Serum Hepcidin and Ferritin to Iron Ratio in Evaluation of Bacterial Versus Viral Infections in Children

Kossiva, Lydia; Gourgiotis, Dimitrios; Tsentidis, Charalampos; Anastasiou, Theodora; Marmarinos, Antonios; Vasilenko, Helen; Sdogou, Triantafyllia; Georgouli, Helen

doi:10.1097/inf.0b013e318256f843

Cited by 14 publications

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“…Previous studies have demonstrated differences in serum iron parameters in children with acute bacterial versus viral infections [18]. We hypothesized that the comparison of hepcidin levels of children convalescing from bacterial and viral infections would not yield significant differences enhancing the role of hepcidin as an acute reactant protein.…”

Section: Introductionmentioning

confidence: 97%

Serum hepcidin: indication of its role as an “acute phase” marker in febrile children

Kossiva

Soldatou

Gourgiotis³

et al. 2013

Ital J Pediatr

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BackgroundHepcidin is classified as a type II acute phase protein; its production is a component of the innate immune response to infections.ObjectiveTo evaluate the alterations of serum hepcidin in children during and following an acute febrile infection.Materials and methods22 children with fever of acute onset (< 6 hours) admitted to the 2nd Department of Pediatrics-University of Athens. Based on clinical and laboratory findings our sample formed two groups: the viral infection group (13 children) and the bacterial infection group (9 children). Hepcidin, ferritin and serum iron measurements were performed in all subjects.ResultsSerum hepcidin values did not differ notably between children with viral and bacterial infection, but a significant reduction of hepcidin was noted in both groups post-infection.ConclusionOur study provides clinical pediatric data on the role of hepcidin in the face of an acute infection. In our sample of children, hepcidin was found to rise during the acute infection and fall post-infection.

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Section: Introductionmentioning

confidence: 97%

Serum hepcidin: indication of its role as an “acute phase” marker in febrile children

Kossiva

Soldatou

Gourgiotis³

et al. 2013

Ital J Pediatr

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“…In addition, our study did not control for the time of onset of illness in relation to the time of presentation, which may also have influence the level of both serum iron and serum ferritin. Hepcidin is another molecules involved in iron regulation, and has been studied for its role in the immune response [19,21]. It's potential role as a marker of infection and inflammation could be explored in future studies.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally they found that the ferritin-to-iron ratio was significantly higher in children who had bacterial infections 1305-7707/14/$27.50 c 2014 -IOS Press and the authors. All rights reserved compared with children with viral infections [19]. Ferritin and other markers of iron metabolism have not been studied in the emergency department.…”

Section: Introductionmentioning

confidence: 99%

Ferritin and iron in pediatric infections in the emergency department: A pilot study

Nasir¹,

James

Perry

et al. 2015

J Pediatr Infect Dis

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We aimed to study ferritin as an acute phase marker in pediatric infections, and investigate its' clinical significance in the emergency department management of the febrile child. Multiple inflammatory markers, including C-reactive protein, procalcitonin, and serum ferritin, and other iron studies were measured in 37 children, from 3 months through 8 years of age, presenting to the emergency department with temperature of 39 degrees Celsius, and 38 patients in the same age group with non-febrile illness. Mean serum ferritin was significantly higher in the febrile group 71.4 ng/mL compared to the non-febrile group 45.1 ng/mL (p < 0.003). Ferritin/iron ratio was 5.28 in the febrile group and 1.72 in the non-febrile group (p < 0.046). Mean serum iron level was significantly lower in the in Febrile compared to non-febrile children. Mean serum iron was also significantly lower in the subgroup of children with bacterial infection: 17.5 µg/dL compared to the group with viral infection 27.1 µg/dL (p < 0.001). The results of this pilot study in the Emergency Department setting confirm previous work from hospitalized patients indicating that ferritin is increased and serum iron is decreased in pediatric infections. Further studies are needed to confirm our findings and to further explore the role of serum iron as a marker of bacterial infection.

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“…In addition, the absorption of iron from the diet and the use of iron for erythropoiesis are reduced, the synthesis of haemoglobin is increased, and apolactoferrin is liberated from neutrophils. That regulation of the iron metabolism often leads to anaemia, especially in the case of chronic inflammatory diseases [9,10].…”

Section: Iron Homeostasis In the Human Organismmentioning

confidence: 99%

Physiological and pathological factors affecting the homeostasis of iron

Zeckei¹,

Obuchowicz²

2018

polp

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Iron plays a key role in many physiological body life processes, including determination of the correct erythropoiesis. Its lack leads to the development of anaemia, and excess iron can be toxic to the body. Iron homeostasis is supervised by the interaction of many proteins, of which hepcidin plays a very important role and whose modulators are transferrin, ferroportin, and erythropoietin. Important factors modifying iron homeostasis include hypoxia, anaemia, and vitamin concentration as well as acute and chronic inflammatory processes. Hepcidin as an acute phase protein can also be an important element in the diagnosis of infectious chronic diseases, especially as an anaemic determinant of these diseases. Its role in the pathomechanism of acute inflammatory states is not entirely clear.

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Serum Hepcidin and Ferritin to Iron Ratio in Evaluation of Bacterial Versus Viral Infections in Children

Abstract: If further studies with larger samples confirm these observations, FIR could be used as an inexpensive, rapid and easily performed complementary index for diagnosis of bacterial infections.

Cited by 14 publications

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Serum hepcidin: indication of its role as an “acute phase” marker in febrile children

Serum hepcidin: indication of its role as an “acute phase” marker in febrile children

Ferritin and iron in pediatric infections in the emergency department: A pilot study

Physiological and pathological factors affecting the homeostasis of iron

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