OBJECTIVETo establish and evaluate a protein microarray method for combined measurement of serum ferritin (SF) and soluble transferrin receptor (sTfR).

METHODSMicroarrayer was used to print both anti-SF antibodies I and anti-sTfR antibodies I on each protein microarray. Anti-SF antibodies II and anti-sTfR antibodies II were used as detection antibodies and goat antibodies coupled to Cy3 were used as antibodies III. The detection conditions of the quantitative analysis method for simultaneous measurement of SF and sTfR with protein microarray were optimized and evaluated. The protein microarray was compared with commercially available traditional tests with 26 serum samples.

RESULTSBy comparison experiment, mouse monoclonal antibodies were chosen as the probes and contact printing was chosen as the printing method. The concentrations of SF and sTfR probes were 0.5 mg/mL and 0.5 mg/mL respectively, while those of SF and sTfR detection antibodies were 5 μg/mL and 0.36 μg/mL respectively. Intra- and inter-assay variability was between 3.26% and 18.38% for all tests. The regression coefficients comparing protein microarray with traditional test assays were better than 0.81 for SF and sTfR.

CONCLUSIONThe present study has established a protein microarray method for combined measurement of SF and sTfR.

Animals ; Antibodies, Monoclonal ; analysis ; Ferritins ; blood ; Mice ; Protein Array Analysis ; methods ; Rabbits ; Receptors, Transferrin ; blood

PURPOSE: Predicting life expectancy of terminally ill cancer patients is very important. In many studies, ferritin is detected at higher levels in the sera of cancer patients, and higher ferritin level correlates with aggressiveness of disease and poor outcomes of patients. This study evaluated a prognostic role of serum ferritin levels in terminally ill cancer patients. METHODS: This study enrolled 65 terminally ill cancer patients from March through June 2012. We assessed routine laboratory findings including serum ferritin levels as well as demographic and clinical characteristics of the patients. To examine the association between serum ferritin levels and patient's characteristics, we used Spearman's correlation analysis, Wilcoxon's rank sum test or Kruskal-Wallis test, as appropriately. For multivariate analysis, Cox's proportional hazard regression model was used to evaluate significance of serum ferritin levels as a prognostic factor. RESULTS: A negative correlation between serum ferritin levels and survival time was found. After adjusting for sex, age, performance status, creatinine levels and white blood cell counts, serum ferritin levels were significantly associated with survival time. CONCLUSION: Even at the very end of life of terminal cancer patients, serum ferritin levels were an independent prognostic factor for survival.
Creatinine ; Ferritins* ; Humans ; Leukocyte Count ; Life Expectancy ; Multivariate Analysis ; Prognosis ; Terminally Ill*

OBJECTIVE: To investigate the influence of iron deficiency on the index of thalassemia screening. METHODS: 876 blood samples of the couples at childbearing age, who underwent red blood cell analysis, hemoglobin electrophoresis, ferritin and gene diagnosis were selected. The samples were divided into normal, iron deficiency, αthalassemia, α-thalassemia combining with iron deficiency, β-thalassemia and β-thalassemia combining with iron deficiency group. The differences of hematology index and hemolobin value A2 between each groups were analyzed. RESULTS: The value of Hb, MCV, MCH, MCHC in iron deficiency, αthalassemia, α-thalassemia combining with iron deficiency, β-thalassemia and β-thalassemia combining with iron deficiency group all were lower than that of normal group, while the value of RDW-CV was higher, in which the difference between β-thalassemia was the highest. The distribution of HbA2 among each groups was not significantly different expect of β-thalassemia. There was no significant correlation between HbA2 and ferritin level. CONCLUSION RDW-CV increases in both iron deficiency and thalassemia. Iron deficiency has no significant effect on the level of hemoglobin A2.
Anemia, Iron-Deficiency ; Erythrocyte Indices ; Ferritins ; Hemoglobin A2 ; analysis ; Humans ; beta-Thalassemia

OBJECTIVETo investigate the clinical features of β-thalassaemia intermediate (TI) patients and the curative effect and side reactions of hydroxyurea therapys.

