Showing 26 results for Iron
Seyed Jalil Mirmohammadi, Azam Sadat Hashemi, Azadah Souzani, Khadijeh Dehghani, Atef Atefi, Zahra Zareian Yazdi,
Volume 1, Issue 1 (11-2010)
Abstract
Abstract
Objective
The incidence of childhood cancer has been increasing nearly one percent per year for the past two decades. Leukemia and lymphoma are the most common types of childhood cancers. This study assessed the relation between environmental factors (Hydrocarbon, agricultural toxin, insecticide) and leukemia/lymphoma in children, which was evaluated by the frequency of the parents’ hazardous occupations, and their smoking, drug addiction, and alcoholism habits.
Methods
This was a case-control study on 86 children with leukemia and non-Hodgkin's lymphoma and 188 healthy controls from March 2007 till March 2010. They were matched in age and sex. Information was gathered via a questionnaire and analyzed by SPSS 15.
Result
There were 32 (37.2%) girls and 54 (62.8%) boys in the case group and the majority were 3-5 years old. In case group fathers’ occupations were mostly farmers 50 (58.1%), followed by painter or exposed to hydrocarbons 14 (16.6%), but in the control group, farmers were 17 (19.7%), and painters or those exposed to hydrocarbons were 5 (5.8%). The frequency of fathers' various occupations was significantly different between cases and controls. In addition, smoking, drug addiction and alcoholism was significantly higher in cases fathers than controls fathers.
Conclusion
The frequency of leukemia and non-Hodgkin's lymphoma in children whose father were painters, exposed to hydrocarbons and farmers are higher than normal children. So people with these occupations should pay more attention and should be protected against these risk factors. The history of addiction and alcoholism was higher in their father.
Md S Akhavan Karbasi , Md R Fallah , Md B Tirandazi , Md M Golestan ,
Volume 3, Issue 1 (3-2013)
Abstract
Abstract
Background
Febrile seizure (FS) is the most common childhood seizures which occur in 2-5% of children. Studies about association between iron deficiency and febrile seizure have shown contradictory results. The purpose of this study was to compare the iron status of children with first febrile seizure and healthy control group.
Materials and Methods
In an analytic case-control study , iron status of 6 to 60 months old admitted children with first FS to Shahid Sadoughi Hospital from December 2011 to August 2012 was evaluated and compared with healthy age and sex matched control children whom were referred for routine health care to primary health care center of Azadshar Yazd, Iran.
Results
Forty five (44%) girls and 55 boys with a mean age of 23.7 ± 14.3 months were evaluated. In children with FS , hemoglobin level (11.46 ± 1.18 g/dl vs. 11.9 ± 0.89 g/dl, p= 0.042) , serum iron levels (48.91 ± 22.96 μg/dl vs. 75.13 ± 35.57 μg/dl , p= 0.001) and serum ferritin level (38.52 ± 11.38 ng/ml vs. 54.32 ± 13.46 ng/ml, p= 0.001) were lower than in healthy children group .
Iron deficiency (48% vs. 28% , odds ratio 4.3, p=0.03) and iron deficiency anemia (22% vs. 10% , odds ratio = 3.16, p= 0.04) were more frequent in children with FS.
Conclusion
Based on the result of this study, iron deficiency could be an important risk factor for development of febrile convulsion. Evaluation of iron status is encouraged to be performed in children with febrile seizure.
Md F Abrishami , Md A Golshan ,
Volume 3, Issue 4 (12-2013)
Abstract
Background
Iron deficiency is one of the most prevalent anemia. 2 million people in the world suffer from it. All young girls are at higher risk for iron defiency anemia, therefore,diagnosis and prevention of this anemia in the young age is very important.
Materials and Methods:
A total of 1500 high school girls educated in five regions of education of Mashhad (ages 14-18 years) were studied. Cell blood count (CBC), serum iron, total iron binding capacity(TIBC),ferritin and peripheral blood smear were performed .
