in comparison with bone marrow iron stores. 107 random BM were selected over a period of 2(1/2) years; in each case, RBC indices where recorded along with ZPP and Perls' Prussian blue reaction for BM iron stores. The specificity and sensitivity were found to be 77.8% and sensitivity 69.8%, respectively. However, the sensitivity increased up to 96.2% when Hb, RBC indices and ZPP were considered for the diagnosis of IDA.

Avaliação do estado nutricional de ferro e anemia em crianças menores de 5 anos de creches públicas / Nutritional assessment of iron status and anemia in children under 5 years old at public daycare centers

OBJETIVO: Avaliar o estado nutricional de ferro e a prevalência de anemia em crianças menores de 5 anos de creches públicas da cidade do Recife (PE). MÉTODOS: Estudo transversal, com amostra aleatória sistemática de 162 crianças, de 6 a 59 meses. O estado nutricional de ferro foi avaliado em termos de reservas corporais (ferritina sérica), transferrinemia (ferro sérico, capacidade total de ligação do ferro e por cento de saturação da transferrina), eritropoiese (protoporfirina eritrocitária livre) e hemoglobinogênese (hemoglobina). RESULTADOS: A prevalência de anemia (hemoglobina < 11,0 g/dL) foi de 55,6 por cento (IC95 por cento 47,3-63,5), a redução dos estoques de ferro (ferritina sérica < 12,0 ng/mL) foi evidenciada em 30,8 por cento (IC95 por cento 22,9-39,3), baixa transferrinemia ( por cento de saturação da transferrina < 16) em 60,1 por cento (IC95 por cento 51,7-68,0) e eritropoiese deficiente (protoporfirina eritrocitária livre > 40 æmol/mol heme) em 69,6 por cento (IC95 por cento 61,0-77,1) das crianças. Os parâmetros de ferro não apresentaram correlação com o gênero (p > 0,05). No entanto, crianças < 24 meses apresentaram concentrações mais baixas de hemoglobina (p < 0,00) e níveis mais elevados de protoporfirina eritrocitária livre (p < 0,000) e de capacidade total de ligação do ferro (p < 0,001), quando comparadas às crianças > 24 meses. A significante correlação observada entre reserva, transferrinemia e eritropoiese representa achado compatível com o esperado ciclo de vida do ferro no organismo. CONCLUSÕES: A deficiência de ferro e a anemia parecem ser um importante problema de saúde pública entre as crianças menores de 5 anos de creches públicas do Recife. Logo, ações efetivas direcionadas à prevenção e ao controle dessa deficiência são fortemente recomendadas nesse contexto ecológico.

OBJECTIVE: To assess nutritional iron status and anemia prevalence in children less than 5 years old at public daycare centers in the city of Recife, PE, Brazil. METHODS: A cross-sectional study, with a systematic random sampling of 162 children aged 6 to 59 months. Nutritional iron status was assessed in terms of body iron reserves (serum ferritin), transferrinemia (serum iron, total iron binding capacity, and transferrin saturation percent), erythropoiesis (free erythrocyte protoporphyrin) and hemoglobin production (hemoglobin). RESULTS: The prevalence of anemia (hemoglobin < 11.0 g/dL) was 55.6 percent (95 percentCI 47.3-63.5), evidence was found of depleted iron stocks (serum ferritin < 12.0 ng/mL) in 30.8 percent (95 percentCI 22.9-39.3), low transferrinemia levels (transferrin saturation percent < 16) in 60.1 percent (95 percentCI 51.7-68.0) and deficient erythropoiesis (free erythrocyte protoporphyrin > 40 æmol/mol heme) in 69.6 percent (95 percentCI 61.0-77.1) of the children. Iron parameters were not correlated with sex (p > 0.05). However, children < 24 months exhibited lower hemoglobin concentrations (p < 0.00) and higher levels of free erythrocyte protoporphyrin (p < 0.000) and total iron binding capacity (p < 0.001) when compared with children > 24 months. The significant correlation observed between reserves, transferrinemia and erythropoiesis is a finding that is compatible with the expected lifecycle of iron in the body. CONCLUSIONS: Iron deficiency and anemia appear to be an important public health problem among children less than 5 years old at public daycare centers in Recife. Therefore, effective actions aimed at the prevention and control of this deficiency are strongly recommended in this ecological context.

