1
|
Wiesenack C, Meybohm P, Neef V, Kranke P. Current concepts in preoperative anemia management in obstetrics. Curr Opin Anaesthesiol 2023; 36:255-262. [PMID: 36794901 PMCID: PMC10155694 DOI: 10.1097/aco.0000000000001252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
PURPOSE OF REVIEW The purpose of this article is to provide an overview of currently recommended treatment approaches for anemia during pregnancy, with a special focus on iron deficiency and iron deficiency anemia (IDA). RECENT FINDINGS As consistent patient blood management (PBM) guidelines in obstetrics are still lacking, recommendations regarding the timing of anemia screening and the treatment recommendations for iron deficiency and IDA during pregnancy are still controversial. Based on increasing evidence, early screening for anemia and iron deficiency should be recommended at the beginning of each pregnancy. To reduce maternal and fetal burden, any iron deficiency, even without anemia, should be treated as early as possible during pregnancy. While oral iron supplements administered every other day are the standard treatment in the first trimester, the use of intravenous iron supplements is increasingly suggested from the second trimester onwards. SUMMARY The treatment of anemia, and more specifically iron deficiency anemia during pregnancy, holds many possibilities for improvement. The fact that the period of risk is known well in advance and thus there is a long optimization phase is per se an ideal prerequisite for the best possible therapy of treatable causes of anemia. Standardization of recommendations and guidelines for screening and treatment of IDA in obstetrics is required for the future. In any case, a multidisciplinary consent is the precondition for a successfully implementation of anemia management in obstetrics to establish an approved algorithm easily enabling detection and treatment of IDA during pregnancy.
Collapse
Affiliation(s)
- Christoph Wiesenack
- Department of Anaesthesiology, Evangelisches Diakoniekrankenhaus, Freiburg, Germany
| | - Patrick Meybohm
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg
| | - Vanessa Neef
- Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Goethe University, Frankfurt, Germany
| | - Peter Kranke
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wuerzburg, Wuerzburg
| |
Collapse
|
2
|
Sood V, Kamboj K, Bhatia P, Sharma V, Kundu M, Ghosh A, Singh SK, Sen T, Kaur P, Ramachandran R, Rathi M, Kohli HS, Gupta KL, Malhotra S, Yadav AK, Kumar V, Jha V. A randomized trial of once daily versus twice daily dosing of oral iron in CKD. Sci Rep 2023; 13:141. [PMID: 36599872 PMCID: PMC9813132 DOI: 10.1038/s41598-022-26589-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 12/16/2022] [Indexed: 01/06/2023] Open
Abstract
We investigated the effect of two dosing regimens of oral iron on iron status and hematological parameters in patients with CKD. In this single center, open label, randomized, active controlled clinical trial, stable adult patients with CKD stage G3-4 with percentage transferrin saturation (%TSAT) ≤ 30% and serum ferritin ≤ 500 ng/ml were eligible. Participants were randomized to receive either 100 mg of ferrous ascorbate once daily (OD group) or 100 mg of ferrous ascorbate twice daily (BD group, total daily dose 200 mg). The primary outcome was change in %TSAT between groups over 12 weeks. The secondary outcomes were changes in other iron status and hematological parameters, serum interleukin-6 (IL-6) and hepcidin. 80 participants were enrolled out of which 76 completed the study. Change in %TSAT was not significantly different between groups (β = - 1.43, 95% CI - 3.99 to 1.12, BD group as reference). The rise in serum ferritin was less in the OD group as compared to BD group (β = - 0.36, 95% CI - 0.61 to - 0.10) whereas MCHC increased in the OD group as compared to decrease in the BD group (β = 0.37, 95% CI 0.067-0.67). These observations need exploration to ascertain the impact of different oral iron dosing strategies in CKD.
Collapse
Affiliation(s)
- Vivek Sood
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Kajal Kamboj
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Prateek Bhatia
- Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vishal Sharma
- Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Monica Kundu
- George Institute for Global Health, New Delhi, India
| | - Arpita Ghosh
- George Institute for Global Health, New Delhi, India
| | - Sanjay Kumar Singh
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Thakur Sen
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Prabhjot Kaur
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Raja Ramachandran
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Manish Rathi
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Harbir Singh Kohli
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Krishan Lal Gupta
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Samir Malhotra
- Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashok Kumar Yadav
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vivek Kumar
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - Vivekanand Jha
- George Institute for Global Health, New Delhi, India
- School of Public Health, Imperial College, London, UK
- Manipal Academy of Higher Education, Manipal, India
| |
Collapse
|
3
|
Obstfeld AE. Hematology and Machine Learning. J Appl Lab Med 2023; 8:129-144. [PMID: 36610431 DOI: 10.1093/jalm/jfac108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/18/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND Substantial improvements in computational power and machine learning (ML) algorithm development have vastly increased the limits of what autonomous machines are capable of. Since its beginnings in the 19th century, laboratory hematology has absorbed waves of progress yielding improvements in both of accuracy and efficiency. The next wave of change in laboratory hematology will be the result of the ML revolution that has already touched many corners of healthcare and society at large. CONTENT This review will describe the manifestations of ML and artificial intelligence (AI) already utilized in the clinical hematology laboratory. This will be followed by a topical summary of the innovative and investigational applications of this technology in each of the major subdomains within laboratory hematology. SUMMARY Application of this technology to laboratory hematology will increase standardization and efficiency by reducing laboratory staff involvement in automatable activities. This will unleash time and resources for focus on more meaningful activities such as the complexities of patient care, research and development, and process improvement.