If mean corpuscular volume (MCV) was less than normal(<76fl) and Red blood cell (RBC) was more than normal(>5×106/mm3 ), hemoglobin electrophoresis was subjected to test by methods of cellulose acetate to check the possibility of thalassemia minor.The data was analyzed by SPSS(version19) and Minitab software.
Result:
This is a descriptive cross sectional research. From 1500 under-experiment people,1094 cases (72.9%) were non-infected, 310 cases(20.7%) had iron deficiency anemia, and 96 cases(6.4%) had other disorders such as thalassemia.
In girls with anemia, 272 cases (87.7%) were in stage I, 17 cases (5.5%) in stage II and 21 cases (6.8%) in stage III. The average age in stage I was higher than stage II and III. . Mean and standard deviation for Hb, Hct, MCV, MCH, MCHC, Fe, TIBC and Ferritin had significant difference in infected and non-infected group.
Conclusion
This study revealed that the prevalence of iron deficiency anemia in young girls are moderate, so that it is important to reduce the prevalence of iron deficiency anemia in young girls.
S Bani , A Hassanpour- Siahestalkhi , Sh Hassanpour, S Mommad- Alizadeh- Charandabi , M Mirghafourvand, Y Javadzadeh,
Volume 4, Issue 1 (3-2014)
Abstract
Background
Iron deficiency anemia is a global health problem, and approximately 50% of anemia is caused by iron deficiency. According to studies, iron supplementation in young females improves iron status by increasing concentration of hemoglobin. To compare of prescribing two methods of iron supplementation administered either on a weekly basis or during menstruation, on hemoglobin level and menstrual blood¸ this double blind Randomized clinical trial study was carried out among female students in Tabriz, Iran.
Materials and Methods
In this double-blind randomized clinical trial, 150 female students allocated randomly in two groups. (75 students took an iron tablet weekly and 75 students took an iron tablet for first four days during their menstruation cycle for 16 weeks). Before and after intervention, the level of hemoglobin was measured and Higham chart was completed by
participants in each group. Chi-square, independent
t-Test, paired t-Test and ANCOVA were used for data analysis.
Results
There was no significant difference between two groups in terms of demographic characteristics, hemoglobin level and amount of menstrual bleeding before and after intervention (p>0.05). Taking iron supplement increased significantly the level of hemoglobin in each group (p<0.001). However, there was no significant difference in amount of menstrual bleeding (p>0.05) when comparing the data before and after intervention in each group.
Conclusion
The two iron supplementation methods (menstrual bleeding period and weekly) have similar results on Hemoglobin level and menstrual bleeding.
Dr A Eghbali, Dr H Taherahmadi , Dr M Shahbazi, Dr B Bagheri , Mrs L Ebrahimi ,
Volume 4, Issue 1 (3-2014)
Abstract
Background
Frequent blood transfusion is often associated with iron overload. Proper use of iron chelators to treat iron overload requires an accurate measurement of iron levels. Magnetic resonance T2-star (T2* MRI) can measure iron level in the heart and liver. Our goal was to see whether an association exists between serum ferritin level and T2* MRI in patients with major beta thalassemia.
Materials and Methods
Sixty patients with a diagnosis of major beta thalassemia were enrolled in the study. They were older than five years old and needed regular transfusion.
Cardiac and hepatic T2*MRI and mean serum ferritin levels were measured within 3 months.
Results
No significant correlation was observed between serum ferritin level and cardiac T2*MRI (p=0.361, r=-0.120).However, a significant correlation was observed between serum ferritin and liver T2*MRI (p=0.021, r=-0.297).
Conclusion
Our results showed an association between hepatic T2*MRI and serum ferritin level.
