不同临界点血清转铁蛋白受体对小儿缺铁性贫血的诊断价值

目的探讨血清转铁蛋白受体(sTfR)在儿童缺铁性贫血(IDA)诊断中的意义。方法6个月~12岁缺铁性贫血儿童50例及正常儿童20例均进行血红蛋白(Hb)、sTfR、血清铁蛋白(SF)、血清铁(SI)、总铁结合力(TIBC)测定,并将受测对象分为正常对照组(C组)、轻度IDA组(IDA1组)、中~重度IDA组(IDA2组),以不同浓度sTfR为临界点计算其诊断IDA的敏感度及特异度以确定最佳的诊断临界点。结果以sTfR浓度40nmol/L为缺铁性贫血的诊断标准时,其敏感度和特异度分别为90%和85%,为敏感度和特异度之和最大的临界点。结论当sTfR为40nmol/L时诊断IDA准确度最高,即为IDA的最佳临界点。     

血清铁蛋白在缺铁性贫血并感染中的诊断价值

目的 研究血清铁蛋白(SF)在并感染的缺铁性贫血(IDA)患儿中的诊断价值。方法 采用酶联免疫吸附试验,检测60例感染性疾病IDA患儿SF,其中38例骨髓铁染色显示铁缺乏患儿为A组[Hb(62.9±21.3)g／L],22例未做骨穿检查患儿为B组[Hb(83.3±16.4)g／L];同时检测20例患同类感染性疾病Hb正常患儿为对照组。结果 对照组SF为(170±150)μg／L,A组和B组分别为(40±32)μg／L、(53±37)μg/L,A、B组均明显低于对照组(P均<0.01)。在有骨髓铁染色作为金标准A组中,若分别以SF<14μg／L、<60μg／L、<100μg／L作为诊断界点,诊断缺铁敏感度分别为15.8％、73.7％、92.1％,约登指数分别为0.26、0.52、0.57,以SF<100μg／L为诊断界值准确性最好;在B组中若以同样几个界点作为判断缺铁标准,其敏感度分别为18.2％、63.6％、95.5％,约登指数为0.18、0.43、0.61,与A组相似。结论 在并感染性疾病的贫血患儿中,建议可将SF<100μg／L作为判断IDA的依据。     

二价金属离子转运蛋白-1和膜铁转运蛋白-1在不同铁状态孕妇胎盘中的表达

目的 测定二价金属离子转运蛋白-1(DMT1) mRNA剪切异构体和膜铁转运蛋白-1(FPN1) mRNA在不同铁状态足月孕妇胎盘中的表达水平,探讨胎盘铁转运及调控机制.方法 选择在郑州大学第一附属医院产科分娩的无高血压、糖尿病、感染、肿瘤、肝炎的足月孕妇69例,其中14例Hb＜100 g/L及血清铁蛋白(SF)≥12 μg/L者排除,符合条件者55例.根据母血Hb、血清铁(SI)、SF将孕妇分为3组:正常组(N组)23例,Hb≥100 g/L,SF≥12 μg/L;铁缺乏组(ID组)20例,Hb≥100 g/L,SF＜12 μg/L;轻度缺铁性贫血组(IDA组)12例,90 g/L≤Hb＜100 g/L,MCV＜80 fL,MCH＜27 pg,MCHC＜320 g/L,SF＜12 μg/L,SI＜8.95 μmol/L;采用血细胞自动计数仪测定其血常规,比色法测定其SI,放射免疫分析法测定其SF.采用反转录-PCR技术检测胎盘组织DMT1 mRNA剪切异构体及FPN1 mRNA表达水平.结果 1.N组、ID组及IDA组含铁反应元件的二价金属离子转运蛋白-1(DMT1-IRE) mRNA分别为(0.568 2±0.116 9)、(0.709 0±0.138 9)、(0.912 8±0.179 8),3组间比较差异有统计学意义(F=23.955 P＜0.01),两两比较亦有统计学意义(Pa＜0.01).2.N组、ID组及IDA组不含铁反应元件的二价金属离子转运蛋白-1(DMT1-nonIRE mRNA)分别为(0.738 0±0.224 0)、(0.806 1±0.212 8)、(0.766 7±0.210 8),3组间比较差异无统计学意义(F=0.562 P＞0.05);3.N组、ID组及IDA组FPN1 mRNA分别为(0.462 5±0.077 6)、(0.507 1±0.074 4)、(0.551 8±0.104 1),3组间比较差异有统计学意义(F=4.767 P＜0.05),其中IDA组与N组比较差异有统计学意义(P＜0.01),而ID组与N组、ID组与IDA组比较差异均无统计学意义(Pa>0.05).结论 ID及IDA孕妇可通过上调胎盘DMT1-IRE mRNA、FPN1 mRNA的转录最大限度的增加了母体血浆铁至胎儿的转运,以保证胎儿铁供给的相对恒定.     