Collapse
Affiliation(s)
- Amrom E Obstfeld
- Department of Pathology & Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA.,Department of Pathology & Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| |
Collapse
|
4
|
Arkew M, Asmerom H, Tesfa T, Tsegaye S, Gemechu K, Bete T, Haile K. Red Blood Cell Parameters and Their Correlation with Glycemic Control Among Type 2 Diabetic Adult Patients in Eastern Ethiopia: A Comparative Cross-Sectional Study. Diabetes Metab Syndr Obes 2022; 15:3499-3507. [PMID: 36388065 PMCID: PMC9656327 DOI: 10.2147/dmso.s386093] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/04/2022] [Indexed: 11/11/2022] Open
Abstract
Background Diabetes has been proposed to inflict an insult on the hematopoietic milieu marked by changes in hematological indices including red blood cell parameters. Thus, this study aimed to assess the red blood cell parameters and their correlation with glycemic control in type 2 diabetic adult patients in comparison with apparently healthy individuals. Methods A comparative cross-sectional study was conducted at the chronic illness clinic of Hiwot Fana Comprehensive Specialized University Hospital from May 20 to July 10, 2022. A total of 220 (110 type 2 diabetic patients and 110 controls) study participants were selected by a simple random sampling technique. Five milliliters of venous blood were collected by the vacutainer blood collection technique. Red blood cell parameters and blood glucose levels were determined using UniCel DxH 800 and Biosystems A25 analyzers, respectively. Independent sample t-test and Pearson correlation test were used for the data analysis. P-value <0.05 was considered statistically significant. Results Statistically significant difference was observed in RBC parameters of T2DM patients and the control group. The mean RBC count, Hgb, Hct (P < 0.001), and MCHC (P = 0.002) in patients with type 2 diabetes was significantly lower than in the control group. However, the mean of RDW was significantly increased in type 2 diabetic patient groups than in the control group (P < 0.001). The mean RBC count, Hct, and Hgb in patients with good glycemic control were significantly higher than the patients with poor glycemic control. Besides, a statistically significant negative correlation was observed between glycemic control and RBC count, Hgb, and Hct level in diabetic patients. Conclusion In this study, a statistically significant difference was observed in red blood cell parameters of type 2 diabetic patients compared to the control group. A significant negative correlation was noted between glycemic control and RBC parameters in type 2 diabetic patients. Therefore, evaluation of RBC parameters should be considered for better management of patients with type 2 diabetes mellitus.
Collapse
Affiliation(s)
- Mesay Arkew
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Haftu Asmerom
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tewodros Tesfa
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Setegn Tsegaye
- College of Health and Medical Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Kabtamu Gemechu
- School of Medical Laboratory Sciences, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Bete
- Department of Psychiatry, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kassahun Haile
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| |
Collapse
|
5
|
Potential of cell tracking velocimetry as an economical and portable hematology analyzer. Sci Rep 2022; 12:1692. [PMID: 35105914 PMCID: PMC8807587 DOI: 10.1038/s41598-022-05654-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 01/12/2022] [Indexed: 12/31/2022] Open
Abstract
Anemia and iron deficiency continue to be the most prevalent nutritional disorders in the world, affecting billions of people in both developed and developing countries. The initial diagnosis of anemia is typically based on several markers, including red blood cell (RBC) count, hematocrit and total hemoglobin. Using modern hematology analyzers, erythrocyte parameters such as mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), etc. are also being used. However, most of these commercially available analyzers pose several disadvantages: they are expensive instruments that require significant bench space and are heavy enough to limit their use to a specific lab and lead to a delay in results, making them less practical as a point-of-care instrument that can be used for swift clinical evaluation. Thus, there is a need for a portable and economical hematology analyzer that can be used at the point of need. In this work, we evaluated the performance of a system referred to as the cell tracking velocimetry (CTV) to measure several hematological parameters from fresh human blood obtained from healthy donors and from sickle cell disease subjects. Our system,
based on the paramagnetic behavior that deoxyhemoglobin or methemoglobin containing RBCs experience when suspended in water after applying a magnetic field, uses a combination of magnets and microfluidics and has the ability to track the movement of thousands of red cells in a short period of time. This allows us to measure not only traditional RBC indices but also novel parameters that are only available for analyzers that assess erythrocytes on a cell by cell basis. As such, we report, for the first time, the use of our CTV as a hematology analyzer that is able to measure MCV, MCH, mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), the percentage of hypochromic cells (which is an indicator of insufficient marrow iron supply that reflects recent iron reduction), and the correlation coefficients between these metrics. Our initial results indicate that most of the parameters measured with CTV are within the normal range for healthy adults. Only the parameters related to the red cell volume (primarily MCV and RDW) were outside the normal range. We observed significant discrepancies between the MCV measured by our technology (and also by an automated cell counter) and the manual method that calculates MCV through the hematocrit obtained by packed cell volume, which are attributed to the artifacts of plasma trapping and cell shrinkage. While there may be limitations for measuring MCV, this device offers a novel point of care instrument to provide rapid RBC parameters such as iron stores that are otherwise not rapidly available to the clinician. Thus, our CTV is a promising technology with the potential to be employed as an accurate, economical, portable and fast hematology analyzer after applying instrument-specific reference ranges or correction factors.