Dr M Ordooei, Dr M Akbarzadeh , Dr R Soleimanizad , Mrs F Shamsi , Dr R Masoumi Dehshiri ,
Volume 4, Issue 3 (9-2014)
Abstract
Background
Endemic goiter is present in most parts of Iran. Iron deficiency adversely affects the physiology of thyroid. The initial steps of thyroid hormone synthesis are catalyzed by thyroperoxidases and are dependent on iron. In many developing countries, children are at high risk of both goiter and iron deficiency anemia. In addition, iron deficiency may alter central nervous system control of thyroid metabolism andalso Iron-deficiency anemia decreases plasma concentrations of thyroxine and triiodothyronine.
Material and method
We conducted a randomized, double-blind,controlled trial in 2-12-y-old children with euthyroid goiter and without iron-deficiency anemia.
The children weredivided into two groups: The Patients who were under treatment with ferrous-sulphat and controls .active treatment consisted of iron supplementation was administered orally with a dose of 2 mg/kg day. The duration of active treatment was 12 weeks.
Results
In this study 40 children (female: 22, male: 18) were divided into two groups randomly. (20 patients in each group).There were no significant differences at baselines between groups with regard to gender, age and weigh.
At the end of the study, the reduction of more than one grade of goiter was significant between iron-treated and placebo groups. In treatment group, 16 patients (80%) had decreased grade of goiter, while in the control group, 3 patients (15%) had grade reduction(P-value<0.001).
Conclusion
At the end of the study, decrease of more than one grade of goiter had significant differences between iron-treated and control groups.
Mr Sharif , M Madani , F Tabatabaie ,
Volume 4, Issue 4 (12-2014)
Abstract
Background
Obese children are at the risk of micronutrient deficiency especially iron deficiency. Given the importance of iron deficiency in this age group and considering the existing discrepancies, present study was performed with the aim of evaluating iron deficiency in obese children.
Material and Method
This study was conducted, in the form of a case-control study, on 100 children aged between 5 to 15 during June and November 2013 in Kashan. Cases consisted of 50 obese children and controls were 50 children who were not obese.Blood sample was drawn to check for serum iron, total iron binding capacity (TIBC) by biochemistry method and plasma ferritin by ELISA method. The obtained data were entered into SPSS software version 16 and statistically analyzed. P < 0.05 was identified as statistically significance.
Results
The mean values of serum iron were 52.38 and 64.50 microg/dL for the case and control groups (P<0.02).
TIBC levels in obese and non-obese Children were 434.80 and 382.28 microg/dL (P<0.008). The ferritin level in the study group was 70.56 versus 68.06 ng/ml in the control group (P=0.79). In the obese children group, 8.3% (n=2) of children with iron deficiency had ferritin levels less than 15 while in control group 100% (n=14) of iron deficient children had ferritin levels below 15 (P<0.001).
Conclusion: In our study, mean serum iron levels were lower among obese children in comparison with control group. However, ferritin concentrations were similar in both groups. It is supposed that due to inflammatory state caused by obesity, serum ferritin levels are naturally higher in obese people. It is suggested that higher levels of ferritin considered as normal reference values in obese people.
H Bazmamoun , Z Razavi , H Esfahani , Ms Arefian ,
Volume 4, Issue 4 (12-2014)
Abstract
Background
Recent studies suggest an association between H. pylori infection and disorders such as iron deficiency anemia and growth delay. Considering the high prevalence of H. pylori infection and iron deficiency anemia, this study was performed in order to evaluate their relevance in children undergoing an upper endoscopy.
Materials and Methods
In this case-control study, children aged 2 to 16 years old, undergoing endoscopy from March 2012 to March 2013 at Besat Hospital of Hamedan, were selected. Participants were divided in H.Pylori infected and non-infected groups. Then the two groups were compared in terms of body mass index (BMI) and the incidence of iron deficiency anemia. The presence of Helicobacter pylori infection in children was confirmed by Giemsa staining of gastric biopsy specimens. Collected data was analyzed by SPSS 17.0 (SPSS Inc., Chicago, IL) and t-test and chi-square.