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目的观察哮喘患儿血清可溶性细胞间粘附分子(sICAM1)和白介素8(IL8)质量浓度及其相关性。方法随机选择2003年10月至2004年6月温州医学院育英儿童医院收治的哮喘患儿急性发作期30例、缓解期30例,30名健康儿童为正常对照组,采用酶联免疫吸附试验(ELISA)测定3组血清sICAM1和IL8质量浓度,并分析其相关关系。结果急性发作组sICAM1为(268.56±24.76)μg/L,IL8为(38.06±8.77)μg/L;缓解期sICAM1为(204.90±25.00)μg/L,IL8为(8.85±1.47)μg/L;正常对照组sICAM1为(186.49±16.55)μg/L,IL8为(7.56±1.68)μg/L。sICAM1的组间差异显著(F=97.50,P<0.01);IL8的组间差异显著(H=64.97,P<0.01)。sICAM1与IL8呈正相关,相关系数r为0.80,P<0.01。结论儿童哮喘急性期sICAM1、IL8明显升高,二者呈正相关,在哮喘急性期炎症反应中sICAM1与IL8起相互协同和促进作用,是儿童哮喘急性发作期炎症反应发生的机制之一。     

血清可溶性转铁蛋白受体对缺铁性贫血的诊断价值

目的探讨血清可溶性转铁蛋白受体(sTfR)对儿童缺铁性贫血(IDA)的诊断价值。方法小细胞低色素性贫血患儿63例根据临床诊断标准分为IDA和非缺铁性贫血(n-IDA)组,测定sTfR及血清铁蛋白(SF)、血清铁(SI)等铁代谢指标,并分别行t检验和ROC曲线分析。结果IDA组sTfR均值高于正常值,与n-IDA组比较具有极显著差异(P<0.001),而IDA组SF和SI均值在正常参考值范围;尽管SF与SI特异度较高,但其敏感度和ROC曲线下面积明显较sTfR低。结论血清sTfR可较准确反映铁贮存状况,是诊断IDA的有效客观指标,在儿童铁缺乏疾病的鉴别诊断中具有重要价值。     

配对观察母婴间铁蛋白关系的研究：附108对分析

本文报道应用放射免疫法测定108对母婴铁蛋白(SF)值。结果新生儿SF明显高于其母亲(p<0.001),分别为339.38±158.9μg/L及29.43±30.04μg/L:新生儿3日内日龄及有无并发症和其SF值相关;85例正常新生儿SF值和胎龄、体重呈正相关。本文还比较了健康和缺铁性贫血母亲的新生儿SF值,前者为399.4±143.7μg/L,盾者力219.4±137.7μg/L,两组有高度显著差异(p<0.01),提示母亲缺铁贫血时影响新生几SF值。     