Utilidad en el post parto de la determinacion de protoporfirina eritrocitaria y su relacion con el receptor soluble de transferrina / Usefulness of erythrocyte protoporphyrin test in the puerperium compared to the soluble transferrin receptor

Se estudió, en 77 puérperas, la relación entre la protoporfirina eritrocitaria (PE), la ferritina sérica(FS) el receptor soluble de transferrina (RsT) y los indicadores hematológicos utilizados en la rutina clínica. En sangre venosa se determinó: Hematocrito (Hto), Hemoglobina (Hb), recuento de glóbulos rojos (GR) yglóbulos blancos (GB) (contador electrónico MEGA); PE (Piomelli); en suero: Rst (ELISA, Orion Diagnostica), FS (ELISA, IMx Ferritina, Abbott) y Proteína C-Reactiva (PCR-Látex, Wiener lab.) Se analizaron sensibilidad (S), especificidad (E) y puntos de corte medienate el modelo ROC (Receiver Operating Characteristics), considerando como gold standard el RsT. Los resultados (media mayor o menor DE) fueron: Hto (%) 35 mayor o menor; Hb (g/l) 113 mayor o menor 18; GRx10 103/mm3 3,893 mayor o menor 489; VCM (fL) 90 mayor o menor 6; GB/mm3 9,543 mayor o menor 2,669; PE (microg/dl GR) 46 mayor o menor 39; RsT (mg/l) 4.7 mayor o menor 2.8; FS (microg/l) 26 mayor o menor 31; PCR (Pos/Neg) 72/5. La PE no correlacionó con FS, pero sí con el RsT (r=0.323, p=0.007). La S y E de la FS fueron de 83% y 63 %, respectivamente, para un punto de corte de 25 (microg/l); para la PE la S fue de 38% y la E de 90% para un punto de corte de 53 (microg/l) GR. Estos resultados sugieren que ese punto de corte en el puerperio, permitiría detectar con un bajo costo un mayor porcentaje de mujeres (16% en nuestro estudio) que presentan deficiencia de Fe pese a sus valores normales de hemoglobina.

Incidencia de la ß-talasemia en San Luis, Argentina: índices hematimétricos en la diferenciación entre ß-talasemia y anemia ferropénica / The frecuency of ß-thalassemia in San Luis, Argentina: hematimetric indexs in the differentiation between ß-thelassemia and ferropenic anemia

A fin de determinar la incidencia de la ß-talasemia en la provincia de San Luis, se analizaron 4400 muestras de pacientes que asistieron a hospitales públicos de toda la provincia. Se detectaron 390 anemias microcíticas (8.86 por ciento) de las cuales 7 resultaron ß-talasemia (0.16 por ciento del total) las que presentaron Hb A2 mayor de 3.5 por ciento. Para determinar las diferencias entre pacientes ferropénicos y ß-talasémicos se analizaron los datos de índices hematimétricos, hierro sérico, ferritina, transferrina, protoporfirina libre eritrocitaria, reticulocitos y HbA2. En pacientes talasémicos se observó que no hubo diferencias significativas en el valor de los índices hematimétricos respecto de los controles y ferropénicos, excepto que incrementó significativamente el contenido de reticulocitos y de HbA2. En pacientes ferropénicos se observó un incremento significativo de los valores de RDW y de protoporfirinas libres eritrocitarias respecto de los talasémicos y los controles. La incidencia de la ß-talasemia en la provincia de San Luis es de 1,6 por cada 1000 habitantes, la cual resulta inferior a la observada en otras provincias, probablemente por las corrientes migratorias que habitaron la región

Blood lead and erythrocyte protoporphyrin levels in Kazakhstan.