Results
In this study, 200 children (94 male and 106 female) were evaluated. The most common presenting symptom in both groups was abdominal pain. 8.2 % (9 cases) of the infected patients and 10.5% (10 cases) of the non-infected patients had iron deficiency anemia which this difference was not statistically significant (p=270). Also, no statistically significant difference was noted between the two groups in terms of gender (p=0.32), hemoglobin (p=0.35), Ferritin levels (p= 0.275) and body mass index (p= 0.273).
Conclusion
The results of this study not showed an association between H. pylori infection and iron deficiency anemia or body mass index in studied children
Sh Gheibi, Hr Farrokh-Eslamlou, M Noroozi, A Pakniyat ,
Volume 5, Issue 1 (3-2015)
Abstract
Background
Since the discovery of Helicobacter pylori, several clinical reports have demonstrated that H. Pylori infection has emerged as a new cause of refractory iron stores in children. We carried out a systematic literature review to primarily evaluate the existing evidence on the association between childhood H. Pylori infection and iron deficiency anemia (IDA) and secondly, to investigate the beneficial effects of bacterium elimination.
Material and Methods
This review concerns important pediatric studies published from January 1991 to October 2014. Fourteen case reports and series of cases, 24 observational epidemiologic studies, seven uncontrolled trials, and 16 randomized clinical trials were included in the review.
Results
Although there are a few observational epidemiologic studies and some randomized trials mostly due to the potential confounders, most studies reported a positive association linking between H. Pylori infection and iron deficiency or iron deficiency anemia among children. In addition, it seems that elimination of H. Pylori infection induces beneficial effects on iron deficiency.
Conclusions
Since the evidence for the association of H. pylori eradication therapy and refractory childhood IDA is not enough and there are contrasting data about such association, future high quality and cohort researches are needed to determine the causal association.
Ms N Valizadeh, Mr V Alinejad, Mr S Hejazi, Mr M Noroozi, Mr A Hashemi, Mr B Rahimi, Mr Sh Nateghi,
Volume 5, Issue 4 (12-2015)
Abstract
Abstract
Background
Iron overload is the main transfusion related side effects in patients with transfusion dependent hemoglobinopathies. Severe iron deposition in tissues leads to organ dysfunction. Many organs can be affected such as heart, liver, and endocrine organs. Cardiac failure and liver fibrosis are the consequent of Iron overload in transfusion dependent hemoglobinopathy. Magnetic Resonance Imaging (MRI) is a safe, noninvasive, and accurate method for the assessment of iron deposition in different tissues. This study assessed iron levels in liver and heart of the patients with transfusion dependent hemoglobinopathies.
Materials and Methods
The studied population consisted of 12 patients (7 male and 5 female) with transfusion dependent hemoglobinopathies, aged between 10-18 years old. Then, Cardiac and liver T2*-weighted magnetic resonance imaging (MRI) were obtained.
Results
In current study, 1patient (8.33%) had severe, 2 patients (16.66%) had moderate and 2(16.66%) had mild cardiac iron deposition. Out of 12 patients, 1 had severe iron deposition in liver (8.33%), 5(41.66%) and 4(33.33%) had moderate and mild hepatic iron deposition, respectively. Differences between Hepatic and cardiac iron levels were not significant between males and females (p>0.05).
Conclusion
Since cardiac and liver iron levels were higher than normal in most of the study group, checking ferritin level and liver function test and also echocardiography in shorter intervals (each 3 months) in involved group is suggested instead of checking routinely in 6 month intervals in patients with transfusion dependent hemoglobinopathies.
Dr H Dalili, Dr A Baghersalimi, Dr S Dalili, Dr F Pakdaman, Dr A Hassanzadeh Rad, Dr M Abbasi Kakroodi, Dr Sm Rezvany, Dr Sh Koohmanaei ,
Volume 5, Issue 4 (12-2015)
Abstract
Background
In the early months of life, Breastfeeding
increases chance of survival, reduces
recovery time after disease and mortality
due to infections such as diarrhea and
acute respiratory infections. However,
infants who are exclusively breast-fed for
more than 6 months in developing
countries may be at increased risk of
anemia. Therefore, the aim of study was to
assess the relation between duration of
breastfeeding and anemia.
