Serum transferrin receptor in children with respiratory infections

Abstract

Objective: To study the effect of infection on iron status in children suffering from acute, mild or severe respiratory infections and to determine the nature of anemia in infection using serum transferrin receptor (sTfR) levels. Design: Forty-three children aged between 3 and 5 y with no evidence of infection and receiving iron supplements in the preceding 100 days served as controls. Twenty-one children with mild upper respiratory infection and 94 children hospitalized for acute pneumonia constituted the experimental group. Hemoglobin (Hb), sTfR and serum ferritin were estimated in all the children at the time of diagnosis and again on the 15th and 30th days after the infection in those who were available for followup. Results: Mean (95% CI) sTfR was 6.08 (5.1 -7.1) mg=l in healthy non-anemic children. Upper respiratory infection had no impact on Hb or sTfR but it significantly elevated serum ferritin levels. Eighty-three percent of the children with pneumonia had Hb less than 110 g=l at the time of diagnosis and had elevated mean sTfR, 18.0 (15.7 -20.3) mg=l. There was a decline in mean sTfR by the 15th day of infection to 14.3 (11.3 -17.4) mg=l with further rise to 22.9 (13.0 -31.9) mg=l by 30 days. Serum ferritin was significantly elevated at the time of diagnosis (85.9; 71.1 -100.8 mg=l) as well as at 15 days (89.1; 68 -110.1 mg=l) with a decline by 30 days. Conclusions: Severe lower respiratory infection exaggerates iron-deficient erythropoiesis by blocking release of iron from the storage pools. sTfR may not be a sensitive and specific tool of assessing true iron status of children exposed to severe infections.

The usefulness of soluble transferrin receptor (sTfR) in differentiating anemia occurring in young children

“…The results of examinations of other authors also demonstrate the usefulness of sTfR concentrations and sTfR/ /logF values in differentiating IDA from IA, as no increase in either parameter was observed in patients with infectious anemia without iron deficiency [27,[42][43][44].…”

Is Iron Deficiency Anaemia, a risk Factor For Wheeze Associated Respiratory Tract Infection in Children?

“…Thus, in present study the prevalence of iron defi ciency anaemia itself is lower than that reported in general (67-77%) 8 which might be due to usage of a strict criteria of combina on of serum ferri n<12 ng/ml and RDW>15%. As aforemen oned, the combined criteria is more specifi c and rules out the chance higher prevalence of IDA 9 . Prevalence of iron defi ciency anaemia as per our criteria in present study was 32% in cases and 24% in control group, however, the diff erence was not signifi cant sta s cally though children with iron defi ciency anaemia were at a higher risk of wheeze associated respiratory diseases (OR=1.49; 95% CI 0.62-3.59).…”

Gambaran Hematologi Anemia Defisiensi Besi pada Anak

“…Tujuh puluh lima anak dengan data lengkap dan Dampak negatif yang diakibatkan oleh ADB pada anak balita berupa gangguan konsentrasi belajar, tumbuh kembang terganggu, penurunan aktifitas fisik maupun kreatifitas menurun, serta menurunkan daya tahan tubuh sehingga meningkatkan risiko infeksi. 2,4 Atas dasar angka kejadian ADB yang tinggi dan dampak negatif yang ditimbulkannya, maka kami melakukan penelitian yang bertujuan untuk mendapatkan gambaran hematologi anemia defisiensi besi pada anak yang dirawat di RSUD Wangaya Denpasar.…”