Transferrina carbohidrato deficiente, gammaglutamil transferasa y volumen corpuscular medio en la evaluación de la ingesta alcohólica reciente de bebedores excesivos / Carbohydrate deficient transferrin for the assessment of recent alcohol intake in excessive drinkers

Background: There are no reliable markers to detect heavy drinking or as a tool to control abstinence compliance in alcoholic treatments. The Mean Corpuscular Volume (MCV), and the gammaglutamyl transpeptidase (GGT), are widely used although their predictive value is somewhat limited due to their low specificity. On the other hand, the Carbohydrate-deficient transferrin (CDT) described in the eighties is highly specific and would be of value in early detection of problem drinking. Aim: To compare the sensitivity and specificity of CDT, GGT, and MCV in order to evaluate their single and combined use as markers for detection of heavy drinking behaviour. Patients and Methods : CDT, GGT, and MCV values were determined in blood samples from (a) alcoholics (drinking more than 100 9 alcohol/day; n=47) and (b) healthy volunteers, teetotalers from the Church of Saints of Later Days (n=34). At the time of sampling alcoholics were presently drinking or had been abstinents for no more than six weeks. ROC curves were used to determine the best cut-off point for each marker. Results: Sensitivity was found to be similar for all three markers. Specificity was found higher for GGT (90.9 percent) and CDT (91.0 percent). The combined use of MCV, GGT and CDT, that is, when at least one of the markers is altered, was shown to detect 83 percent of the patients. No correlation was observed between the markers and the level of alcohol intake. Conclusions: CDT could be of value as a marker to detect heavy drinking when used with GGT and MCV values combined. CDT is particularly higher in drinking alcoholics and remains significantly high for at least six weeks after they stop drinking

Serum transferrin deficiency in neonatal respiratory distress syndrome

Serum transferrin was estimated by turbidimetry in 10 neonates with respiratory distress syndrome [RDS] and also in cord blood samples from 10 preterm babies and 7 infants of diabetic mothers [IDM] as risk groups for RDS. Ten full term healthy babies were included at birth as a control group. The mean serum transferrin values were significantly low in the groups of RDS [162.6 +/- 26 mg/dL] and preterm infants [169.2 +/- 22.1 mg / dL] as compared to the IDM [210.7 +/- 18.7 mg / dL] and the healthy babies [212.7 +/- 47.1 mg / dL]. It is possible that prematurity may developmentally lead to a decreased serum transferrin level and consequently to the availability of free [unbound] iron ready to catalyze the peroxidation of surfactant in the alveoli. By follow up, infants of RDS who had afatal outcome were more transferrin deficient than those who recovered. Moreover, the preterm infants and the IDM who developed RDS later had significantly lower cord blood transferrin concentrations than those who grew normally. We recommend screening of infants at risk of developing RDS for cord blood transferrin. lron chelation in RDS is worth trial and breast feeding and plasma transfusion as sources of antioxidants may offer adjuvant lines of prevention and treatment of RDS

Sobrecarga de hierro en atransferrinemia hereditaria / Iron overload in hereditary atransferrinemia

En un niño con diagnóstico de atransferrinemia hereditaria, la presentación de dos cuadros que sugerían hepatitis viral, determinó la práctica de una biopsia hepática percutánea que mostró lesión hepática severa por sobrecarga de Fe. La combinación de flebotomía con reposición del volumen a base de plasma normal, permitió la remoción de 3877.5 mg de Fe en 8 meses. En la revisión de la literatura, no se encontró mención del empleo de un tratamiento similar en el manejo de la sobrecarga de Fe en atransferrinemia hereditaria, tal vez por el corto número de familias informadas con esta enfermedad