METHODSTwenty nine patients with TI were divided into hydroxyurea therapy group and no hydroxyurea therapy group; the curative effect and side reactions in 2 groups were compared; the situation of blood transfusion in the 2 groups was evaluated.

RESULTSIn hydroxyurea therapy group, the hemoglobin level increased after treatment for 3 months; the reticulocyte percentage obviously decreased after treatment for 12 months; the serum ferritin had been maintained at a low level; while in no hydroxyurea therapy group, the levels of hemoglobin and reticulocytes were not significantly improved after treatment, the serum ferritin level gradually increased. In hydroxyurea therapy group, 12 cases were out of blood transfusion after treatment for 12 months, effective rate of treatment was 85.71%; while in no hydroxyurea therapy group, the blood transfusion dependency was not improved after treatment. No serious side reactions were found in all the hydroxyurea treated patients.

CONCLUSIONThe hydroxyurea shows a better curative effect on TI patients, no serious side reactions occur in all the patients treated with hydroxyurea, but the long-term curative effect and side reactions should be observed continuously.

Blood Transfusion ; Ferritins ; analysis ; Hemoglobins ; analysis ; Humans ; Hydroxyurea ; therapeutic use ; Reticulocytes ; cytology ; Treatment Outcome ; beta-Thalassemia ; drug therapy

Anemia is one of the commonest extraintestinal manifestations of inflammatory bowel disease (IBD). The pathogenesis of anemia in IBD is complex but iron deficiency combined with inflammation is the most common factor related to the development of anemia. However, other causes such as vitamin B12 and folate deficiency, hemolysis, myelosuppression and drug also should not be overlooked. In addition to ferritin, inflammatory markers and new biochemical parameters such as hepcidin and ferritin index are being tested as diagnostic a tool. First step for treatment is disease activity control and iron supplementation. Although oral iron is widely used, intravenous iron therapy should be considered in patients who are intolerant to oral iron therapy, have severe and refractory anemia or are in active disease state. Recently, new intravenous iron formulations have been introduced and due to their safety and easy usage, they have become the standard treatment modality for managing anemia in IBD. Erythropoietin and transfusion can be considered in specific situations. Vitamin B12 and folate supplementation is also important in patients who are deficient of these micronutrients. Since anemia in IBD patients could significantly influence the disease outcome, further studies and standard guideline for IBD are needed.
Anemia/*drug therapy/etiology ; Biomarkers/analysis ; Ferritins/analysis ; Hepcidins/analysis ; Humans ; Inflammatory Bowel Diseases/complications/*diagnosis ; Iron/*therapeutic use ; Vitamin B 12/therapeutic use

OBJECTIVETo investigate the current status of vitamin A deficiency in preschool children in Dongguan, China, as well as the effect of vitamin A on serum ferritin, red blood cell, and reticulocyte parameters.

METHODSCluster sampling was performed from April 2015 to December 2016 to select 2 085 preschool children (3-6 years old) without any disease in Dongguan. Routine blood test, reticulocyte count, serum ferritin measurement, hemoglobin electrophoresis, and vitamin A measurement were performed for all children. The associations of age and sex with vitamin A and serum ferritin concentrations were analyzed. The effect of vitamin A concentration on serum ferritin, red blood cell, and reticulocyte parameters and the effect of reduced iron storage caused by vitamin A deficiency on red blood cell parameters were evaluated.

RESULTSOf the 2 085 children, 140 (6.71%) had reduced iron storage, and 678 (32.52%) had vitamin A deficiency. Among the 678 children with vitamin A deficiency, 647 (95.4%) had subclinical deficiency and 31 (4.6%) had clinical deficiency. There was no significant difference in vitamin A concentration between boys and girls, however girls had a significantly higher serum ferritin concentration than boys (P<0.05). The clinical vitamin A deficiency group had a significantly higher serum ferritin concentration than the subclinical vitamin A deficiency group and the normal group (P<0.05). In cases of vitamin A deficiency, the reduced iron storage group had significant reductions in mean corpuscular volume and mean corpuscular hemoglobin than the normal iron storage group (P<0.05). Compared with the normal vitamin A group, the vitamin A deficiency group had significantly lower hemoglobin concentration, mean corpuscular hemoglobin, red blood cell count, hematocrit, absolute reticulocyte count, reticulocyte percentage, and reticulocyte hemoglobin content, as well as a significantly higher mean corpuscular volume (P<0.05).