Collapse
|
6
|
Nii M, Okamoto T, Sugiyama T, Aoyama A, Nagaya K. Reticulocyte hemoglobin content changes after treatment of anemia of prematurity. Pediatr Int 2022; 64:e15330. [PMID: 36321339 DOI: 10.1111/ped.15330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 07/15/2022] [Accepted: 08/10/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Iron deficiency during infancy is associated with poor neurological development, but iron overload causes severe complications. Appropriate iron supplementation is therefore vital. Reticulocyte hemoglobin content (RET-He) provides a real-time assessment of iron status and chracterezes hemoglobin synthesis in preterm infants. However, the existing literature lacks detailed reports assessing chronological changes in RET-He. The aim of this study was to assess the chronological changes in RET-He during oral iron dietary supplementation, and concomitant therapy with recombinant human erythropoietin (rHuEPO) in preterm very low birthweight infants. METHODS Very low birthweight infants, admitted to our neonatal intensive care unit were analyzed retrospectively. Hemoglobin (Hb), reticulocyte percentage (Ret), mean corpuscular volume, RET-He, serum iron (Fe), and serum ferritin were recorded. Data at birth (T0), the initial day of rHuEPO therapy (T1), the initial day of oral iron supplementation (T2), 1-2 weeks (T3), 3-4 weeks (T4), 5-6 weeks (T5), and 7-8 weeks (T6) from the initial day of oral iron supplementation were extracted, and their changes over time were examined. RESULTS Reticulocyte hemoglobin content was highest at birth and declined rapidly thereafter, especially after starting rHuEPO therapy. There was no upward trend in RET-He after the initiation of oral iron supplementation, with a slower increase during 5-6 weeks after the initiation of iron therapy. CONCLUSIONS During the treatment of anemia of prematurity, low RET-He levels may be prolonged. Anemia of prematurity should therefore be assessed and treated on a case-by-case basis, while considering the iron metabolic capacity of preterm infants.
Collapse
Affiliation(s)
- Mitsumaro Nii
- Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital, Hokkaido, Japan
| | - Toshio Okamoto
- Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital, Hokkaido, Japan
| | - Tatsutoshi Sugiyama
- Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital, Hokkaido, Japan
| | - Aiko Aoyama
- Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital, Hokkaido, Japan
| | - Ken Nagaya
- Division of Neonatology, Center for Maternity and Infant Care, Asahikawa Medical University Hospital, Hokkaido, Japan
| |
Collapse
|
7
|
Kee YK, Jeon HJ, Oh J, Shin DH. Hypochromic red cells as predictors of anemia in patients undergoing hemodialysis: an observational retrospective study. Sci Rep 2021; 11:24215. [PMID: 34931015 PMCID: PMC8688501 DOI: 10.1038/s41598-021-03746-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 12/08/2021] [Indexed: 11/09/2022] Open
Abstract
The percentage of hypochromic red blood cells (%HRC) estimates the availability of iron by evaluating the degree of hemoglobinization. We investigated whether %HRC was a predictor of anemia in patients undergoing hemodialysis. We recruited 142 patients undergoing routine hemodialysis between 2017 and 2019. Delta hemoglobin level (ΔHb)1mo-baseline was calculated as the difference between the hemoglobin level at 1 month after study enrollment and that at the time of study enrollment. Development of anemia was defined as hemoglobin level ≤ 15% of baseline. The median %HRC was 3.1%. There was a significant negative correlation between (ΔHb)1mo- baseline and %HRC (r = − 0.63, P < 0.001). The incidence of anemia was significantly higher in patients with %HRC > 3.1% than in those with %HRC ≤ 3.1%. In the multivariate logistic regression analysis, %HRC was significantly related to the development of anemia (odds ratio 2.57, 95% confidence interval [CI] 1.72–3.85, P < 0.001). The best cutoff value for %HRC to predict the development of anemia was 4.3%, with a sensitivity and specificity of 67.74 (95% CI, 54.7–79.1) and 97.50 (95% CI, 91.3– 99.7), respectively. %HRC is an independent predictor of anemia in patients undergoing hemodialysis. %HRC ≤ 4.3% is an early marker to consider changing the anemia treatment.
Collapse
Affiliation(s)
- Youn Kyung Kee
- Department of Internal Medicine, College of Medicine, Hallym University, Kangdong Sacred Heart Hospital, 150, Seongan-ro, Gangdong-gu, Seoul, 05355, Korea
| | - Hee Jung Jeon
- Department of Internal Medicine, College of Medicine, Hallym University, Kangdong Sacred Heart Hospital, 150, Seongan-ro, Gangdong-gu, Seoul, 05355, Korea
| | - Jieun Oh
- Department of Internal Medicine, College of Medicine, Hallym University, Kangdong Sacred Heart Hospital, 150, Seongan-ro, Gangdong-gu, Seoul, 05355, Korea
| | - Dong Ho Shin
- Department of Internal Medicine, College of Medicine, Hallym University, Kangdong Sacred Heart Hospital, 150, Seongan-ro, Gangdong-gu, Seoul, 05355, Korea.
| |
Collapse
|
8
|
Olinder J, Ehinger D, Liljenborg E, Herwald H, Rydén C. Plasma Levels of Hepcidin and Reticulocyte Haemoglobin during Septic Shock. J Innate Immun 2020; 12:448-460. [PMID: 32950976 DOI: 10.1159/000508561] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 05/03/2020] [Indexed: 12/13/2022] Open
Abstract
Septic shock, a serious consequence of disseminated infection that has a high mortality, is due to a dysregulated, severe immune response triggered by the infection. Acute phase reactants play key roles in sepsis, for example, hepcidin regulating iron metabolism. Reticulocyte haemoglobin (Ret-He) depends on available iron in blood, indirectly regulated by hepcidin. This study aimed at exploring rapid changes in hepcidin and Ret-He in patients with septic shock receiving adequate antibiotic treatment. Fifteen patients, included within an hour of admission to the intensive care unit, were evaluated by microbiological tests and cultures, Sequential Organ Failure Assessment score, and plasma levels of hepcidin, Ret-He, heparin-binding protein (HBP), leucocytes, C-reactive protein, procalcitonin (PCT), and lactate. Samples were taken every morning for 7 consecutive days. Maximal levels of hepcidin (median 61 nmol/L; reference 1-12 nmol/L) were seen at the time of inclusion, then declining steadily similar to PCT and lactate levels. Ret-He values decreased transiently in response to increased hepcidin, normalization occurred at 96 h upon decrease of hepcidin levels. Maximal levels of HBP were noted 24 h after inclusion. In conclusion, hepcidin promptly declined within the first 24 h in patients with septic shock receiving adequate antibiotic treatment in contrast to Ret-He and HBP.