A pilot study was conducted to examine the extent of lead exposure and prevalence of iron deficiency in 3 major cities of Kazakhstan. Blood lead (B-Pb.) and erythrocyte protoporphyrin (ZnPP) levels of 475 children, age range 6 months to 7 yeas were measured. The mean B-Pb. levels in the different cities ranged from 4-7 micrograms/dl (minimum 1 to max 29 micrograms/dl) and similarly the mean ZnPP levels ranged from 26-32 micrograms/dl (minimum 12 and maximum 95 micrograms/dl), thus confirming low level lead poisoning of children at some sites. One to four year olds had greater than 10 micrograms/dl B-Pb in 18-27% cases compared with 3-7% cases in five to seven year olds. Prevalence of iron deficiency in 6 months to 4 year old children was the highest ranging from 28-86% compared with 4 to 15% in 4-7 year olds. However, there was remarkably low prevalence (4%) of iron deficiency in a group of 5-6 years olds. This study suggests that a targeted B-Pb and ZnPP monitoring together with an iron supplementation programme in the 3 cities of Kazakhstan is essential. Environmental education appears to have had a positive impact in lowering B-Pb at one site and should thus be expanded nationwide.

Lead exposure and iron deficiency among Jammu and New Delhi children.

In order to examine the prevalence of lead exposure and iron deficiency in Jammu, blood lead (B-Pb) and erythrocyte protoporphyrin (EP-ZnPP) levels were measured in a group of 125 children and compared with B-Pb and EP levels of 46 New Delhi children. The mean B-Pb level of Jammu children was 15 micrograms/dl and ZnPP level 46 micrograms/dl. The frequency distribution of B-Pb in Jammu children according to the 1997 CDC stratification showed that only 33% were below the 10 micrograms/dl "normal" threshold levels and 50.5% were between 10-19 micrograms/dl, an increasing level of concern. The remaining 16.5% were in the medical intervention lead poisoned level between 20-87 micrograms/dl with corresponding EP levels between 29-160 micrograms/dl. The mean B-Pb and ZnPP levels for New Delhi children were 14 micrograms/dl and 55 micrograms/dl respectively. This study on Jammu children shows a modest increase in mean B-Pb and EP levels from those in 1985; the percentage of children with higher levels of B-Pb > 10 micrograms/dl have significantly increased. Moreover, the continued underlying high prevalence of iron deficiency among these children predisposes them to increased lead absorption from various sources thus aggravating further, the detrimental effects of lead. Therefore, a more extensive screening of all children below 10 years of age and an ongoing B-Pb and EP monitoring and iron supplementation programme for Jammu and New Delhi is essential. An environmental assessment of the sources leading to serious lead intoxication problem in Jammu, a rapidly growing and overpopulated city of the state of Jammu and Kashmir is strongly recommended.

Efecto de la suplementación con hierro y su frecuencia en gestantes / Effect of iron supplementation and its frequency during pregnancy

Se estudiaron 203 gestantes, clinicamente sanas, asistidas en el Hospital Diego Paroissien (La Matanza, Provincia de Buenos Aires). A la primera visita médica prenatal (edad gestacional 16.9 semanas + 3.8) (To) fueron asignadas, al azar, a uno de tres grupos: G1 y G2 recibieron 60 mg de hierro (Fe) elemental (como fumarato ferroso) por día o cada 3 días, respectivamente; GC fue el control sin suplementar. Se realizó el seguimiento hasta la semana 34-37 de edad gestacional (Tf), en las gestantes que completaron el seguimiento (43 por ciento del total). A To y Tf se determinó, en sangre entera: hematocrito (Hto); hemoglobina (Hb); protoporfirina eritrocitaria (PE) (según Piomelli); en suero: ferritina (FERR) (ELISA). El porcentaje de gestantes con valores anormales, a To (n=203), para los indicadores estudiados fue: Hb (g/dl) <10.5: 2.6 por ciento; PE (mug/dl de glóbulos rojos) >70: 4.8 por ciento; FERR (ng/ml) <10: 4.4 por ciento. Los resultados de las mujeres que completaron el seguimiento (X + DE) fueron, a To y Tf, respectivamente: Hto (por ciento): GC 37.7 + 3.4 y 36.0 + 3.2 (p<0.05); G1: 38.8 + 2.2 y 38.0 + 2.6; G2: 39.0 + 2.7 y 37.7 + 3.7; Hb (g/dl): GC: 12.5 + 1.2; 11.9 + 1.3 (p<0.05): G1: 12.6 + 1.1.; 12.8 + 1.1; G2: 12.9 + 0.9; 12.2 + 1.5; PE (mug/dl glóbulo rojo): GC: 30 + 17; 43 + 22 (p<0.01); G1: 26 + 13; 38 + 21 (p<0.01); G2: 26 + 16; 31 + 26; FERR (ng/ml): GC: 75 + 67; 31 + 49 (p<0.01); G1: 46 + 34; 19 + 10 (p<0.01); G2: 43 + 11; 11 + 7 (p<0.01). Estos resultados evidencian: a) la suplementación con Fe evitó la disminución de Hb; b) los depósitos de Fe disminuyeron independientemente de la suplementación y de la frecuencia de administración; c)la variación de PE dependió de la frecuencia de la dosis, siendo más conveniente la administración intermitente para mantener una adecuada eritropoyesis.