细菌性腹泻的内毒素血症：附33例分析

本文采用鲎试验合成基质偶氮显色法检测33例细菌性腹泻患者血浆内毒素值,并以44例正常健康儿童作为对照,检测结果:(1)正常儿童血浆内毒素值(x±s)为37.27±38.49pg/ml;(2)细菌性腹泻患儿血浆内毒素值为257.76±251.8pg/ml,细菌性腹泻急性期内毒素值明显高于对照组(P<0.01);(3)对其中20例患者急性期与恢复期血浆内毒素测定,急性期血浆内毒素值325.5±246.2pg/ml,恢复期血浆内毒素值为54.5±61.83pg/ml,提示恢复期较急性期明显下降(P<0.01);(4)细菌性腹泻有中毒症状组与无中毒症状组血浆内毒素值分别为362.3±276.9pg/ml及170.6±196.3pg/ml(P<0.05)。     

一氧化氮和一氧化氮合酶与慢性病贫血

目的测定慢性病贫血(anemia of chronic disease,ACD)患儿血清中一氧化氮(NO,ni-tric oxide)、可诱导型一氧化氮合酶(iNOS,inducible nitric oxide synthase)及血清铁蛋白(Fn,ferritin)浓度,以探讨三种物质的变化及它们在ACD中的作用机制,为ACD的防治提供实验依据。方法采用硝酸还原酶法和酶联免疫吸附法分别测定ACD患儿30例、健康对照组儿童21例血清中NO、iNOS及血清铁蛋白含量。结果①ACD组血清中NO浓度为157.13±28.75(μmol/L),健康对照组儿童血清中NO浓度为33.97±6.79(μmol/L),ACD组明显高于健康对照组(P<0.01),且与贫血程度呈正相关、与Hb含量成负相关(r=-0.66);②ACD组和健康对照组儿童血清中iNOS活力分别为30.66±8.70(U/ml)和9.58±3.72(U/ml),ACD组高于健康对照组,两者比较有显著性差异(P<0.01);③ACD组血清中iNOS活力与N0含量成正相关,相关系数为0.873;④ACD组血清中Fn均值为311.77±73.56(ng/ml),健康对照组儿童血清中Fn均值为31.82±13.80(ng/ml),ACD组高于健康对照组(P<0.01)。结论NO在ACD的发病中可能起重要作用,而NO主要是在iNOS的诱导下产生。ACD组中N0及诱导型一氧化氮合酶与血红蛋白含量成负相关,与贫血程度呈正相关,从而提示使用iNOS抑制剂或可抑制NO的产生,为临床治疗ACD提供新的途径。     

造血器官及血液疾病

891675 齐齐哈尔地区朝鲜族6个月～6岁儿童铁缺乏症的调查/韩国栋…∥中华血液学杂志。-1989,10(7).-366 调查704名儿童,采用随机数字表法选出220例,对其缺铁状况进行评价。结果正常者77例(35％);隐性缺铁(ID:Hb≥110g/L,FEP<0.63 μmol/L,SF≤20 μt g/L)116例(52.7％);红细胞内缺铁(IDE:Hb≥110,FEP≥0.63,SF≤20)14例(6.4％);缺铁性贫血(IDA:Hb<110,FEP≥0.63,SF≤20,FEP/Hb≥2.8,Ect<33％)13例(5.9％)。三期铁缺乏症共143例,合计患病率为65.0％,     

