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Amin K, Bansal M, Varley N, Wang H, Amin S. Reticulocyte hemoglobin content as a function of iron stores at 35-36 weeks post menstrual age in very premature infants. J Matern Fetal Neonatal Med 2019; 34:3214-3219. [PMID: 31662016 DOI: 10.1080/14767058.2019.1680631] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Premature infants are born with lower iron stores and are at risk for iron deficiency during early infancy. To prevent iron deficiency, premature infants are routinely supplemented with 2 mg/kg/day oral elemental iron. Reticulocyte hemoglobin content (RET-He), a measure of iron deficiency, has not been well evaluated prior to discharge in premature infants. OBJECTIVES Our objectives were to evaluate RET-He and its correlation with serum ferritin (SF), an index of iron stores, at 35-36 weeks postmenstrual age (PMA) in ≤32 weeks gestational age (GA) infants. METHODS We performed a prospective nested study involving 24-32 weeks GA infants who were receiving 2 mg/kg/day oral elemental iron with full enteral feedings at 35-36 weeks PMA. Infants with the following conditions were excluded: craniofacial malformation, chromosomal disorders, TORCH (toxoplasmosis, other infections, rubella, cytomegalovirus, and herpes simplex), culture-proven sepsis, C-reactive protein >5 mg/l within 10 days of iron status assessment, or erythropoietin therapy. SF and RET-He were measured at 35-36 weeks PMA using chemiluminescence immunoassay and Sysmex XN hematology analyzer, respectively. RET-He <27 pg was deemed indicative of iron deficiency. RESULTS Ninety-eight infants were studied, of which 21 infants had RET-He <27 pg. There was a positive correlation between RET-He and SF (coefficient 0.22, p = .03) that remained significant after controlling for GA (coefficient 0.21, p = .03) and frequency of prior erythrocyte transfusions (coefficient 0.21, p = .03). On stratified analysis, there was a positive correlation between SF and RET-He in females (N = 52, coefficient 0.23, p = .02), but not in males (N = 46, coefficient 0.05). CONCLUSIONS Most premature infants receiving 2 mg/kg/day oral elemental iron are iron replete for erythropoiesis at 35-36 weeks PMA. RET-He increases with an increase in iron stores, suggesting that additional iron supplementation prior to discharge to very premature infants with borderline low RET-He may help prevent iron deficiency during early infancy.
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Affiliation(s)
- Kanhai Amin
- Student Academic Internship Program, University of Rochester Medical Center, Rochester, NY, USA
| | - Meenakshi Bansal
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center and Rochester General Hospital, Rochester, NY, USA
| | - Nonie Varley
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center and Rochester General Hospital, Rochester, NY, USA
| | - Hongyue Wang
- Department of Biostatistics, University of Rochester Medical Center, Rochester, NY, USA
| | - Sanjiv Amin
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
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Adelvand P, Hamid M, Sardari S. The intrinsic genetic and epigenetic regulator factors as therapeutic targets, and the effect on fetal globin gene expression. Expert Rev Hematol 2017; 11:71-81. [DOI: 10.1080/17474086.2018.1406795] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Pegah Adelvand
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammed Hamid
- Department of Molecular Medicine, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
| | - Soroush Sardari
- Drug Design and Bioinformatics Unit, Medical Biotechnology Department, Biotechnology Research Center, Pasteur Institute of Iran, Tehran, Iran
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Jiang Z, Luo HY, Huang S, Farrell JJ, Davis L, Théberge R, Benson KA, Riolueang S, Viprakasit V, Al-Allawi NAS, Ünal S, Gümrük F, Akar N, Başak AN, Osorio L, Badens C, Pissard S, Joly P, Campbell AD, Gallagher PG, Steinberg MH, Forget BG, Chui DHK. The genetic basis of asymptomatic codon 8 frame-shift (HBB:c25_26delAA) β(0) -thalassaemia homozygotes. Br J Haematol 2016; 172:958-65. [PMID: 26771086 DOI: 10.1111/bjh.13909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 11/09/2015] [Indexed: 11/27/2022]