Intoxicaçäo pelo chumbo: zinco protoporfirina no sangue de crianças de Santo Amaro da Purificaçäo e de Salvador, BA / Lead poisoning: zinc protoporphyrin in blood of children from Santo Amaro da Purificaçäo and Salvador, Bahia, Brazil

Um estudo epidemiológico de corte transversal avaliou a intoxicaçäo por chumbo em todas as 101 crianças de um a cinco anos de idade, residente num raio de 500 metros de uma fundiçäo de chumbo, a qual funcionava desde 1960 em Santo Amaro da Purificaçäo (BA). A intoxicaçäo por chumbo foi avaliada através de dosagem da concentraçäo de zinco protoporfirina em sangue total (ZPP). Os resultados foram comparados com aqueles obtidos para 98 crianças da mesma faixa etária, de uma creche de Salvador. Em Santo Amaro, a média geométricada ZPP foi de 65,5 µg/dl(DPG=1,7), muito acima portanto do limite de normalidade de 30,0 µg/dl recomendado pelo CDC-EUA. Uma criança, excluída das análises estatísticas, apresentou resultado de ZPP muito elevado: 789 µg/dl. Em Salvador a média geométrica de ZPP foi de 31,0 µg/dl(DPG=1,6). Valores de ZPP "extremamente elevados" (acima de 156,0 µg/dl) foram observados em 8 por cento das crianças de Santo Amaroe em nenhuma (0 por cento) das crianças de Salvador, sendo esta diferenca estatística altamente significante...

Valores normales del hemograma y otras variables hematológicas en sujetos mayores de 60 años / Standard values of blood cell count and other hematological counts in people older than 60 years old

We studied 36 men and 94 women aged 60 to 85 years, without nutritional deficiences or illness that could interfere with hematopiesis, to characterize the normal limits of red and white blood cell counts. Lower limit of hemoglobin normal values were 132 g/l for men and 125 g/l for women. The corresponding figures for MCV were 85 fl and 83 fl for men and women respectively. Lower and upper normal limits for leukocyte count in both sexes were 3.66 and 9.36 x 10 9/l. Hypersegmented neutrophils existed in 7 percent of men and 14 percent of women in spite that folate and vitamin B12 deficiencies were excluded. We concluded that blood cell counts of elderly people have mild deviations of normal values for young adults. Aged humans have a low white cell and bands counts, and elderly women have a higher hemoglobin concentration

Protoporfirina libre eritrocitaria en función de la edad de ratas en crecimiento / Free erythrocyte protoporphyrins related to age in growing rats