维生素D3对儿童桥本甲状腺炎TH1/TH2型细胞因子的影响

目的 在T细胞和单核细胞水平观察1α,25(OH)2D3对儿童桥本甲状腺炎(HT)TH1/TH2型细胞因子的影响,为1α,25(OH)2D3干预儿童HT TH1/TH2功能失衡提供理论依据.方法 以2003-07-2004-08重庆医科大学儿童医院收治的27例HT患儿为研究对象,以17名健康儿童作对照.将其外周血单个核细胞(PBMC)分成两份一份用于活化T细胞,另一份进一步分离出单核细胞并分别培养.设1α,25(OH)2D3干预组和对照组,收集培养上清液.ELISA检测上清液中干扰素(IFN)-γ、白细胞介素(IL)-4、IL-10、IL-12水平.结果 HT组PB-MC产生IFN-γ、IL-12质量浓度显著高于健康对照,分别为(2 146.15±355.01)pg/mL和(1 462.00±101.52)pg/mL(P＜0.01)、(119.18±28.65)pg/mL和(102.84±23.86)pg/mL(P＜0.01);而IL-4、IL-10的表达显著低于健康对照组,分别为(52.26±7.17)pg/mL和(59.32±4.21)pg/mL(P＜0.01)、(132.99±12.04)pg/mL和(171.41±35.72)pg/mL(P＜0.01).1α,25(OH)2D3干预后HT患儿IFN-γ、IL-12表达显著下调,分别为(1536.00±243.95)pg/mL(P＜0.01)、(98.57±11.98)pg/mL(P＜0.01);IL-10表达在HT组和健康对照组均上调,分别为(184.15±35.34)pg/mL(P＜0.01)、(223.77±53.36)pg/mL(P＜0.01);IL-4的变化不明显(P＞0.05);IFN-γ/IL-4比值显著降低,IL-10/IL-12比值显著升高.结论 在T细胞和抗原提呈细胞水平,1α,25(OH)2D3能通过抑制HT增强的TH1型细胞因子分泌,纠正TH1/TH2细胞因子失衡.理论上1α,25(OH)2D3可作为免疫调节剂改善儿童HT TH1/TH2细胞因子失衡.     

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目的探讨网织红细胞平均血红蛋白质量在小儿缺铁性贫血中的诊断价值。方法采用拜耳ADVIA120全自动血液分析仪检测50名健康儿童和59例临床诊断为缺铁性贫血患儿的外周血细胞和网织红细胞血红蛋白质量,同时用BeckmanCx9测定血清铁蛋白质量浓度,将所得数据进行统计学分析。结果血红蛋白(Hb)、平均红细胞体积(MCV)、单个网织红细胞平均血红蛋白(CHr)质量、血清铁蛋白(SF)在缺铁性贫血患儿明显低于健康儿童,而平均红细胞体积分布宽度(RDW)在缺铁性贫血患儿明显高于健康儿童。结论CHr质量作为诊断儿童缺铁性贫血的指标,具有重要的临床价值。     

Measurement of reticulocyte hemoglobin content to diagnose iron deficiency in Saudi children

Iron deficiency and iron deficiency anemia are common conditions in children, especially in developing countries. It is often difficult for the pediatrician to know which indices should be used in the diagnosis of these conditions in children. Reticulocyte hemoglobin (Hb) content (CHr) has been shown to be an accurate indicator of anemia, however whether its use suits the situation in developing countries or not is unclear. The aim of this study was to evaluate the value and effectiveness of using CHr as a method to diagnose iron deficiency and iron deficiency anemia in Saudi children. The samples for the study were collected from 305 children suspected to have anemia. Complete blood count, transferrin saturation (Tfsat), ferritin, circulating transferrin receptor (TfR) and CHr were measured. Three groups were defined, iron deficiency (Tfsat <20%, Hb >11 g/dL; n=120), iron deficiency anemia (Tfsat <20%, Hb <11 g/dL; (n=73) and controls (Tfsat >20%; n=112). The anemic group had significantly lower macrocytic anemia (MCV), mean corpuscular hemoglobin (MCH) and CHr. All of the variables in the anemia group were significantly lower than those of the control group except for the ferritin level. Compared to the control group, the iron deficiency group also showed significantly lower values except for transferrin receptor and the ferritin levels. CHr levels of <26 pg correlated well with anemic states. CHr together with a complete blood count may provide an alternative to the traditional hematologic or biochemical panel for the diagnosis of iron deficiency and iron deficiency anemia in young children and is cost-effective in developing countries. A CHr cut-off level of 26 pg is considered to be a reasonable indicator of anemic states.     