Materials and Methods
In this analytical cross-sectional study, 400
neonates registered in primary health care
system since birth time. Complete blood
count and serum ferritin were obtained.
Data were analyzed by chi- square test and
regression analysis. P-value less than 0.05
was considered significant and 95%
confidence interval was noted.
Results
Results of this study showed that 199
infants were anemic (Hemoglobin (Hb)
concentration <11 mg/dl). Ten percent of
anemic patients reported Ferritin< 12ng/dl
and %25 of anemic children had iron
deficiency anemia (IDA). In Binominal
logistic regression, merely kind of delivery
and duration of breastfeeding were
effective factors. Binominal logistic
regression also showed that natural vaginal
delivery and exclusive breastfeeding up to
6 months had a significant influence on
anemia. Exclusive breast feeding for 6
months or more increased the likelihood of
anemia. In addition, 4 months exclusive
breastfeeding decreased 0.686 fold the
likelihood of anemia.
Conclusion
It seems that revision of health program
recommendations for iron supplementation
can be constructive. National planning to
promote the level of knowledge regarding
natural vaginal delivery and appropriate
period for clamping can be recommended.
Dr Sh Gheibi, Dr M Noroozi, Dr S Hejazi, Dr M Karamyyar, Dr H Farrokh-Eslamlou,
Volume 6, Issue 1 (3-2016)
Abstract
Abstract
Background
Iron-deficiency anemia is a widespread public health problem with major consequences for human health especially, children. However, in a fraction of patients an underlying cause is never found during routine investigation. Recent studies have
suggested an association between Helicobacter pylori (H. Pylori) infection and iron-deficiency anemia.
Case presentation
Here is reported four school aged children (two male, two female) with refractory severe iron-deficiency anemia associated
H. Pylori gastritis. Mean age of the patients was 13.62 years old and they were admitted with chief complaints of abdominal, chest pain weakness, headache and respiratory distress. Mean hemoglobin level in patients was 6.2 g/dl with persistence to iron therapy. After the diagnosis and therapy of H. pylori infection, clinical complaints, hemoglobin level and iron profiles were being normal and they gained weight.
Conclusion
This study suggests screening of H. pylori infection and appropriate treatment in any case of refractory moderate to severe irondeficiency anemia, especially with clinical manifestations of gastrointestinal tract in children.
Dr Ali Ghasemi, Dr Alireza Ataei Nakhaei, Dr Anahita Alizadeh Ghamsari, Dr Maryam Salehi, Dr Farnaz Kalani-Moghaddam,
Volume 7, Issue 2 (3-2017)
Abstract
Background: Opium is a new source of lead and considered as a cause of lead poisoning. As anemia and lead poisoning affect growth and behavior negatively, their timely prevention, diagnosis, and treatment are essential. The aim of thi study is evaluation of the prevalence of anemia, iron deficiency anemia, and lead poisoning in children with opioid toxicity.
Materials and Methods: In this cross-sectional study, 150 children admitted to the pediatric poisoning unit of Imam Reza hospital, Mashhad, Iran from May 2015-2016 were divided into two groups of methadone/tramadol and raw opium toxicity. For each child hematocrit, hemoglobin, RDW (red blood cell distribution width ), MCV (mean corpuscular volume), CRP(C-reactive protein), and blood lead level (BLL) were tested. One hundred children without opioid toxicity from a simultaneous study were considered as control group and compared with our patients regarding BLL.
Results: The patients’ mean age was 33.08±33.35 months. The prevalence of anemia and lead poisoning was 40% and 83.3%, respectively; neither indicating a significant difference between the M/T and opium groups (p=0.241, 0.227). On the other hand, 125(83.3%) and 63(63%) cases and controls had lead poisoning (BLL>5µg/dl), respectively, showing a significant difference (p<0.001). Lead poisoning was not significantly different between the controls and the cases under 2 years of age (p=0.085).