CONCLUSIONSVitamin A deficiency is prevalent in preschool children in Dongguan, China, and it may adversely affect serum ferritin, red blood cell, and reticulocyte parameters.

Child ; Child, Preschool ; Erythrocytes ; chemistry ; Female ; Ferritins ; blood ; Hemoglobins ; analysis ; Humans ; Male ; Vitamin A ; blood ; Vitamin A Deficiency ; blood

BACKGROUND: Iron deficiency anemia is the most common form of anemia in India. Hemoglobin A1c (HbA1c) is used in diabetic patients as an index of glycemic control reflecting glucose levels of the previous 3 months. Like blood sugar levels, HbA1c levels are also affected by the presence of variant hemoglobins, hemolytic anemias, nutritional anemias, uremia, pregnancy, and acute blood loss. However, reports on the effects of iron deficiency anemia on HbA1c levels are inconsistent. We conducted a study to analyze the effects of iron deficiency anemia on HbA1c levels and to assess whether treatment of iron deficiency anemia affects HbA1c levels. METHODS: Fifty patients confirmed to have iron deficiency anemia were enrolled in this study. HbA1c and absolute HbA1c levels were measured both at baseline and at 2 months after treatment, and these values were compared with those in the control population. RESULTS: The mean baseline HbA1c level in anemic patients (4.6%) was significantly lower than that in the control group (5.5%, p<0.05). A significant increase was observed in the patients' absolute HbA1c levels at 2 months after treatment (0.29 g/dL vs. 0.73 g/dL, p<0.01). There was a significant difference between the baseline values of patients and controls (0.29 g/dL vs. 0.74 g/dL, p<0.01). CONCLUSIONS: In contrast to the observations of previous studies, ours showed that HbA1c levels and absolute HbA1c levels increased with treatment of iron deficiency anemia. This could be attributable to nutritional deficiency and/or certain unknown variables. Further studies are warranted.
Adolescent ; Adult ; Anemia, Iron-Deficiency/*blood/drug therapy ; Child ; Female ; Ferritins/blood ; Hemoglobin A, Glycosylated/*analysis ; Hemoglobins/analysis ; Humans ; Iron/therapeutic use ; Male ; Time Factors

OBJECTIVETo explore the relationship between Helicobacter pylori (Hp) infection and iron status using serum ferritin (SF) as a marker for total iron and to identify the related factors of iron nutritional status among preschool children.

METHODSBy cluster sampling, we recruited 475 preschool children aged 2 to 7 years. A structured questionnaire and diet form were sent to the parents of these children to obtain related information about the socioeconomic level and dietary intakes. After collecting blood samples, the following indexes were measured. Hp IgG antibodies were measured with a dot enzyme-linked immunoassay; hemoglobin, Hct, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red blood cell distribution width index (RDW) with automatic Complete Blood Count; SF with an immunoradiometric assay. Stool Hp antigen and occult bleeding were measured with ELISA among individuals who were Hp seropositive. Hp status was defined as positive when both serum and stool antigen tests were positive, Hp status was defined as negative when serum antigen test was negative; 24-hour weighting and recording methods were used to dietary survey for three days in May and December 2001, respectively, dietary intakes including energy, protein and micronutrient were calculated using nursery school nutrition software and evaluated by Chinese Dietary Reference Intakes (DRIs). Mann-Whitney test was used to compare mean ranks of SF in Hp-positive and Hp-negative children. To obtain an adjusted estimate of the impact of Hp infection on SF, a multivariate analysis of covariance was done to evaluate the different level of SF between Hp infected and non-infected status. The relationship between iron deficiency and gender, age, socioeconomic condition, iron intake, and calcium intake was assessed by univariate analysis. An unconditional multivariate logistic regression analysis was also performed. Iron deficiency status was dichotomized and placed as the dependent variable. Hp infection status was incorporated together with possible confounding factors as independent variables in a final logistic regression model. All the data were managed by EPI Info 5.01a and analyzed by SAS (Version 6.12).