Collapse
Affiliation(s)
- Jon Olinder
- Department of Infectious Diseases, Helsingborg Hospital, Helsingborg, Sweden, .,Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden,
| | - Daniel Ehinger
- Department of Pathology, University and Regional Laboratories, Region Skåne, Helsingborg, Sweden
| | - Erik Liljenborg
- Department of Orthopaedic Surgery, County Hospital Halland, Halmstad, Sweden
| | - Heiko Herwald
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Cecilia Rydén
- Department of Infectious Diseases, Helsingborg Hospital, Helsingborg, Sweden.,Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| |
Collapse
|
9
|
Restrepo-Gallego M, Díaz LE, Rondó PHC. Classic and emergent indicators for the assessment of human iron status. Crit Rev Food Sci Nutr 2020; 61:2827-2840. [PMID: 32619106 DOI: 10.1080/10408398.2020.1787326] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Iron deficiency is the leading cause of anemia, a significant global public health problem. Different methods exist for assessing iron nutritional status, including laboratory tests that focus on storage, transportation, and iron functional compartment parameters. Classical markers such as bone marrow, serum iron, ferritin, hemoglobin, erythrocyte parameters, transferrin, transferrin receptors, and zinc protoporphyrin are discussed in this review. Additional parameters calculated from these indicators, including transferrin saturation, ferritin index and Thomas plot, and some emergent parameters such as hepcidin, erythroferrone, and low hemoglobin density are also discussed. There is no a single indicator for assessing iron nutritional status. Therefore, the use of more than one indicator may be the best practice to obtain the correct diagnosis, also considering the influence of inflammation/infection on many of these indicators. The constant validation of the current parameters, the improvement of assessment methods, and the identification of new indicators will be the key to refine the assessment of iron nutritional status and the right choice of treatment for its improvement.
Collapse
Affiliation(s)
| | - Luis E Díaz
- Doctorate Program in Bioscience, La Sabana University, Chía, Colombia
| | - Patrícia H C Rondó
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
10
|
Dinh NH, Cheanh Beaupha SM, Tran LTA. The validity of reticulocyte hemoglobin content and percentage of hypochromic red blood cells for screening iron-deficiency anemia among patients with end-stage renal disease: a retrospective analysis. BMC Nephrol 2020; 21:142. [PMID: 32321449 PMCID: PMC7178621 DOI: 10.1186/s12882-020-01796-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/06/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Early detection of iron-deficiency anemia (IDA) can enhance the efficiency and effectiveness of clinical treatment and quality of life for end-stage renal disease (ESRD) patients. This study aimed to evaluate the validity of CHr and %Hypo in screening IDA among ESRD patients and compare their performance with screening IDA among non-ESRD patients. METHOD A retrospective analysis of 312 participants was conducted at Cho Ray Hospital, Vietnam, including healthy control participants and ESRD patients. Receiver operator characteristics curves and the area under the curve (AUC) of models were used to evaluate the performance of CHr, %Hypo. Optimal cut-off values were determined using Youden's index. RESULTS Detecting IDA in ESRD patients is more complicated, as the screening performance of CHr and %Hypo in predicting IDA among ESRD patients were lower than non ESRD group, but still reasonable with AUC = 0.748 (95% CI: 0.656-0.840, power = 0.997) and 0.740 (95% CI: 0.647-0.833, power = 0.996), respectively. Cut-off values of CHr < 31.5 pg and %Hypo> 10.0 pg are recommended to obtain optimal screening ability for Vietnamese ESRD patients. CONCLUSION CHr and %Hypo appears to be useful tools for screening IDA among both non ESRD and ESRD patients. The low cost and accessible of the two markers encourage their utility as effective screening tools in clinical practice.
Collapse
Affiliation(s)
- Nhan Hieu Dinh
- Department of Pharmacology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
- Department of Internal Medicine, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam.
| | | | - Loan Thi Anh Tran
- Department of Hematology Laboratory, Cho Ray Hospital, Ho Chi Minh City, Vietnam
| |
Collapse
|
11
|
Affiliation(s)
- Gaurav Chhabra
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India. E-mail:
| |
Collapse
|
12
|
Urrechaga E, de la Hera P, Aguayo FJ. Reticulocyte hemoglobin and hypochromic erythrocytes in the study of erythropoiesis in patients with inflammatory bowel disease. Scandinavian Journal of Clinical and Laboratory Investigation 2019; 80:124-128. [DOI: 10.1080/00365513.2019.1700549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
13
|
Mani L, Fatimah-Muis S, Kartini A. The correlation of intake phytate and tannin on serum transferrin receptor and hemoglobin in stunted overweight adolescents. POTRAVINARSTVO 2019. [DOI: 10.5219/1191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Stunted overweight teenagers are at risk of having iron deficiency. Iron deficiency is caused by various factors including the high food absorption inhibitors of iron such as phytate and tannins. Phytate and tannin contain polyphenol compounds which have a strong ability to bind iron so that it inhibits iron absorption in the intestine. This study aims to analyze the correlation between phytate, tannin intake and serum transferrin receptor (sTfR) and hemoglobin in stunted overweight adolescents. The research method was a cross-sectional study of 64 stunted overweight adolescents selected by consecutive sampling in four high schools/vocational high schools in Banyumanik District, Semarang City. Phytate and tannin intake data using SQ-FFQ method. The serum transferrin receptor examination uses the ELISA method and the hemoglobin level uses the Cyanomethemoglobin method. The results of the study, most of the respondents had high phytate and tannin intake of 96.9% and 89.1%. Respondents with low serum transferrin receptor were 7.8% and low hemoglobin levels were 7.8%. There was no correlation between phytate intake with serum transferrin receptor or hemoglobin (p1 = 0.937 r1 = -0.010, p2 = 0.192 r2 = 0.165). Tannins were significantly correlated with serum transferrin receptor and hemoglobin (p1 = 0.005 r1 = 0.344, p2 = 0.002 r2 = -0.374). Based on multivariate analysis, tannin is a determinant of hemoglobin (R2 = 0.257). Conclusion is that tannin is positively correlated with serum transferrin receptor and hemoglobin in stunted overweight adolescents. Excessive tannin intake can cause deficiency in stunted overweight adolescents.
