Iron deficiency without anaemia: a diagnosis that matters

Al-Naseem, Abdulrahman; Sallam, Abdelrahman; Choudhury, Shamim; Thachil, Jecko

doi:10.7861/clinmed.2020-0582

Cited by 82 publications

(83 citation statements)

References 60 publications

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“…The causes that lead to iron deficiency can be grouped into the following categories: inadequate food intake, increased body needs, decreased absorption, chronic inflammation and chronic blood loss. Absorption of iron occurs mainly in the stomach and proximal intestine under the influence of hydrochloric acid, which is necessary for the conversion of Fe 3+ to Fe 2+, which is easier to digest [1].…”

Section: Results Discussionmentioning

confidence: 99%

Scientific reviews. Principles of diagnosis and treatment of iron deficiency anemia in children

Korol¹,

Khromykh²,

Rudenko³

et al. 2021

Rep. of Vinnytsia Nation. Med. Univ.

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Annotation.In Europe, the overall prevalence of iron deficiency anemia is 2-4%, with two peaks: young children (2.3-15%) and adolescents (3.5-13% – in boys, 11-33% – in girls). Iron deficiency occurs earlier than anemia, which is characterized by a decrease in the size and iron saturation of erythrocytes, and they become microcytic and hypochromic. Therefore, anemia can be prevented by early diagnosis and treatment of latent iron deficiency. The aim of the work was to analyze and systematize the main problematic issues of diagnosis and treatment of iron deficiency anemia in children. To conduct the study, we analyzed databases PubMed, Cochrane Library, Google Scholar, etc., referring to the vast majority of publications from the last five years (2016-2021), in addition to three articles published in 2012 and 2014. The main criteria for selecting sources were: the availability of the latest methods for the diagnosis of anemia, modern methods of treatment of iron deficiency anemia in children. Analysis of the identified literature sources showed that iron deficiency in the laboratory and clinically can manifest itself at different stages. Negative iron balance, which persists after a decrease in iron stores, is manifested by a decrease in hemoglobin and the development of anemia. A decrease in the number of erythrocytes or the level of hemoglobin (Hb) by 5 percentile below the normal value of hemoglobin, determined for a given age in healthy people, is called anemia. Routine screening for iron deficiency should be performed in children aged 6 to 24 months. Screening consists of identifying risk factors and laboratory testing if available. Determination of serum ferritin during the first screening is the main diagnostic tool in children with risk factors for iron deficiency and signs of anemia. Ferritin levels should always be carefully evaluated, as ferritin is nonspecifically elevated in a variety of inflammatory conditions. Other screening tests, such as reticulocyte levels, iron transferrin saturation, and serum iron-binding capacity, are performed to confirm the diagnosis. The choice and route of administration of iron requires consideration of the cause that led to its deficiency, the severity of symptoms and condition of the patient, the probable and desired rate of hematological response, risks and complications of treatment, availability of resources and preferences of the patient. Oral iron remains a priority for the treatment of children with iron deficiency anemia, but it is necessary to consider situations where first-line therapy will be administered by intravenous means. Thus, based on the analysis of the literature, we can conclude that iron deficiency anemia remains an urgent medical and social problem today. Children with iron deficiency anemia develop cognitive impairment that does not fully recover even after treatment. Therefore, further research aimed at improving methods of prevention, early diagnosis and treatment of iron deficiency anemia in different age groups of children should be promising.

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Section: Results Discussionmentioning

confidence: 99%

Scientific reviews. Principles of diagnosis and treatment of iron deficiency anemia in children

Korol¹,

Khromykh²,

Rudenko³

et al. 2021

Rep. of Vinnytsia Nation. Med. Univ.