Reticulocyte parameters: markers of early response to oral treatment in children with severe iron-deficiency anemia

The aim of the present study was to determine the effects of exclusive oral iron supplementation (iron sulphate 2 mg/kg/die) in asymptomatic children with severe iron-deficiency anemia [median hemoglobin (Hb) level before treatment 6.3 g/dL; range 4.5 to 7 g/dL] and to investigate the accuracy of Hb, reticulocyte hemoglobin content (CHr), and absolute reticulocyte count (ARC) as markers for monitoring early response to treatment. The increase in ARC and CHr was statistically significant at day +3. There was a significant association between suitable logarithmic functions of the percentage increase in CHr and ARC at day +3 and the fraction of required Hb increase compared with baseline to reach the mean reference value for age and sex at day +14. If these results are confirmed in a larger population, ARC and CHr could be considered affordable and widely available markers to detect early responders to oral iron therapy, and to switch unresponsive children to parenteral iron supplementation or transfusion.     

Treatment of iron deficiency anemia and associated protein-losing enteropathy in children

PURPOSE: The aims of this study were to evaluate the response of oral iron treatment in children with iron deficiency anemia (IDA) fed whole cow's milk (WCM) or soy formula; to compare the incidence of fecal blood loss in infants fed WCM and soy formula; and to evaluate the incidence and relation of protein-losing enteropathy (PLE) and IDA by testing serum albumin, fecal blood loss, and fecal alpha1-antitrypsin (alpha1AT). METHODS: Twenty-four children with nutritional IDA were randomly assigned to receive either 16 oz WCM or soy formula daily. Both groups were treated with daily therapeutic oral iron during 12 weeks. Stool specimens for hemoglobin losses were collected at weeks 0, 3, 6, and 12. Levels of serum albumin and fecal alpha1AT were tested at diagnosis and when IDA was corrected. RESULTS: Anemia was corrected in 21 of the 24 children by week 6 or 12. Median fecal hemoglobin losses were not increased in either group at diagnosis or during treatment. Seven of 24 children had PLE at diagnosis with elevated fecal alpha1AT levels of 72 to 381 mg/dL that returned to normal after correction of IDA. Their initial fecal alpha1AT levels averaged 170 mg/ dL at diagnosis and 21 mg/dL after the IDA was corrected. Excessive WCM intake of 30 oz/day or more was present in 63% of the infants. CONCLUSIONS: Treatment of nutritional IDA with oral iron was just as effective with a limited quantity of either WCM or soy formula. Fecal hemoglobin losses were uncommon and did not differ in children at diagnosis or during treatment of IDA. PLE associated with IDA resolves when the IDA is corrected, but differences between children fed WCM or soy formula could not be detected.     

Diagnostic Yield of Upper Gastrointestinal Endoscopy in the Evaluation of Iron Deficiency Anemia in Older Children and Adolescents

Iron deficiency anemia (IDA) is frequent in childhood. Inadequate nutrition and gastrointestinal malabsorption are the frequent causes of IDA in children. But reduced iron absorption and insidious blood loss from the gastrointestinal tract has been identified as the most frequent causes of IDA in older children and adolescents. Therefore the authors evaluated the frequency and etiologies of the upper gastrointestinal system pathologies causing IDA in older pediatric population. Patients with known hematological or chronic diseases, heavy menstrual flow, and obvious blood loss were excluded from the study. Forty-four children between the ages of 9.5 and 17.5 years and diagnosed with IDA were enrolled. They underwent upper gastrointestinal endoscopy and biopsy from esophagus, stomach, and duodenum. Mean age and hemoglobin (Hb) levels of study group (32 boys, and 12 girls) were 14.6 ± 2.0 years and 7.9 ± 1.8 g/dL, respectively. Only 1 patient had a positive serology testing with anti-tissue transglutaminase and small bowel biopsy correlating with celiac disease. Endoscopy revealed abnormal findings in 25 (56.8%) patients (21 endoscopic antral gastritis, 2 active duodenal ulcers, and 2 duodenal polyps). Helicobacter pylori (HP) infection was identified by using antral histopathological evaluation in 19 of 44 children (43.2%). In 2 of duodenal samples, one patient had celiac disease, and the other one was diagnosed as giardiasis. In conclusion, there are different etiologies resulting in IDA in older children and adolescents. When older children and adolescents are found to have iron deficiency, HP infection and other gastrointestinal pathologies should be ruled out before iron deficiency treatment.     