La protoporfirina libre eritrocitaria (FEP) detecta deficencias marginales de hierro (Fe) pero su aplicación a estudios poblacionales ha sido causa de discusión acerca de si la disminución en función de la edad, observada en los primeros años de vida, correspomde a un proceso fisiológico normal o a deficiencia de Fe. para interpretar esta observaciones se estudiaron ratas Wistar, que desde el destete hasta los 95 días (t95), recibieron una dieta isocalórica con 20 o 30// de proteinas (caseina), N2O y N3O, respectivamente, y cantidades de vitaminas y minerais adecuadas para la rata en crecimiento. Se registró cada tres días el peso corporal y el consumo de alimento; a los 26, 28, 33, 50, 65 y 95 días de edad, se determinó en sangre: Hemoglobina (Hb), Hematocrito (Hto) y FEP. Se calcularon las relaciones: a) µg FEP/dL de eritrocitos (g.r.); y b) FEP/Hb. Los resultados de Hb, FEP/dL g.r. y FEP/Hb, obtenidos para las distintas edades de ambos grupos estudiados, se analizaron meidante análisis de varianza de un criterio (ANOVA I), calculando la mínima diferencia significativa para un nível de p < 0,01. Los consumos de alimentos y los pesos corporales de los animales de igual edad de ambos grupos se compararon aplicando el test de Student. En ambos grupos, a lo largo de la experiencia, los pesos corporales se ubicaron dentro de los carriles de normalidad de los gráficos percentilados de Peso/Edad de nuestro vivero. Los valores de Hb y Hto se incrementaron y los de µg FEP/dL g.r. y de FEP/Hb disminuyeron significativamente, para ambos grupos, desde el destere hasta t95. En todos los casos las diferencias no fueron significativas entre N 20 y N30 para las mismas edades. Estos resultados, similares a los observados en la población infantil americana seleccionada para establecer los valores normativos, permiten concluir que: a) el modelo experimental es adecuado para interpretar la información suministrada por la FEP como indicador de estado nutricional con respecto al Fe; b) si el aporte de Fe es correcto se pueden mantener elevada velocidades de ganancia de peso (VGP), con aumento simultáneo de la Hb y disminución de la FEP; c) la disminución de la FEP desde el destete hasta la edad adulta refleja un comportamiento fisiológico normal, cuando no hay deficiencia de Fe

Iron nutritional status of preschool children.

Low hemoglobin and low MCHC levels were indicative of high incidence of iron deficiency in preschool children. The extent of iron deficiency as assessed by serum ferritin and free erythrocyte protoporphyrin showed a different trend. While FEP levels were highly suggestive of extensive iron deficiency (in 40-45% of children below the age of 5 years), low serum ferritin was seen in only 16-20% of children. The discrepant finding of high serum ferritin, and high erythrocyte protoporphyrin despite low MCHC in the present study, possibly reflects iron deficiency status along with chronic infection resulting in hyperferritinemia and hyperprotoporphyrinemia. It may be also due to associated folate deficiency resulting in non utilization of iron leading to the elevated levels of protoporphyrin.

Utilización de un micrométodo sencillo para la determinación de protoporfirina eritrocitaria libre por fluorimetría / Use of a simple micromethod for the determination of free erythrocyte protoporphyrin by fluorimetry

En 80 muestras de sangre heparinizada, procedentes de 40 sujetos sanos y de 40 que presentaban deficiencia de hierro, se determinó la concentración de protoporfirina eritrocitaria libre (PEL) por el micrométodo fluorimétrico descrito por Piomelli y por la técnica espectrofotométrica de Heller empleada en nuestro laboratorio. No se encontró diferencia significativa entre los valores obtenidos por los 2 métodos al aplicar la prueba t de Student para series apareadas (t = 0,90, p > 0,05) y se obtuvo un coeficiente de correlación de 0,99 (p < 0,001) al realizar el análisis de regresión lineal. El micrométodo fluorimétrico mostró un coeficiente de variación del 2,7

Ferritina sérica y protoporfirina eritrocitaria como indicadores de deficiencia de hierro en niños lactantes / Serum ferritin and erythrocyte protoporphyrin as iron deficiency indicators in infants

A nueve niños con anemia por deficiencia de hierro se les determinó el índice protoporfina eritrocitaria/hemoglobina (PPE:Hb) y los niveles de ferritina sérica antes, a los 15 y a los 30 días de administración de 2 mg de hierro/kg de peso/ día. Todos presentaron niveles anormales altos de protoporfirina y anormalmente bajos de ferritina, que descendieron y aumentaron respectivamente al administrarles el hierro. Estos cambios fueron estadísticamente significativos (p<0.05 ó mejor), aunque los valores no llegaron a igualar en ese tiempo los correspondientes a los niños controles a quienes también se les administró hierro. Por lo tanto, ambos indicadores resultaron muy sensibles para detectar la deficiencia de hierro y la respuesta al tratamiento. No obstante, el índice PPE:Hb, no logró identificar la deficiencia de hierro de reserva, pero es una prueba práctica, rápida y de bajo costo, en contraste con el radioinmunoensayo para ferritina sérica. Los valores de protoporfirina eritrocitaria fueron normales en estos niños, lo cual indica que este no es un buen indicador para detectar la deficiencia prelatente de hierro