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“…The importance of iron deficiency screening and treatment in surgical patients arise from the fact that maintaining an absolute iron deficiency may lead to iron deficiency anaemia or iron deficiency without anaemia and specific complications. On the other hand, intravenous iron administration for these patients prevents the appearance of iron-deficiency erythropoiesis [ 5 , 27 ]. Additionally, acute kidney injury (AKI) is more often described in patients undergoing major surgical interventions due to different factors, including blood volume waste and iron deficiency.…”

Section: Discussionmentioning

confidence: 99%

“…In surgical patients, preoperative anaemia has a prevalence of approximately 40% of patients, reaching 90% after major surgeries [ 2 , 3 , 4 ]. Iron deficiency anaemia (IDA) presents a high prevalence (affecting 1.2 billion people), and iron deficiency without anaemia (IDWA) being even more frequent [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

The Importance of Iron Administration in Correcting Anaemia after Major Surgery

Ţigliş

Cobilinschi

Mirea

et al. 2021

The Journal of Critical Care Medicine

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Introduction: Postoperative anaemia can affect more than 90% of patients undergoing major surgeries. Patients develop an absolute iron deficiency in the face of significant blood loss or preoperative anaemia and major surgery. Studies have shown the negative impact of these factors on transfusion requirements, infections, increased hospitalisation and long-term morbidities. Aim of the study: The research was performed to determine the correlation between intravenous iron administration in the postoperative period and improved haemoglobin correction trend. Material and methods: A prospective study was conducted to screen and treat iron deficiency in patients undergoing major surgery associated with significant bleeding. For iron deficiency anaemia screening, in the postoperative period, the following bioumoral parameters were assessed: haemoglobin, serum iron, transferrin saturation (TSAT), and ferritin, direct serum total iron-binding capacity (dTIBC), mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH). In addition, serum glucose, fibrinogen, urea, creatinine and lactate values were also collected. Results: Twenty-one patients undergoing major surgeries (52,38% were emergency and 47,61% elective interventions) were included in the study. Iron deficiency, as defined by ferritin 100-300 μg/L along with transferrin saturation (TSAT) < 20 %, mean corpuscular volume (MVC) < 92 fL, mean corpuscular haemoglobin (MCH) < 33 g/dL, serum iron < 10 μmol/L and direct serum total iron-binding capacity (dTIBC) > 36 μmol/L, was identified in all cases. To correct the deficit and optimise the haematological status, all patients received intravenous ferric carboxymaltose (500-1000 mg, single dose). Using Quadratic statistical analysis, the trend of haemoglobin correction was found to be a favourable one. Conclusion: The administration of intravenous ferric carboxymaltose in the postoperative period showed the beneficial effect of this type of intervention on the haemoglobin correction trend in these groups of patients.

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“…On the other hand, the mean value for adult Japanese men is 150 ng/mL or more. Upon identifying a low ferritin level (≤100 ng/mL) in a middle-aged Japanese man, some bleeding or other form of blood loss is suspected, as is common with intestinal hemorrhages or repeated blood donation [1,10].…”

Section: Ferritinmentioning

confidence: 99%

Personalized Nutritional Therapy Based on Blood Data Analysis for Malaise Patients

Arakaki¹,

Li²,

Kaneko³

et al. 2021

Nutrients

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As medical doctors, we routinely check patient blood chemistry and CBC data to diagnose disease. However, these data and methods of analysis are very rarely used to find pre-disease conditions or treat undiagnosed malaise. Masatoshi Kaneko Ph.D. found that many pre-disease conditions and types of malaise could be detected using his unique method of blood data analysis, and could also be treated using personalized nutritional therapy as an alternative to using drugs. The authors of this article introduce personalized nutritional therapy based on blood data analysis (Kaneko’s method), and present and discuss some clinical cases. In total, 253 pre-disease or undiagnosed patients were treated using this nutritional therapy approach, and most of them recovered from their chronic symptoms and pre-disease conditions. This novel nutritional therapy has the potential to help many presymptomatic and undiagnosed patients suffering from malaise.

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Iron deficiency without anaemia: a diagnosis that matters

Cited by 82 publications

References 60 publications

Scientific reviews. Principles of diagnosis and treatment of iron deficiency anemia in children

Scientific reviews. Principles of diagnosis and treatment of iron deficiency anemia in children

The Importance of Iron Administration in Correcting Anaemia after Major Surgery

Personalized Nutritional Therapy Based on Blood Data Analysis for Malaise Patients

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