Conclusion: A single episode of opioid toxicity does not result in anemia. However, a significant difference was observed between the cases and controls regarding lead poisoning. Although the BLL in the cases under two years of age was higher than the controls, the difference was not significant.
Dr , Mr ,
Volume 8, Issue 1 (1-2018)
Abstract
Background: This study primarily aimed to investigate the possible association between the risk of suffering from Iron Deficiency (ID) and body weight status among a group of obese, overweight, and normal body weight children. The second aim of this study was to assess Serum Iron (SI), Serum Ferritin (SF), Total Iron Binding Capacity (TIBC), Hemoglobin (Hb), and Body Mass Index (BMI) among the recruited children.
Materials and Methods: In this case-control study, a total of 150 disease-free children aged between 6-59 months were recruited conveniently from Amman. Children were grouped as normal body weight, overweight, and obese. BMI and BMI Z-scores were determined and the intake of many macro- and micronutrients were estimated. Serum iron, SF, TIBC, and Hb were measured to detect the presence of ID.
Results: The mean concentration of SI was significantly higher in normal body weight than in overweight and obese children. The mean concentration of TIBC was significantly lower in normal body weight children than that in overweight and obese children (P<0.05). Nutrients intake findings showed that daily intakes of saturated fat and sugar were significantly higher in overweight and obese children than those in normal children. Iron intake was significantly lower in normal body weight than in obese children. The daily intake of selenium was significantly higher among normal body weight and obese children than overweight children (p<0.05).
Conclusion: This study supports the findings of the presence of an association between weight gain and ID despite that iron intake among obese children was higher than those with normal body weight.
Dr Azam Hashemi, Dr Zahra Bahrololoomi, Dr Samaneh Salarian,
Volume 8, Issue 2 (2-2018)
Abstract
Background: Early childhood caries (ECC) is one of the important caries occuring in children under the age of 6. ECC is defined as possible risk factor for iron deficiency-related anemia. In this review study, the current evidence about the effect of ECC on the prevalence of anemia was studied.
Material and Methods: A systematic review on ECC and anemia was done based on published article in PubMed and Google scholar databases. The search profiles included ECC/risk factor, SECC/ risk factors, ECC/anemia, ECC/ferritin, and ECC/iron deficiency. Inclusion criteria comprised of all studies that focused on ECC and anemia or related fields.
Results: A total of 3546 articles on early childhood caries were identified in PubMed and google scholar databases. After screening the titles and abstracts as well as limitation the subjects to ECC and risk factors, 175 articles underwent further investigation, of which 12 articles on ECC and anemia were finalized. Other research efforts in this regard had been made through theses and reported in non-PubMed English journals; thus, Conducting further search by Google, 3 more relevant articles were discovered.
Conclusion: According to this literature review on ECC and anemia, it is suggested to consider ECC as one of the risk factors for iron deficiency and anemia in children. More studies are needed to examine lifestyle and socioeconomic risk factors that can be associated with the malnourished status of these children. Preventive strategies against ECC should be developed to reduce the risk of iron deficiency and its related anemia.
Dr Mahbubeh Hosseini, Dr Durdi Qujeq , Dr Ahmad Tamaddoni , Dr Mohammad Ranaee, Dr Karimollah Hajian-Tilaki ,
Volume 8, Issue 4 (10-2018)
Abstract
Background: This study aimed to compare the effect of the aqueous extracts of Anethum graveolens, Urtica dioica, and Silybum marianum with deferoxamine (DFO)on iron-overloaded rats.