Collapse
|
14
|
Enko D, Wagner H, Kriegshäuser G, Wögerer J, Halwachs-Baumann G, Schnedl WJ, Zelzer S, Fauler G, Mangge H, Markus H, Meinitzer A. Iron status determination in individuals with Helicobacter pylori infection: conventional vs. new laboratory biomarkers. Clin Chem Lab Med 2019; 57:982-989. [PMID: 31154451 DOI: 10.1515/cclm-2018-1182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 12/05/2018] [Indexed: 12/28/2022]
Abstract
Background Helicobacter pylori has been associated with iron deficiency (ID). This study is aimed at investigating ID with conventional (ferritin, transferrin saturation [TSAT]) and new biomarkers (soluble transferrin receptor [sTfR], sTfR/log ferritin, reticulocyte hemoglobin content [CHr], hepcidin-25) in patients sub-grouped by the presence or absence of H. pylori infection. Methods In total, 200 consecutive outpatients, who were referred for the H. pylori 13C-urea breath test (13C-UBT), underwent blood testing for ID. Additionally, Thomas-plot (TP)-analyses (sTfR/log ferritin, CHr) were calculated. Results Fifty-three and 147 individuals were found with and without H. pylori infection, respectively. Patients with H. pylori infection showed a higher sTfR concentration (p<0.02) and a higher sTfR/log ferritin ratio (p<0.05). Based on a ferritin <30 μg/L and/or a TSAT <20%, 25/53 (47.2%) patients with H. pylori infection and 63/147 (42.9%) without H. pylori infection showed ID. Based on TP-analyses, 10/53 (18.9%) patients with and 17/147 (11.6%) without H. pylori infection were identified with ID. Completed eradication therapy tended to be associated with functional ID. Conclusions Helicobacter pylori infection was associated with significantly higher plasma sTfR concentrations and sTfR/log ferritin ratios. Patients with H. pylori eradication therapy were more often detected with functional ID compared to patients without eradication therapy, when using the new biomarkers.
Collapse
Affiliation(s)
- Dietmar Enko
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Helga Wagner
- Department of Applied Statistics, Johannes Kepler University Linz, Linz, Austria
| | - Gernot Kriegshäuser
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Julia Wögerer
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria
| | | | | | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Günter Fauler
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Herrmann Markus
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| |
Collapse
|
15
|
Kim G, Jo Y, Cho H, Min HS, Park Y. Learning-based screening of hematologic disorders using quantitative phase imaging of individual red blood cells. Biosens Bioelectron 2019; 123:69-76. [DOI: 10.1016/j.bios.2018.09.068] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
|
16
|
Peri-operative treatment of anaemia in major orthopaedic surgery: a practical approach from Spain. BLOOD TRANSFUSION = TRASFUSIONE DEL SANGUE 2017; 15:296-306. [PMID: 28151388 DOI: 10.2450/2017.0177-16] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 08/31/2016] [Indexed: 12/16/2022]
Abstract
In patients undergoing major orthopaedic surgery, pre-operative anaemia, peri-operative bleeding and a liberal transfusion policy are the main risk factors for requiring red blood cell transfusion (RBCT). The clinical and economic disadvantages of RBCT have led to the development and implementation of multidisciplinary, multimodal, individualised strategies, collectively termed patient blood management, which aim to reduce RBCT and improve patients' clinical outcome and safety. Within a patient blood management programme, low pre-operative haemoglobin is one of the few modifiable risk factors for RBCT. However, a survey among Anaesthesia Departments in Spain revealed that, although pre-operative assessment was performed in the vast majority of hospitals, optimisation of haemoglobin concentration was attempted in <40% of patients who may have benefitted from it, despite there being enough time prior to surgery. This indicates that haemoglobin optimisation takes planning and forethought to be implemented in an effective manner. This review, based on available clinical evidence and our experience, is intended to provide clinicians with a practical tool to optimise pre-operative haemoglobin levels, in order to minimise the risk of patients requiring RBCT. To this purpose, after reviewing the diagnostic value and limitations of available laboratory parameters, we developed an algorithm for the detection, classification and treatment of pre-operative anaemia, with a patient-tailored approach that facilitates decision-making in the pre-operative assessment. We also reviewed the efficacy of the different pharmacological options for pre-operative and post-operative management of anaemia. We consider that such an institutional pathway for anaemia management could be a viable, cost-effective strategy that is beneficial to both patients and healthcare systems.