RESULTSTotally 64 children were diagnosed as Hp-positive and 305 as Hp-negative. Mann-Whitney test and multivariate analysis of covariance both showed that SF concentration was significantly lower in Hp infected individuals than non-infected individuals. Adjusted mean level and 95% confidence interval of SF in infected and non-infected children was 23.62 microg/L (7.13 microg/L-78.26 microg/L), 33.48 microg/L (10.28 microg/L-109.06 microg/L), respectively. The relationship between Hp infection and iron deficiency status persisted in logistic regression analysis after adjusting for possible confounding factors (OR: 7.95; 95% CI 2.56 - 24.67).

CONCLUSIONIron nutritional status was reduced in Hp infected preschool children. Hp infection appears to be an independent risk factor or an added stressor on iron status among preschool children.

Antibodies, Viral ; blood ; Child ; Child, Preschool ; Erythrocyte Indices ; Female ; Ferritins ; blood ; Helicobacter Infections ; blood ; Helicobacter pylori ; immunology ; Hemoglobins ; analysis ; Humans ; Logistic Models ; Male ; Multivariate Analysis ; Nutrition Assessment

PURPOSE: Hemophagocytic lymphohistiocytosis (HLH) is a rare but fatal disorder characterized by fever, splenomegaly, pancytopenia, and hemophagocytosis in the bone marrow and other tissues. In this study, we investigated the clinical manifestations and prognostic factors in patients with HLH. METHODS: We retrospectively analyzed the data from 29 patients who were diagnosed whit HLH in the Severance Children's Hospital from Jan. 1996 to Feb. 2007. RESULTS: The median age at diagnosis was 3.8 years (range 0.1-12.2). The ratio of male to female patients was 1.1:1. The 5-year overall survival rate was 55.2% with a median follow-up duration of 32 months. In a multivariate analysis, the duration of fever before admission (survival vs. non-survival, 6.5 days vs. 14 days, P=0.010), the interval from the day of fever onset to the day of initiation of etoposide (survival vs. non-survival, 10 days vs. 35 days, P=0.002) and the presence of neurologic symptoms (survival vs. non-survival, 1 case vs. 7 cases, P=0.010) were independent, poor prognostic factors of HLH. EBV infection, gender, and the level of serum ferritin had no relations to the poor prognosis of the disease. CONCLUSION: This study showed that the presence of neurologic symptoms and a longer duration of fever were related to a poor prognosis. Therefore, if a patient develops neurologic symptoms and the duration of fever is prolonged, a prompt diagnostic approach and aggressive treatment for HLH are necessary.
Bone Marrow ; Epstein-Barr Virus Infections ; Etoposide ; Female ; Ferritins ; Fever ; Follow-Up Studies ; Humans ; Lymphohistiocytosis, Hemophagocytic ; Male ; Multivariate Analysis ; Neurologic Manifestations ; Pancytopenia ; Prognosis ; Retrospective Studies ; Splenomegaly ; Survival Rate

Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman disease is a rare disorder characterized by proliferation of distinctive histiocytes within lymph node sinuses and lymphatics, sometimes involving extranodal sites. However, clinical suspicion is difficult and there is also a lack of useful diagnostic markers for this disorder prior to histological confirmation. High elevation of serum ferritin is known to be a useful diagnostic marker for various hematologic diseases, including hemophagocytic lymphohistiocytosis and lymphoma. Here, we report a case of fever of unknown origin that presented along with highly elevated serum ferritin (5,780 ng/mL), and was finally diagnosed as Rosai-Dorfman disease by lymph node biopsy.
Adult ; C-Reactive Protein/analysis ; Female ; Ferritins/*blood ; Histiocytosis, Sinus/blood/*diagnosis/pathology ; Humans ; L-Lactate Dehydrogenase/blood ; Lymph Nodes/pathology ; Positron-Emission Tomography and Computed Tomography