Materials and Methods: In this case control study, fresh leaves of Anethum graveolens and Urtica dioica as well as seeds of Silybum marianum were washed with water and rinsed with deionized water to remove possible pesticide and preservative residue. Forty eight male rats were randomly divided into six groups: negative control, positive control (iron overload), Anethum graveolens group, Urtica dioica group, Silybum marianum group, , and DFO group. Iron dextran was injected intraperitoneally (i.p.) at 50 mg/kg body weight for 12 weeks (once a week) to establish the iron overload condition. While normal rats received normal saline, rats in the treated groups orally received three plant extracts and DFO (subcutaneously) weekly for 8 weeks (once a week). At the end of the experiment, changes in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activity were measured using AST and ALT kits from Zist Chem Diagnostics Co. (Tehran, Iran) and histological changes were observed by hematoxylin and eosin staining of the liver.
Results: Iron overloaded rats showed a slightly increase in the serum ALT and AST activity compared to control group (4.97±0.12, 60.79±1.16 vs. 3.92±0.10, 50.24±0.82U/L, respectively) (p value< 0.05). However, relative to iron overloaded rats, treatment with Anethum graveolens, Urtica dioica, and Silybum marianum extracts and DFO significantly decreased the activity of ALT and AST (AlT: activity (4.37 ±0.08, 4.58±0.06, 4.74 ±0.09 and 3.96 ±.015 U/L , respectively );( AST: 53.68±1.24, 55.78±1.03, 57.87±1.15 and 51.65 ±0.66 U/L, respectively) (p value< 0.05). Treatment of iron overloaded rats with Anethum graveolens, Urtica dioica, and Silybum marianum also significantly improved the liver dysfunction.
Conclusion: Anethum graveolens, Urtica dioica, and Silybum marianum may be potential medicinal herbs which can reduce liver damage caused by iron overload.
Dr Shaimaa Pessar,
Volume 9, Issue 3 (6-2019)
Abstract
Background: Many Red Blood Cell (RBC) indices have been developed based on mathematical formulae to discriminate beta-thalassemia trait (βTT) from iron deficiency anemia (IDA). The latter two conditions represent the most common causes of microcytic hypochromic anemia in Egypt. This study aimed To evaluate the diagnostic reliability of 24 published discriminant indices for differentiating βTT from IDA in Egyptians.
Materials and Methods: A cross sectional study included a total of 166 subjects (108 IDA & 58 βTT) aged 1-18 years were recruited from Hematology laboratory of Pediatric Hospital, Ain Shams University, Cairo, Egypt. A full diagnostic algorithm was performed using complete blood count, hemoglobin electrophoresis by High Performance Liquid Chromatography (HPLC), iron profile and PCR detection of 22 mutations common for βTT. Twenty-four formulas were applied and their performance characteristics were calculated for each index.
Results: The highest accuracy (True positive + True negative/ All cases) & Youden's Index (Sensitivity+Specificity-100) were for Red Cell Distribution Width (RDWI) and Hameed index closely followed by Keikhaei index while the least performance was for RDW-SD, RDW-CV and Shine & Lal indices.
Conclusion The superiority of an index over another in distinguishing βTT from IDA allowed only partially better selection of cases warranting further confirmatory molecular studies. None of the studied formulae provided a surrogate test for Hb electrophoresis as mass screening.
Dr Mozhgan Hashemieh ,
Volume 9, Issue 4 (10-2019)
Abstract
Advances in the management of transfusion dependent thalassemic patients have improved the survival of these patients. The most important consequence of repeated and frequent transfusions is iron accumulation in vital organs. The magnetic resonance imaging (MRI) is a non-invasive and valid technique for the estimation of iron stores. Despite multiple studies about cardiac and liver MRI T2*, there is limited experience about pancreatic MRI. Although there is a weak correlation between hepatic and pancreatic siderosis, MRI assessment of iron deposition in the pancreas can reduce cardiac morbidity. Pancreatic siderosis may be a predictor for the development of glucose dysregulation. Pancreatic R2* > 100 Hz is a risk factor for glucose intolerance or even overt diabetes. Splenectomy can accentuate the pancreatic iron overload. Early intensive chelation therapy in thalassemia patients can reverse glucose metabolism impairment. In this review, the MRI assessment of pancreatic iron overload in transfusion dependent thalassemia, the correlation between pancreas with liver and myocardial hemosiderosis and the importance of pancreatic iron overload in pathogenesis of diabetes mellitus in these patients were discussed.