Collapse
|
17
|
Al‐Ghananim RT, Nalbant D, Schmidt RL, Cress GA, Zimmerman MB, Widness JA. Reticulocyte Hemoglobin Content During the First Month of Life in Critically Ill Very Low Birth Weight Neonates Differs From Term Infants, Children, and Adults. J Clin Lab Anal 2016; 30:326-34. [PMID: 25968472 PMCID: PMC4644110 DOI: 10.1002/jcla.21859] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 04/08/2015] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Reticulocyte hemoglobin content (RET-He)-an established indicator of iron status in children and adults-was determined in very low birth weight (VLBW) infants. METHODS Longitudinal retrospective RET-He data in 26 VLBW neonates during the first month of age were compared with: (a) concurrent complete blood counts (CBCs), including hemoglobin (Hb) concentration, reticulocyte count, and immature reticulocyte fraction (IRF), and erythropoietin (EPO) levels; (b) clinical variables; and (c) RET-He data from the literature for term infants, children, and adults. RESULTS RET-He within 24 hr following birth was 31.8 ± 1.1 pg (mean ± SEM). This was followed by an abrupt, significant decline to 28.3 ± 1.1 pg at 2-4 days, and to steady state levels of 28.4 ± 0.5 pg thereafter. The changes in RET-He were mirrored by changes in plasma EPO, reticulocyte count, and IRF, but not Hb. Steady state RET-He values after 4 days were significantly lower than RET-He values for term infants, children, and adults (31.6 ± 0.11, 32.0 ± 0.12, and 33.0 ± 0.13 pg, respectively). CONCLUSION Although RET-He values in VLBW infant were lower than term infants, children, and adults, the significance and mechanism(s) responsible are unknown. The present VLBW infant data are relevant to investigations assessing hemoglobinization following treatment with recombinant human EPO (r-HuEPO) and/or iron.
Collapse
Affiliation(s)
| | - Demet Nalbant
- Department of PediatricsUniversity of Iowa College of MedicineIowa CityIowa
| | - Robert L. Schmidt
- Department of PediatricsUniversity of Iowa College of MedicineIowa CityIowa
| | - Gretchen A. Cress
- Department of PediatricsUniversity of Iowa College of MedicineIowa CityIowa
| | - M. Bridget Zimmerman
- Department of BiostatisticsCollege of Public HealthUniversity of IowaIowa CityIowa
| | - John A. Widness
- Department of PediatricsUniversity of Iowa College of MedicineIowa CityIowa
| |
Collapse
|
18
|
Crispin P, Sinclair F, Andriolo K. Low haemoglobin density for detecting iron deficiency across a large population, including pregnancy. Int J Lab Hematol 2016; 38:397-402. [DOI: 10.1111/ijlh.12510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 03/21/2016] [Indexed: 11/29/2022]
Affiliation(s)
- P. Crispin
- Haematology Department; Canberra Hospital; Woden ACT Australia
| | - F. Sinclair
- Australian National University Medical School; Canberra ACT Australia
| | | |
Collapse
|
19
|
Zamora TG, Guiang SF, Georgieff MK, Widness JA. Iron is prioritized to red blood cells over the brain in phlebotomized anemic newborn lambs. Pediatr Res 2016; 79:922-8. [PMID: 26866907 PMCID: PMC4899227 DOI: 10.1038/pr.2016.20] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Accepted: 12/03/2015] [Indexed: 12/17/2022]
Abstract
BACKGROUND Critically ill preterm and term neonates are at high risk for negative iron balance due to phlebotomy that occurs with frequent laboratory monitoring, and the high iron demand of rapid growth. Understanding the prioritization of iron between red blood cells (RBCs) and brain is important given iron's role in neurodevelopment. METHODS Ten neonatal twin lamb pairs (n = 20) underwent regular phlebotomy for 11 d. Lambs were randomized to receive no iron or i.v. daily iron supplementation from 1 to 5 mg/kg. Serum hemoglobin concentration and reticulocyte count were assayed, iron balance calculated, and iron content of RBCs, liver, brain, muscle, and heart measured at autopsy. RESULTS Among phlebotomized lambs: (i) liver iron concentration was directly related to net iron balance (r = 0.87; P < 0.001) and (ii) brain iron concentration was reduced as a function of net iron balance (r = 0.63) only after liver iron was depleted. In animals with negative iron balance, total RBC iron was maintained while brain iron concentration decreased as a percentage of the iron present in RBCs (r = -0.70; P < 0.01) and as a function of reticulocyte count (r = -0.63; P < 0.05). CONCLUSION Phlebotomy-induced negative iron balance limits iron availability to the developing brain.
Collapse
Affiliation(s)
- Tara G Zamora
- Children’s Hospitals and Clinics of Minnesota. St. Paul, MN, USA,Department of Pediatrics, University of Minnesota School of Medicine. Minneapolis, MN, USA,Corresponding Author Contact: Tara G Zamora, MD, 347 N Smith Ave Suite 505 St. Paul MN 55102, P: 651-220-6264 F: 651-220-7777,
| | - Sixto F Guiang
- Department of Pediatrics, University of Minnesota School of Medicine. Minneapolis, MN, USA
| | - Michael K Georgieff
- Department of Pediatrics, University of Minnesota School of Medicine. Minneapolis, MN, USA
| | - John A Widness
- Department of Pediatrics, University of Iowa School of Medicine. Iowa City, Iowa, USA
| |
Collapse
|
20
|
Urrechaga E, Borque L, Escanero JF. Clinical Value of Hypochromia Markers in the Detection of Latent Iron Deficiency in Nonanemic Premenopausal Women. J Clin Lab Anal 2016; 30:623-7. [PMID: 26899023 DOI: 10.1002/jcla.21912] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 11/05/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Iron deficiency (ID) is the most common cause of anemia in fertile women and hemoglobin (Hb) within the reference interval does not exclude ID. The consequence of an imbalance between the iron requirements and supply is a reduction of red-cell Hb content, which causes hypochromic cells. The aim of this study was to assess the reliability of new parameters low Hb density (LHD%), reticulocyte Hb equivalent (RetHe), and percentage of hypochromic erythrocytes (%HypoHe) in the detection of latent ID (LID), defined as depletion of iron stores without anemia. METHODS Two hundred fifty consecutive nonanemic women in fertile age (18-40 years, mean 33.5 years), whose analyses had been requested by general practitioners, were included. Independent samples t-test, receiver operating characteristic (ROC) curve analysis (gold standard for detecting LID ferritin <30 μg/l), and Cohen's kappa index were applied. RESULTS One hundred fifty-three women had ferritin within the reference range and Hb >120 g/L; 97 (38.8%) had LID. The results were as follows: %HypoHe-AUC 0.934, cutoff 1.6%, sensitivity 85.7%, specificity 92.1%; RetHe-AUC 0.914, cutoff 29.9 pg, sensitivity 86.8%, specificity 85.7%; LHD%-AUC 0.898, cutoff 5.0%, sensitivity 85.9%, specificity 84.1%. Applying those cutoffs, agreement between ferritin and %HypoHe was κ 0.61 and 0.56 for RetHe and LHD%. CONCLUSIONS LHD%, %HypoHe, and RetHe emerge as reliable tests for the investigation of LID and could improve the ability to detect ID before anemia is present.
