No abstract available.
Anemia, Iron-Deficiency* ; Blood Platelets* ; Child* ; Humans ; Iron* ; Platelet Count*

Long-term repeated regular blood donation may result in the loss and deficiency of iron. Epidemiological studies have indicated that blood donation frequency, demographical characteristics, and genetic factors are associated with iron deficiency. Our review summarizes the progress in research of etiology of iron deficiency in blood donors and intervention measures to provide evidence for the health management of non-remunerated blood donors in China.
Blood Donors ; Ferritins ; Humans ; Iron ; Iron Deficiencies ; Risk Factors

Despite improved perioperative management and surgical techniques, patients undergoing hepatobiliary and pancreatic (HBP) surgery often need to be transfused. Although disadvantages of transfusion and advantages of patient blood management (PBM) have been recognized, study results of the effects of PBM in HBP surgery are rare. The aim of this article was to review the current status of PBM in Korea in patients having HBP surgery. PBM in HBP surgery consists of increasing preoperative hemoglobin level, preoperative blood conservation, and preoperative autologous blood donation. The main intraoperative modalities used to conserve blood in recent studies were autologous techniques of acute normovolemic hemodilution and intraoperative cell salvage (Cell Saver®). In postoperative PBM, blood augmentation with erythropoietin and iron are also used depending on the postoperative hemoglobin level. Advances in surgical, anesthesiologic and pharmacologic strategies have contributed to a reduction of blood loss during HBP surgery in all patients.
Blood Donors ; Erythropoietin ; Hemodilution ; Humans ; Iron ; Korea

OBJECTIVETo evaluate the efficacy and safety of deferasirox in heavily iron-overloaded patients with beta-thalassemia major.

METHODSA single arm, open-label clinical trial was conducted to evaluate the efficacy and safety of deferasirox in the treatment for 23 patients with beta-thalassemia major and heavily iron-overloaded in 3 years follow-up.

RESULTSThe 23 patients never received regular chelation before enrolling this trial [the mean baseline of serum ferritin was (5433.96 ± 2873.90) µg/L]. In this trial, a deferasirox dose of 20 mg×kg(-1)×d(-1) could stabilize serum ferritin levels, while of ≥ 30 mg×kg(-1)×d(-1) reduced the levels and achieved negative iron balance. There were no serious adverse events related to the drug. Most common adverse events were mild increases of liver enzyme and serum creatinine levels. Overall, 23 patients could tolerate the drug on schedule and all completed the trial.

CONCLUSIONAs a new oral iron chelator, deferasirox has a significant efficacy for the treatment of iron overload. The effectiveness is dependent on the courses of treatment and the dose of deferasirox. The single-dose used is safe and tolerated, so deferasirox can remarkably improve life quality of patients.

Humans ; Iron ; blood ; Iron Overload ; Quality of Life ; Treatment Outcome ; beta-Thalassemia ; blood

Iron deficiency is a major complication of regular blood donation as a result of regular iron loss from each donated blood unit. Ninety-two regular blood donors and 95 first time blood donors attending a hospital-based blood transfusion centre were assessed as to their haematological and iron status by blood counts and serum ferritin levels as an indicator of iron stores. All donors had passed the haemoglobin-screening test using a copper sulphate method prior to blood donation. Ferritin levels were found to be significantly lower among regular blood donors (47.8 mmol/L) as compared to first time blood donors (94.2 mmol/L). Iron deficiency as observed by low ferritin levels was seen in 7.4% of all first time donors as compared to 17.4% in regular donors. Male first time donors showed a low prevalence of iron deficiency but the prevalence significantly increased with regular blood donation. Female first time and regular blood donors however did not show any significant differences in prevalence of iron deficiency, with both groups exhibiting prevalence rates similar to male regular donors. The association between haemoglobin levels and iron deficiency was poor and the copper sulphate-screening test was found insensitive to anaemia with many donors passing the test and donating blood despite being anaemic. It is concluded that a high prevalence of iron deficiency is present among regular male blood donors and all female donors. Besides, the use of the copper sulphate screening test as a sole criterion for anaemia screening should be reviewed. Ferritin measurements should be included in the routine assessment of blood donors especially among regular blood donors.
seconds ; Blood Donors ; Iron deficiency, NOS ; In Blood ; Prevalence aspects

OBJECTIVETo investigate the abnormalities of iron metabolism, the prevalence and risk factors of iron overload and clinical characteristics of patients with aplastic anemia (AA).

METHODSA cross-sectional study was conducted on 520 newly diagnosed AA patients.

RESULTSIron overload was observed in 66(13%) of 520 AA patients,in which a higher prevalence of iron overload was seen not only in patients with infections(19/86, 22%)than those without infections (47/434, 11%, P<0.01), but also in patients with hepatitis associated AA(HAAA) (6/22, 19%) than the idiopathic cases (60/488, 12%, P>0.05). Excluded the patients with infections and/or HAAA, 43 of 405(11%)cases had iron overload, including 14 of 248(6%) cases without history of blood transfusion and 29 of 157 patients (18%, P<0.01) with transfusion. In univariate analysis, higher levels of serum ferritin (SF), serum iron (SI) and transferrin saturation (TS) were mainly observed in adult male patients with severe AA (SAA) and significantly upward with increasing blood transfusion (P<0.01). No differences of soluble transferrin receptor (sTfR) were observed between adults and children, males and females, hepatitis and idiopathic AA. However, patients with infections had significantly lower level of sTfR (0.50 mg/L) than cases without infections (0.79 mg/L, P<0.01). The level of sTfR in SAA patients (0.70 mg/L) was only half of that in non-SAA (NSAA) (1.36 mg/L, P<0.01). Patients with increasing blood transfusion had significantly downward levels of sTfR (P<0.01). In multivariate analysis, more than 8 U blood transfusion (OR=10.52, P<0.01), adults (OR=3.48, P<0.01), males (OR=3.32, P<0.01) and infections (OR=2.09, P<0.01) were independent risk factors.