Dr Majid Ghanavat, Dr Ali Reza Fazeli Varzaneh, Dr Nahid Reisi,
Volume 9, Issue 4 (10-2019)
Abstract
Background: Deferasirox (DFX), Deferoxamine (DFO), and Deferiprone (DFP) are iron chelators that can be used in thalassemic patients with iron overload.
Materials and Methods: This clinical trial was performed on 108 thalassemic patients who were randomly divided into group A (n=54) and B (n=54). Group A received combination of DFX and DFP, and group B received DFO and DFP for six months. Serum ferritin level was measured at the beginning of the study, 3, and 6 months after the treatment; The heart and liver iron deposition rates were also measured at the beginning of the study, and 6 months after the treatment in both groups and compared using Magnetic Resonance Imaging T2 plus (MRI T2*).
Results: The mean age of patients in group A and B was 17.29±4.3 and 17.89±5.61 years old, respectively. Serum ferritin level significantly reduced after the treatment (Serum ferritin level at baseline, 3, and 6 months after the treatment in Group A: 2476.25±1289.32, 2089.62±1051.64 and 1290.22±724.78 ng/ml, respectively; in Group B: 2044.63±989.82, 1341.30±887.62 and 1229.41±701.22 ng/ml, respectively) (p<0.01, for both groups). MRI T2* heart and liver was also improved at the end of the study in both groups (p<0.01, for both groups). However, the combination of DFO/DFP significantly decreased severity grades of liver iron deposition in comparison to DFX/DFP regimen after six months (p<0.01).
Conclusion: The results of the present study indicated that both combination therapies of DFO/DFP and DFX/DFP could improve heart and liver MRI T2*. However, DFO/DFP combination therapy was more effective in reducing the severity grades of liver iron deposition.
Dr Reihaneh Mortazavi Ardestani, Dr Masoud Ardestani,
Volume 11, Issue 1 (1-2021)
Abstract
Background: Iron overload is caused early progression of atherosclerosis in beta thalassemia patients due to regular repeated blood transfusion. MRI T2* is a gold standard non-invasive method for detecting hepatic and cardiac iron overload. The aim of this study was the comparison of carotid intima media thickness (CIMT) in the patients and healthy control groups with Doppler ultrasound for early diagnosis of atherogenesis. Another purpose was to assess the relationship between CIMT and iron overload among patients.
Materials and methods: This cross-sectional study was performed on twenty patients referred to the Sarvar clinic and twenty age- and sex-matched control group. The CIMT was measured with Color Doppler ultrasound in both groups. Then, MRI T2* results, demographic, and therapeutic information were extracted from their documents.
Results: CIMT was insignificantly higher in the patients compared to the control group. For example, it was 0.49 ± 0.05 vs. 0.45 ± 0.03 (p = 0.009) for the right common carotid artery (RCCA) and 0.48 ± 0.06 vs. 0.46 ± 0.04 (p = 0.17) for the left common carotid artery (LCCA). There was no strong relationship between CIMT and age (p = 0.09 for RCCA, p = 0.00 for LCCA), sex, chelation type (for example, p = 0.51 for RCCA with Desferal and p = 0.91 for LCCA with Desferal), age at diagnosis, age at the beginning on transfusion (p = 0.49 for RCCA, p = 0.20 for LCCA), age at the start of chelator (p = 0.74 for RCCA, p = 0.78 for LCCA), and hepatic and cardiac iron overload.
Conclusion: Preventive and curative methods should be planned to cease its progression. Furthermore, early initiation of chelator drugs with better efficacy and compliance may reverse the hepatotoxic and adverse myocardial effects of excessive iron.