Collapse
Affiliation(s)
| | - Luís Borque
- Department of Pharmacology and Physiology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| | - Jesús F Escanero
- Department of Pharmacology and Physiology, Faculty of Medicine, University of Zaragoza, Zaragoza, Spain
| |
Collapse
|
21
|
Hoepers ATDC, Menezes MM, Fröde TS. Systematic review of anaemia and inflammatory markers in chronic obstructive pulmonary disease. Clin Exp Pharmacol Physiol 2015; 42:231-9. [PMID: 25641228 DOI: 10.1111/1440-1681.12357] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 12/12/2014] [Accepted: 12/27/2014] [Indexed: 11/30/2022]
Abstract
This systematic review synthesizes the relevant published articles on the prevalence of anaemia in patients with chronic obstructive pulmonary disease (COPD) and its relationship with inflammatory markers. The upregulation of erythropoietin in anaemia maintains homeostasis. However, anaemic COPD patients do not respond to increased levels of erythropoietin. The increased levels could be an indicator of the peripheral erythropoietin resistance in COPD. Anaemia and inflammation are associated with an increased risk of hospitalization and mortality in these patients. The understanding of anaemia in chronic inflammation is that anaemia is at least partially due to the excessive production of inflammatory cytokines, which can contribute to improvements in the management, prognosis, and survival of patients with COPD and anaemia.
Collapse
|
22
|
Enko D, Wagner H, Kriegshäuser G, Kimbacher C, Stolba R, Halwachs-Baumann G. Assessment of human iron status: A cross-sectional study comparing the clinical utility of different laboratory biomarkers and definitions of iron deficiency in daily practice. Clin Biochem 2015; 48:891-6. [DOI: 10.1016/j.clinbiochem.2015.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 05/08/2015] [Indexed: 02/07/2023]
|
23
|
|
24
|
Basora M, Colomina MJ, Tio M, Mora L, Sánchez-Etayo G, Salazar F, Ciércoles E, Paños M, Guerrero E, Berge R. Optimizing preoperative haemoglobin in major orthopaedic surgery using intravenous iron with or without erythropoietin. An epidemiologic study. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2015; 62:313-321. [PMID: 25698609 DOI: 10.1016/j.redar.2014.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 07/06/2014] [Accepted: 07/10/2014] [Indexed: 06/04/2023]
Abstract
AIM To evaluate the effectiveness of intravenous iron treatment, with or without associated erythropoietin (rHuEPO), measured as haemoglobin (Hb) increase. The relationships between the Hb increase and parameters used to evaluate anaemia were analysed. MATERIAL AND METHOD Retrospective observational study carried out in two third-level hospitals between January 2005 and December 2009. The study included patients with iron deficiency anaemia scheduled for elective orthopaedic surgery and treated with intravenous iron sucrose alone or associated with rHuEPO. Treatment efficacy was analysed based on the Hb increase from baseline to just before surgery. RESULTS A total of 412 patients who received a median of 800mg of iron sucrose were included; 125 of them (30.4%) additionally received 2.4 vials of rHuEPO. The Hb increase was 0.8 (1.1) g/dL in patients treated with intravenous iron and 1.5 (1.3) g/dL in those additionally given rHuEPO(P<.01). The percentage of hypochromic red blood cells (r=0.52) and soluble transferrin receptor (r=0.59) value were significantly correlated to the Hb increase in patients receiving iron. CONCLUSIONS In patients with iron deficiency anaemia, the effectiveness of iron sucrose treatment to optimize Hb before surgery was moderate; adjuvant administration of erythropoietin improved the results. Determination of functional iron status parameters may improve the treatment effectiveness.
Collapse
Affiliation(s)
- M Basora
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic, Barcelona, España.
