Anemia en infecciones agudas febriles leves

Abstract

Anemia in mild acute febrile illnessesThis study was designed to furtrer characterize anemia associated to mild infections in children. Thirteen infants and children aged 4 months to 10 years end with an acute febrile illness, all from an outpatient clinic, were included in this study. A blood sampe was ootained at diagnosis and 30 days later, for comple'e blood count, serum iron, total iron binding capacity, transferrin saturation, free erythrocyle orotoporphyrin, serun fe'ri-in, erythrocyte sedimentation rate ana C reactive protein. During the acute infection there was a significant reduction of blood hemoglobin [11.5 ± : .2 vs. '2.0 ± 1.6 g/l; E> < 0.02), -eticulocyte count index [0.3 ± 0.2 vs. 0.7 ± 0.4; p < 0.02], serum iron [36.6 ± 20.6 vs. 73.8 ± 34.8 pg/d ; p<0.001), transferrin saturation (11.1 ± 7.1% vs. 20.8 ± 12.0 % , p < 0.001) crd a significant rise in mean red blood cell volume [80 ± 5 vs. 77 ± 5 fl; p < 0.01) and serum : erritr (mean 26, range 8 to 86 vs. 10, range ^ a 21 ng/l; p < 0.004). Three children had a fall in hemoglobin greater tr.an • g/dl. This anemia was likely causec by reduced red cell output due to blockage of iron release and in some cases associated to hemo.ysis. Free erythocyle p r otoporphyrin was useful to distinguish iron deficiency anemia from anemia due to "he acute infection. C react : ve protein activity was also use £ ul because all patients had more than 6 me/I during the acute phase of infection.

Iron, Anemia, and Infection

“…Studies by Murray et al 44 are widely quoted as evidence for a protective effect of iron deficiency on infection. In a prospective randomized trial of 137 adult Somali nomads with iron deficiency anemia, only patients with an otherwise normal nutritional status were enrolled.…”

“…During the acute infection there was a statistically relevant fall in hemoglobin, serum iron, and transferrin saturation and a statistically significant increase in serum ferritin. 44 In childhood there are also many mild, shortlived infections that would usually not warrant medical consultation. In a prospective study, we used immunization with attenuated measles virus as a model of a predictable mild viral i l l n e s~.~~.~~ We observed a significant drop in hemoglobin concentration by days 9 to 14 postvaccination.…”

Iron‐deficiency anemia in infant development: Implications for growth, cognitive development, resistance to infection, and iron supplementation

“…In two retrospective studies, children who had a history of mild infections during the previous 1 to 3 months had a higher incidence of anemia and sedimentation rate, particularly infants younger than 12 months of age (Reeves et al, 1984;Jansson et al, 1984). Olivares et al (1995) evaluated the hematological status of children between the ages of 6 months and 10 years who were seen for common acute febrile infections in an outpatient health clinic. A blood sample was obtained at the time of diagnosis and after 30 days.…”