Diagnostic yield of upper gastrointestinal endoscopy in the evaluation of iron deficiency anemia in older children and adolescents

Iron deficiency anemia (IDA) is frequent in childhood. Inadequate nutrition and gastrointestinal malabsorption are the frequent causes of IDA in children. But reduced iron absorption and insidious blood loss from the gastrointestinal tract has been identified as the most frequent causes of IDA in older children and adolescents. Therefore the authors evaluated the frequency and etiologies of the upper gastrointestinal system pathologies causing IDA in older pediatric population. Patients with known hematological or chronic diseases, heavy menstrual flow, and obvious blood loss were excluded from the study. Forty-four children between the ages of 9.5 and 17.5 years and diagnosed with IDA were enrolled. They underwent upper gastrointestinal endoscopy and biopsy from esophagus, stomach, and duodenum. Mean age and hemoglobin (Hb) levels of study group (32 boys, and 12 girls) were 14.6 ± 2.0 years and 7.9 ± 1.8 g/dL, respectively. Only 1 patient had a positive serology testing with anti-tissue transglutaminase and small bowel biopsy correlating with celiac disease. Endoscopy revealed abnormal findings in 25 (56.8%) patients (21 endoscopic antral gastritis, 2 active duodenal ulcers, and 2 duodenal polyps). Helicobacter pylori (HP) infection was identified by using antral histopathological evaluation in 19 of 44 children (43.2%). In 2 of duodenal samples, one patient had celiac disease, and the other one was diagnosed as giardiasis. In conclusion, there are different etiologies resulting in IDA in older children and adolescents. When older children and adolescents are found to have iron deficiency, HP infection and other gastrointestinal pathologies should be ruled out before iron deficiency treatment.     

血常规指标对儿童铁缺乏的预测作用

目的探讨血常规指标在筛查儿童铁缺乏中的预测价值。方法回顾性分析2017年6月至2019年5月浙江大学医学院附属儿童医院1443名6月龄~18岁健康体检儿童(男862名、女581名)的血常规指标及血清铁蛋白(SF)水平。以SF<20μg/L为铁缺乏判断依据,同时伴有贫血(6月龄~5岁血红蛋白<110 g/L,6~18岁血红蛋白<120 g/L)为缺铁性贫血(IDA)组:SF<20μg/L同时排除贫血为无贫血铁缺乏组,SF≥20μg/L合并贫血者为铁状态不明贫血组,SF≥20μg/L无贫血者为健康对照组。定量资料以±s或M(四分位间距)描述,组间比较应用方差分析或非参数秩和检验分析,并应用受试者工作特征曲线(ROC)分析血常规指标及低血红蛋白密度百分比(LHD)对IDA及铁缺乏的预测价值。结果1443名儿童年龄2.1(3.3)岁,健康对照组1061例,无贫血铁缺乏组292例,铁状态不明贫血组43例,IDA组47例。铁缺乏发生率高于贫血发生率[23.5%(339/1443)比6.2%(90/1443),χ2=169.76,P<0.01]。无贫血铁缺乏组LHD、红细胞分布宽度(RDW)均高于健康对照组[0.088(0.093)比0.073(0.068),0.131±0.013比0.126±0.008,P均<0.01],平均红细胞体积(MCV)、平均血红蛋白浓度(MCHC)均低于健康对照组[(80±4)比(83±4)fl,(326±9)比(329±8)g/L,P均<0.01];IDA组LHD[0.322(0.544)]、RDW(0.151±0.018)均高于无贫血铁缺乏组,MCV[(73±6)fl]、MCHC[(309±14)g/L]均低于无贫血铁缺乏组(P均<0.01)。MCHC、LHD、RDW、MCV预测铁缺乏的曲线下面积(AUC)分别为0.63(95%CI:0.60~0.67)、0.63(95%CI:0.60~0.67)、0.67(95%CI:0.63~0.70)和0.73(95%CI:0.69~0.76)。以MCV<80.2 fl、RDW>0.131或MCHC<322 g/L为界值,筛查铁缺乏的灵敏度分别为0.540、0.469和0.336,均高于血红蛋白筛查铁缺乏的灵敏度(0.139,χ2=121.70、87.47、35.56,P均<0.01)。结论血常规中MCV、RDW、MCHC均可作为铁缺乏的筛查指标,简便易于基层推广。     

