ABC of Clinical haematology: Iron deficiency anaemia

Frewin, Rebecca; Henson, Andrew; Provan, Drew

doi:10.1136/bmj.314.7077.360

Cited by 50 publications

(31 citation statements)

References 6 publications

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“…This general degree of undernutrition might have decreased the possible response to treatment. Indeed, an increase of 1.5 gal of Hb over 2 months is well below the 20 gal increase over 3 weeks that is the normal response to treatment in iron de®ciency (Frewin et al, 1997). It should be emphasised that in the present population 2 months of treatment only corrected anaemia in 6% of the women who received treatment.…”

Section: Discussionmentioning

confidence: 96%

Treatment for iron deficiency anaemia with a combined supplementation of iron, vitamin A and zinc in women of Dinajpur, Bangladesh

et al. 1999

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Objective: The study was set up to determine to what extent the addition of a supplement of vitamin A alone or in combination with zinc would improve standard iron treatment and correction of iron de®ciency anaemia. Design: 216 non-pregnant anaemic women of 15 ± 45 years of age with haemoglobin levels 100 gal were randomly assigned to three treatment groups. One group (A) received iron alone, a second group (B) received iron and vitamin A, and a third group (C) received iron, vitamin A and zinc. Every woman was given one iron capsule per day for 60 days as FeSO 4 containing 60 mg of elemental iron. In addition, groups B and C received 200 000 IU of vitamin A, given as a supervised dose, on the ®rst day of the treatment after collection of the blood sample. Group C received one zinc tablet per day for 60 days as zinc gluconate containing 15 mg of elemental zinc. Setting: The north-western part of Bangladesh in the urban slums of Dinajpur district between February and August 1995. Subjects: To select women with a haemoglobin level of 100 gal, all the women of four randomly selected municipal slums of the district in the targeted age group (328) were invited to take part in the study. Blood samples were analysed for haemoglobin, serum iron, total iron binding capacity (TIBC), ferritin, retinol and zinc. Results: Out of the 328 women screened, 254 (77.5%) had a haemoglobin level 100 gal and 322 (98%) 120 gal. The three treatment schedules signi®cantly increased haemoglobin levels and improved iron parameters, except for serum iron in the group who received iron alone. The group who received iron, vitamin A and zinc responded best with an increase in haemoglobin of 17.9 gal as compared to the group receiving iron alone (13.4 gal). Iron and vitamin A treatment gave an intermediate response of 15.9 gal. However, these differences are only statistically signi®cant only for the group who received iron, vitamin A and zinc and only for the increase in haemoglobin, P 0.03. Conclusion:The results are suggestive that the addition of vitamin A and zinc to the treatment for anaemia can increase haemoglobin levels more than with iron alone. Sponsorship: The present study was ®nanced by grant FWO 1.5.092.96 and Nutrition Tiers Monde.

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Section: Discussionmentioning

confidence: 96%

Treatment for iron deficiency anaemia with a combined supplementation of iron, vitamin A and zinc in women of Dinajpur, Bangladesh

et al. 1999

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“…A normal or raised ferritin may also indicate another cause of MHA, such as anaemia of chronic disorder (of which HIV and TB are common causes locally). [2][3][4] Therefore, such an over-simplified approach will misdiagnose or over-diagnose IDA.…”

Section: Sudden Death On An Aeroplanementioning

confidence: 99%

“…Even in this group, a trial of therapy with 200 mg of ferrous iron is more correctly recommended for 3 weeks prior to review for response, as opposed to the 2 months, as suggested by the authors. 3 A positive response is present when the haemoglobin concentration (Hb) has increased by 2 g/dl after 3 weeks of therapy. This confirms the diagnosis of IDA, the cause of which still needs to be ascertained.…”

Section: J G Prinsloomentioning

confidence: 99%

“…No correlation co-efficient is stated, and it is not possible to comment on the appropriateness of the use of the haemoglobinometer, although they recommend it for general practice. 3 There is no consensus on the investigation and management of iron deficiency anaemia (IDA). 2 The gold standard for the diagnosis of iron deficiency is bone marrow aspirate stained for iron, and no single biomarker can serve as a proxy.…”

Section: J G Prinsloomentioning

confidence: 99%

“…The assessment of iron deficiency anemia (IDA) is incomplete without demonstrating iron-deficient erythropoiesis, by looking at the red cell indices (mean corpuscular volume, mean cell haemoglobin and mean cell haemoglobin concentration (MCV, MCH and MCHC)). 2,3 A serum ferritin is mandatory if the indices suggest microcytic hypochromic anaemia (MHA). A low ferritin confirms IDA, but a normal ferritin does not exclude iron deficiency.…”

Section: Sudden Death On An Aeroplanementioning

confidence: 99%

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