Microcytic anemia: Differential Diagnosis and Management of Iron Deficiency Anemia

Massey, Ann

doi:10.1016/s0025-7125(16)30339-x

Cited by 83 publications

(51 citation statements)

References 34 publications

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“…Despite the fact that most premenopausal women were taking contraceptives, menstrual blood loss in some women can explain this observation. Iron is an essential element in diverse aspects of physiology (13). Besides the known consequences of anemia, various nonhematological effects of iron deficiency (e.g., reduced work performance, defects in immunity, and impaired intestinal function) have been observed (24,25).…”

Section: Soluble Transferrin Receptor Levels In Diabetesmentioning

confidence: 99%

“…Given the relatively high probability that ulcers or malignant tumors may be the cause of blood loss, this anemic condition warrants extensive investigation of the gastrointestinal tract (12)(13)(14). Fecal occult blood testing was repeatedly negative, as were the history and clinical examination, and none of the patients undergoing gastroscopy showed these lesions.…”

Section: De Block and Associatesmentioning

confidence: 99%

“…This may cause iron deficiency anemia, which is a common (although frequently overlooked) manifestation of autoimmune gastritis (8)(9)(10)(11)(12). On the other hand, iron deficiency anemia can also arise by malignant or inflammatory diseases, especially from the gastrointestinal tract (13,14), and atrophic gastritis predisposes patients to gastric carcinoma and carcinoid tumors (15,16).…”

mentioning

confidence: 99%

“…Iron plays an essential role in hemoglobin synthesis, electron transport for cellular respiration, DNA synthesis, and other vital enzymatic reactions (13). Early detection and treatment of iron deficiency and the conditions that are at its origin could significantly reduce morbidity.…”

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Soluble transferrin receptor level: a new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetes.

et al. 2000

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Abbreviations: ANOVA, analysis of variance; AUC ROC , area under the curve for receiver operating characteristics; CV, coefficient of variation; Nl, normal range; PCA, parietal cell antibody; sTfR, soluble transferrin receptor.A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Soluble Transferrin Receptor LevelA new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetesOBJECTIVE -A total of 15-20% of type 1 diabetic patients have parietal cell antibodies (PCAs). PCA ϩ subjects are at increased risk for iron deficiency anemia and atrophic gastritis. Recently, soluble transferrin receptor (sTfR) levels have proven to be a sensitive indicator for iron deficiency. They are, in contrast with ferritin levels, independent of inflammation, liver and hormonal status, and sex. We are the first to evaluate sTfR levels in type 1 diabetes and tested the hypothesis of higher sTfR levels in patients with PCAs and/or autoimmune gastritis.RESEARCH DESIGN AND METHODS -We examined 148 type 1 diabetic patients (85 men and 63 women; 50 were PCA ϩ ) and 59 sex-and age-matched control subjects (30 men and 29 women). The main outcome measures were sTfR levels, iron deficiency anemia, and atrophic gastritis. Logistical regression analysis tested risk factors for iron deficiency.RESULTS -Iron deficiency was present in 38 subjects. Iron (P Ͻ 0.0001) and ferritin (P Ͻ 0.0001) levels but not sTfR levels were lower in women. sTfR levels were similar in diabetic and control subjects but were higher in PCA ϩ subjects (P = 0.015). In diabetic subjects, iron deficiency anemia was more prevalent in PCA ϩ than in PCA -patients (odds ratio 3.07, P = 0.013) and was associated with sex (P = 0.0001), age (P = 0.046), and sTfR (P = 0.0008) levels. Atrophic gastritis was present in 15 of 28 PCA ϩ and in 1 of 11 PCA -diabetic subjects (P = 0.014). sTfR levels tended to be higher in patients with atrophic gastritis (P = 0.062).CONCLUSIONS -In type 1 diabetes, sTfR levels can be used to diagnose iron deficiency anemia, which is more prevalent in PCA ϩ subjects. sTfR levels are higher in PCA ϩ individuals who are at risk for developing atrophic gastritis.

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Section: Soluble Transferrin Receptor Levels In Diabetesmentioning

confidence: 99%

Section: De Block and Associatesmentioning

confidence: 99%

mentioning

confidence: 99%

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Soluble transferrin receptor level: a new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetes.

et al. 2000

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“…Thalassemia is a widespread hematologic abnormality that affects about 5% of the world population, and it is most prevalent in the Mediterranean countries [1]. Iron deficiency anemia (IDA) and thalassemia are groups of blood disorders with microcytic hypochromic manifestations [2,3]. Laboratory diagnosis of thalassemia is a very serious concern due to increasing in need of prenatal diagnosis of hemoglobin chain disorders [4].…”

Section: Introductionmentioning

confidence: 99%

Salivary ferritin and iron as a marker and new discriminating indices between iron deficiency anemia and thalassemia: a meta-analysis

Rahim¹

2017

Russ. Open Med. J.

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Abstract:Purpose -We performed a meta-analysis of all eligible case-control studies published to date, to assess the association of salivary ferritin and iron with hematological disorders. Methods -We conducted Medline/PubMed and Scopus searches for papers published from January 1, 1980, through January 1, 2013. Data were merged the summary mean difference were estimated using either a random-effects model or a fixed-effects model. Results -There were 3 studies including 196 cases and 70 controls. There was a statistically significant difference in the salivary ferritin and iron between hematological diseases and control groups, and the summary estimate of mean difference was 1.37 (95%CI: 0.01-2.74) and 2.23 (0.92-3.54) in salivary ferritin and iron, respectively. The stratification showed the same statistically significant differences in the salivary ferritin between Iron deficiency anemia (IDA) with thalassemia intermedia (TI), and IDA with thalassemia major (TM) groups. Besides, the stratification showed that there were statistically significant differences in the salivary iron between IDA with TM groups, while no statistically significant difference was observed between IDA with TI. Conclusion -Saliva ferritin iron and ferritin increase significantly in patients with thalassemia compared to IDA. Salivary ferritin and iron can be used as a diagnostic marker and new discriminating indices routinely to differentiate IDA from thalassemia, especially thalassemia trait; furthermore, their easy applicability, safe, relatively simple, and noninvasive procedure may be an important advantage compared to blood sample collection. Consequently, it could be promising to develop a simplified testing and differentiating procedure, which could reach many clinical decision-makers as a diagnostic potential.

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Diagnosis of Iron Deficiency Anemia in the Elderly by Transferrin Receptor–Ferritin Index

Rimon

Levy²,

Sapir³

et al. 2002

Arch Intern Med

122

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Microcytic anemia: Differential Diagnosis and Management of Iron Deficiency Anemia

Cited by 83 publications

References 34 publications

Soluble transferrin receptor level: a new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetes.

Soluble transferrin receptor level: a new marker of iron deficiency anemia, a common manifestation of gastric autoimmunity in type 1 diabetes.

Salivary ferritin and iron as a marker and new discriminating indices between iron deficiency anemia and thalassemia: a meta-analysis

Diagnosis of Iron Deficiency Anemia in the Elderly by Transferrin Receptor–Ferritin Index

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