Reticulocyte hemoglobin content for the diagnosis of iron deficiency

SUMMARY: Identification of iron deficiency (ID) is essential to initiate early treatment to prevent long-term systemic complications of ID anemia. This study was undertaken to evaluate the efficiency of the parameter reticulocyte hemoglobin content (CHr) compared with other laboratory parameters in the assessment of ID in a pediatric population. Blood samples were obtained for 237 children who received routine pediatric care visits in a primary care clinic (mean age: 63.7 mo; male:female ratio: 1.08:1). A multiple stepwise logistic regression analysis identified CHr as the most accurate marker independently associated to ID. A CHr cutoff value of 25 pg (sensitivity: 94%; specificity: 80%) proved an optimal performance predicting ID. Therefore, we conclude that the hematologic parameter CHr constitutes a valuable screening tool for the identification of ID with or without anemia in childhood.     

HEMORHEOLOGICAL PARAMETERS IN CHILDREN WITH IRON-DEFICIENCY ANEMIA AND THE ALTERATIONS IN THESE PARAMETERS IN RESPONSE TO IRON REPLACEMENT

Aim: Iron-deficiency anemia (IDA) is a common disorder in pediatric patients. There are a limited number of studies having controversial results in investigating red blood cell (RBC) deformability and aggregation in adult IDA patients. The aim of this study is to determine the change of hemorheological parameters, including RBC deformability, aggregation, and plasma and whole blood viscosity, in children with IDA following iron supplementation therapy. Materials and Methods: The study was performed on 20 children with IDA (average age 35.5 ± 6.5 months) and 20 age-matched healthy children. The anemia group was treated with 5 mg/kg/day peroral iron for 2 months. Hematological and hemorheological parameters were determined before and after treatment. An ectacytometer was used for the assessment of RBC deformability and aggregation and a cone-plate rotational viscometer for plasma and whole blood viscosities. Hematological parameters were determined using an electronic hematology analyzer. Results: Although IDA resulted in a decrement in RBC deformability, aggregation, plasma, and whole blood viscosities, these parameters returned to control values after iron supplementation therapy. Serum ferritin levels and hematological parameters (Hb, MCV, MCH, MCHC) that were lower in IDA patients were also found to be increased after treatment. Conclusion: Iron treatment not only reverses the symptoms of anemia but also may contribute to blood flow regulation by causing increments in the alterations observed in hemorheological parameters during anemia.     

Leukocyte DNA damage in children with iron deficiency anemia: effect of iron supplementation

Iron deficiency is frequently associated with anemia. Iron is a transition-metal ion, and it can induce free radical formation, which leads to formation of various lesions in DNA, proteins, and lipids. The aim of this study was to investigate baseline oxidative DNA damage and to clarify the role of the administration of a therapeutic dose of iron on DNA oxidation in children with iron deficiency anemia (IDA). Twenty-seven children with IDA and 20 healthy children were enrolled in the study. Leukocyte DNA damage (strand breaks and Fpg-sensitive sites) was assessed using comet assay before and after 12 weeks of daily iron administration. Before the iron administration, the frequency of DNA strand breaks in the children with IDA was found to be lower than those in the control group (P < 0.05), but there was not a significant difference for frequency of Fpg-sensitive sites. After 12 weeks of iron administration, the frequency of both DNA strand breaks and Fpg-sensitive sites were found to be increased (P < 0.01). No significant association was determined between DNA damage parameters and hemoglobin, hematocrit, serum iron, total iron binding capacity, and ferritin. In conclusion, basal level of DNA strand breaks is at a low level in children with IDA. After iron administration, DNA strand breaks and Fpg-sensitive sites, which represent oxidatively damaged DNA, increased. However, this increase was unrelated to serum level of iron and ferritin.