| | - M J Colomina
- Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - M Tio
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic, Barcelona, España
| | - L Mora
- Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - G Sánchez-Etayo
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic, Barcelona, España
| | - F Salazar
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic, Barcelona, España
| | - E Ciércoles
- Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - M Paños
- Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - E Guerrero
- Servicio de Anestesiología y Reanimación, Hospital Universitario Vall d'Hebron, Barcelona, España
| | - R Berge
- Servicio de Anestesiología, Reanimación y Terapéutica del Dolor, Hospital Clínic, Barcelona, España
| |
Collapse
|
25
|
Teixeira C, Barbot J, Freitas MI. Reference values for reticulocyte parameters and hypochromic RBC in healthy children. Int J Lab Hematol 2015; 37:626-30. [DOI: 10.1111/ijlh.12374] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 03/16/2015] [Indexed: 10/23/2022]
Affiliation(s)
- C. Teixeira
- Department of Pathology; Laboratory Hematology Unit; Centro Hospitalar do Porto; Porto Portugal
| | - J. Barbot
- Department of Medicine; Pediatric Hematology Unit; Centro Hospitalar do Porto; Porto Portugal
| | - M. I. Freitas
- Department of Pathology; Laboratory Hematology Unit; Centro Hospitalar do Porto; Porto Portugal
| |
Collapse
|
26
|
Tin SS, Wiwanitkit V. Prohepcidin, anemia and inflammatory markers in non-diabetic uremic patients. Ren Fail 2015; 37:185. [DOI: 10.3109/0886022x.2014.959432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
27
|
Posluszny JA, Napolitano LM. How do we treat life-threatening anemia in a Jehovah's Witness patient? Transfusion 2014; 54:3026-34. [DOI: 10.1111/trf.12888] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 08/17/2014] [Accepted: 08/18/2014] [Indexed: 12/14/2022]
Affiliation(s)
- Joseph A. Posluszny
- Division of Acute Care Surgery [Trauma, Burns, Critical Care, Emergency Surgery]; Department of Surgery; University of Michigan; Ann Arbor Michigan
| | - Lena M. Napolitano
- Division of Acute Care Surgery [Trauma, Burns, Critical Care, Emergency Surgery]; Department of Surgery; University of Michigan; Ann Arbor Michigan
| |
Collapse
|
28
|
Ng EHY, Leung JHW, Lau YS, Ma ESK. Evaluation of the new red cell parameters on Beckman Coulter DxH800 in distinguishing iron deficiency anaemia from thalassaemia trait. Int J Lab Hematol 2014; 37:199-207. [PMID: 24867505 DOI: 10.1111/ijlh.12262] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 04/23/2014] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The new red blood cell (RBC) parameters such as reticulocyte haemoglobin content and percentage of hypochromic red cells or equivalent, although useful in the laboratory assessment of iron deficiency anaemia (IDA), are confounded by thalassaemia trait (TT). We aim to evaluate the new red cell parameters on the Beckman Coulter DxH800 in distinguishing between IDA and TT. METHODS A total of 246 normal subjects, 102 patients with IDA and 115 subjects with TT were accrued for the study. The parameters studied were red blood cell size factor (RSF), low haemoglobin density (LHD%), microcytic anaemia factor (MAF), standard deviation of conductivity of the nonreticulocyte population (SD-C-NRET) and unghosted cell (UGC). Comparison between groups was performed by Student's t-test, and the diagnostic performance was determined by receiver operating characteristic (ROC) curve analysis. RESULTS Both the LHD% and RSF were significantly higher in IDA than TT, whereas MAF and SD-C-NRET were significantly lower. The SD-C-NRET showed the best diagnostic performance as a single parameter. A formula, [(RBC + Hb) × (HCT + SD-C-NRET)]/RDW-SD, was devised to distinguish between IDA and TT. With a cut-off value of 23, the area under the curve (AUC) was 0.995 (95% CI of 0.99-1.00), the sensitivity was 97%, and the specificity was 99.1%. CONCLUSIONS The new RBC parameters on Beckman Coulter DxH800 provide useful information in distinguishing between IDA and TT, which is important for clinical decision-making and for streamlining laboratory testing. A new formula is devised that performs better than other discriminant functions in the literature.
Collapse
Affiliation(s)
- E H Y Ng
- Department of Pathology, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong
| | | | | | | |
Collapse
|
29
|
Ambayya A, Su AT, Osman NH, Nik-Samsudin NR, Khalid K, Chang KM, Sathar J, Rajasuriar JS, Yegappan S. Haematological reference intervals in a multiethnic population. PLoS One 2014; 9:e91968. [PMID: 24642526 PMCID: PMC3958408 DOI: 10.1371/journal.pone.0091968] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 02/17/2014] [Indexed: 01/24/2023] Open
Abstract
INTRODUCTION Similar to other populations, full blood count reference (FBC) intervals in Malaysia are generally derived from non-Malaysian subjects. However, numerous studies have shown significant differences between and within populations supporting the need for population specific intervals. METHODS Two thousand seven hundred twenty five apparently healthy adults comprising all ages, both genders and three principal races were recruited through voluntary participation. FBC was performed on two analysers, Sysmex XE-5000 and Unicel DxH 800, in addition to blood smears and haemoglobin analysis. Serum ferritin, soluble transferrin receptor and C-reactive protein assays were performed in selected subjects. All parameters of qualified subjects were tested for normality followed by determination of reference intervals, measures of central tendency and dispersion along with point estimates for each subgroup. RESULTS Complete data was available in 2440 subjects of whom 56% (907 women and 469 men) were included in reference interval calculation. Compared to other populations there were significant differences for haemoglobin, red blood cell count, platelet count and haematocrit in Malaysians. There were differences between men and women, and between younger and older men; unlike in other populations, haemoglobin was similar in younger and older women. However ethnicity and smoking had little impact. 70% of anemia in premenopausal women, 24% in postmenopausal women and 20% of males is attributable to iron deficiency. There was excellent correlation between Sysmex XE-5000 and Unicel DxH 800. CONCLUSION Our data confirms the importance of population specific haematological parameters and supports the need for local guidelines rather than adoption of generalised reference intervals and cut-offs.
Collapse
Affiliation(s)
- Angeli Ambayya
- Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia
| | - Anselm Ting Su
- Department of Community Medicine and Public Health, Universiti Malaysia Sarawak, Kuching, Sarawak, Malaysia
| | | | | | - Khadijah Khalid
- Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia
| | - Kian Meng Chang
- Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia
| | - Jameela Sathar
- Department of Haematology, Hospital Ampang, Ampang, Selangor, Malaysia
| | | | | |
Collapse
|