Serum protein and transferrin determinations to distinguish kwashiorkor from iron deficiency anaemia.

Masawe, A. E. J.; Rwabwogo-Atenyi, J

doi:10.1136/adc.48.12.927

Cited by 18 publications

(4 citation statements)

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“…Many pathologic states in which the saturation of transferrin with iron is elevated are associated with an increased occurrence of infection (7,23,24). When children with kwashiorkor, whose transferrin levels are severely depressed (17), are given iron therapy before their transferrin levels become normal, a high incidence of death from infection ensues (18). Taken together, these various clinical observations support the concept that transferrin may play a role in nonspecific immunity to bacterial and fungal infections.…”

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confidence: 54%

The Postnatal Hypotransferrinemia of Early Preterm Newborn Infants

1976

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ExtractPreterm newborns were found to be markedly hypotransferrinemic when compared with normal term infants. At birth the concentration of transferrin in sera from preterm infants of gestational age equal to or less than 32 weeks is 45% of that found in normal term infant sera. The preterm infant transferrin levels slowly rise so that 7-8 weeks after birth they are 78% of the level found in the sera of normal term infants. We also found that the serum transferrin concentrations at birth correlate with gestational age. Therefore, the transferrin levels postnatally in early preterm infants reflect postconceptional rather than postnatal age. Specula tionSince we found that early preterm newborns are markedly hypotransferrinemic, administration of iron to such infants during their first few postnatal months may be contraindicated. Harmful side effects of iron during this period might include an increased susceptibility to infection because of the known bacteriostatic and fungistatic activities of iron-free transferrin.The serum iron-binding protein transferrin has been known to possess bacteriostatic and fungistatic activities since it was first described by Schade and Caroline in 1946 (20). Subsequently, the function of transferrin as an iron transport protein has been well established (14), but the role of transferrin in nonspecific immunity still remains to be clarified completely.Nevertheless, the results of many recent studies have reiterated the bacteriostatic properties of serum transferrin in vitro and in vivo in experimental animals. I t has been concluded that iron-free transferrin is bacteriostatic because it can compete successfully with many pathogens for iron when this essential nutrient is present in limiting amounts (4-7, 10, 19,22). Such a mechanism of bacteriostasis is reasonable considering the extraordinarily high affinity which transferrin has for iron (I).In the normal human, serum transferrin is only 30-40% saturated with iron. Many pathologic states in which the saturation of transferrin with iron is elevated are associated with an increased occurrence of infection (7,23, 24). When children with kwashiorkor, whose transferrin levels are severely depressed (17), are given iron therapy before their transferrin levels become normal, a high incidence of death from infection ensues (18). Taken together, these various clinical observations support the concept that transferrin may play a role in nonspecific immunity to bacterial and fungal infections.The transferrin in sera of newborns is highly saturated with iron (2 1). Since early preterm newborn infants are particularly susceptible to infection, the aim of this study was to examine the transferrin levels in the sera of these infants during their first few months of life. MATERIALS AND METHODSTransferrin was purified from a pool of outdated human blood by a modification of a method described previously (16). Eight hundred milliliters of plasma were diluted in the cold with 800 ml 0.01 M Tris-HCI, pH 8.8. Nonglobulin proteins were precipitated by...

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confidence: 54%

The Postnatal Hypotransferrinemia of Early Preterm Newborn Infants

1976

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“…The high prevalence of hypotransferrinemia is worth emphasizing and understanding. The synthesis of transferrin is affected by poor nutrition (4), and low transferrin concentrations are seen in patients with kwashiokor, but not out of proportion to the general level of hypoproteinemia (47). In our population, the prevalence of a low transferrin level far exceeded that of either albumin or prealbumin.…”

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confidence: 72%

Hypotransferrinemia of Chronically Hemodialyzed Patients

Kirschbaum

1999

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Increasingly, the iron needs of hemodialysis patients receiving erythropoietin are being met by infusions of intravenous iron guided by laboratory tests to measure body iron availability. The interpretation of assays based on ferritin and transferrin must take into account the effect of inflammation on both proteins and malnutrition on the latter. In our chronic hemodialysis population, hypotransferrinemia was present in greater than 90% of the patients. Using statistical methods and laboratory studies, we sought to identify the principal reasons for the high prevalence of hypotransferrinemia. We observed that transferrin levels were disproportionately low relative to albumin and prealbumin and correlated inversely with ferritin levels. There was no correlation between transferrin and the soluble transferrin receptor. After the infusion of 900 mg of iron, transferrin saturation increased and total transferrin decreased so that unsaturated iron bonding capacity decreased as well. Ferritin concentrations increased significantly after iron loading. Attempts to demonstrate activation of the patients' antioxidant mechanisms associated with iron infusion were negative. We concluded that the low transferrin may be principally the result of diminished synthesis related to the chronic inflammatory status of hemodialysis patients, which favors production of ferritin, but iron and nutritional status may also influence the blood transferrin concentration. These factors make interpretation of transferrin-dependent assessment of body iron stores unreliable and can result in inadequate or overly aggressive iron-replacement therapy.

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“…One can assume that these diseases may also lead to modifications in the metabolism of serum proteins and therefore influence their effectiveness as indicators of nutritional status. Thus, previous studies indicate that Fe-deficiency anaemia could lead to increased transferrin synthesis (Morton & Tavill, I 977) and increased serum transferrin concentrations (Mosawe & Rwabwogo-Atenyi, 1973). In view of the fact that prealbumin and transferrin may be more and more used for early detection of undernutrition it seems timely to assess the influence of other diseases than PEM on serum prealbumin and transferrin concentrations.…”

Section: ; Gabr Et Al 1971;mentioning

confidence: 99%