Abstract
Two 21-year old dizygotic twin men of Iraqi descent were homozygous for HBB codon 8, deletion of two nucleotides (-AA) frame-shift β(0) -thalassaemia mutation (FSC8; HBB:c25_26delAA). Both were clinically well, had splenomegaly, and were never transfused. They had mild microcytic anaemia (Hb 120-130 g/l) and 98% of their haemoglobin was fetal haemoglobin (HbF). Both were carriers of Hph α-thalassaemia mutation. On the three major HbF quantitative trait loci (QTL), the twins were homozygous for G>A HBG2 Xmn1 site at single nucleotide polymorphism (SNP) rs7482144, homozygous for 3-bp deletion HBS1L-MYB intergenic polymorphism (HMIP) at rs66650371, and heterozygous for the A>C BCL11A intron 2 polymorphism at rs766432. These findings were compared with those found in 22 other FSC8 homozygote patients: four presented with thalassaemia intermedia phenotype, and 18 were transfusion dependent. The inheritance of homozygosity for HMIP 3-bp deletion at rs66650371 and heterozygosity for Hph α-thalassaemia mutation was found in the twins and not found in any of the other 22 patients. Further studies are needed to uncover likely additional genetic variants that could contribute to the exceptionally high HbF levels and mild phenotype in these twins.
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Affiliation(s)
- Zhihua Jiang
- Departments of Medicine, Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Hong-Yuan Luo
- Departments of Medicine, Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Shengwen Huang
- Departments of Medicine, Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - John J Farrell
- Departments of Medicine, Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Lance Davis
- Departments of Medicine, Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Roger Théberge
- Center for Biomedical Mass Spectrometry, Boston University School of Medicine, Boston, MA, USA
| | - Katherine A Benson
- Departments of Medicine, Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Suchada Riolueang
- Department of Paediatrics and Thalassaemia Centre, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Vip Viprakasit
- Department of Paediatrics and Thalassaemia Centre, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nasir A S Al-Allawi
- Faculty of Medical Sciences, Scientific Research Centre, University of Duhok, Duhok, Iraq
| | - Sule Ünal
- Division of Paediatric Haematology, Department of Paediatrics, Hacettepe University, Ankara, Turkey
| | - Fatma Gümrük
- Division of Paediatric Haematology, Department of Paediatrics, Hacettepe University, Ankara, Turkey
| | - Nejat Akar
- Department of Paediatric Molecular Genetics, Medical School, Ankara University, Ankara, Turkey
| | - A Nazli Başak
- Department of Molecular Biology and Genetics, Neurodegeneration Research Laboratory, Boğaziçi University, Istanbul, Turkey
| | - Leonor Osorio
- Laboratório de Genética Molecular, Faculdade de Ciências e Tecnologia, Universidade Nova de Lisboa, Caparica, Portugal
| | - Catherine Badens
- Laboratoire de génétique moléculaire, Centre de référence Thalassémies, APHM, Hôpital d'enfants de la Timone, Marseille, France
| | - Serge Pissard
- Departement de genetique, GHU Henri Mondor, Créteil, France
| | - Philippe Joly
- Laboratoire de Biochimie et de Biologie Moléculaire, Hôpital Edouard Herriot, Unité de Pathologie Moléculaire du Globule Rouge, Hospices Civils & Université Claude Bernard-Lyon 1, Lyon, France
| | - Andrew D Campbell
- Department of Pediatrics, University of Michigan School of Medicine, Ann Arbor, MI, USA
| | - Patrick G Gallagher
- Departments of Pediatrics, Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Martin H Steinberg
- Departments of Medicine, Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Bernard G Forget
- Departments of Medicine, Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - David H K Chui
- Departments of Medicine, Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA
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