CONCLUSIONAA patients had higher iron burden and were high-risk populations occurring iron overload. The iron overload occurred in 18% of patients with blood transfusion and in 6% of patients without transfusion.

Anemia, Aplastic ; complications ; physiopathology ; Blood Transfusion ; Ferritins ; blood ; Hepatitis ; complications ; Humans ; Iron ; blood ; metabolism ; Iron Overload ; physiopathology ; Risk Factors

The purpose of this study was to compare iron related indices in patients with iron deficiency anemia and chronic causative diseases between geriatric older than 65 years and adult, nongeriatric younger than 65 years groups. Iron deficiency anemia (IDA) cases with chronic disorders from Youngdong Severance hospital from June, 1991 to April, 1994, older than 65 years (17 cases), and younger than 65 years (29 cases) were analysed with iron related indices. Mean hemoglobin was 7.8 +/- 2.2 g/dl in geriatric IDA and 8.0 +/- 1.8 g/dl in adult IDA without significant difference. RDW value was 19.5 +/- 2.6 in geriatric IDA and 18.4 +/- 3.2 in adult IDA with no significant difference. Serum iron and transferrin saturation between geriatric IDA were 22.7 +/- 12.3 ug/dl, 6.7 +/- 4.1% and 28.6 +/- 16.6 ug/dl, 7.1 +/- 4.4% in adult IDA with no significant difference, but TIBC was significantly lower (P = 0.011) in geriatric IDA than in adult IDA patients (357.2 +/- 83.2, 413.6 +/- 54.0 ug/dl). In normal elderly people, serum ferritin was 152.5 +/- 95.4 ng/ml in male and 111.1 +/- 54.1 ng/ml in female with range 19.8 approximately 367.7 ng/ml in male and 11.7 approximately 238.7 ng/ml in female and was higher than that of normal adult in both sexes (147.0 +/- 108.0, 35.3 +/- 20.5 ng/ml) (P = 0.045). Serum ferritin in geriatric IDA was 13.8 +/- 11.8 ng/ml and 5.7 +/- 4.0 ng/ml in adult IDA with significant difference(P = 0.001). The Upper margin for geriatric IDA was 37 ng/ml with 95% confidence interval. In the diagnosis of geriatric IDA with causative diseases, we should consider that TIBC does not increase and the upper margin for serum ferritin is suggested to increases up to 37 ng/ml.
Aged ; Aged, 80 and over ; Anemia, Iron-Deficiency/*blood ; Female ; Ferritin/blood ; Hemoglobins/analysis ; Human ; Iron/blood ; Korea ; Male

Recently, there is a growing concern for loss of iron among repeat blood donors. We evaluated the effects of blood donation to iron deficiency in several studies and propose following measures to prevent iron depletion among repeat blood donors. We reviewed and analyzed comprehensively results of several domestic and foreign studies and cited Korean blood donor's statistics data. There is a high prevalence of iron depletion in repeat blood donors. Predictors of iron depletion (serum ferritin <12~15 ng/mL) included a high frequency of blood donation, short donation interval, and female gender regardless of blood donation type. Taking iron supplements reduced the risk of iron depletion for repeat blood donors. We would like to propose the following preventive measures for repeat blood donors. 1) Test for serum ferritin for repeat donors who donate at least three times per year. If the donors show low serum ferritin level which is below 15 ng/mL, 2) Increase the donation interval or limit of blood donation frequency and 3) Recommend iron supplement for a certain period.
Anemia, Iron-Deficiency ; Blood Donors ; Female ; Ferritins ; Humans ; Iron ; Prevalence ; Tissue Donors

PURPOSE: Flow cytometric automated reticulocyte analysis is a superior method to manual reticulocyte counting, with respect to precision and sensitivity. Furthermore, flow cytometric analysis is able to measure immature reticulocyte fraction(IRF) and reticulocyte cellular indices(RCI:cell hemoglobin content: CHr, mean cell volume:MCVr, cell hemoglobin concentration mean:CHCMr, distribytion width:RDWr, HDWr, CHDWr). In this study, we investigated the mean values and clinical significances of IRF and RCI in healthy children and pediatric anemia patients. METHODS: IRF and RCI were measured with an automated blood cell analyzer, ADVIA 120(Bayer, USA) using oxazine 750 dye, in 57 healthy children and 61 children with anemia. The anemia group consisted of 27 iron deficiency anemia(IDA) patients and 34 patients with anemia associated with acute infection(AAI). We compared the mean values of IRF and RCI in the control group classified according to age, between anemia groups and the control group, and between the IDA group and the AAI group. RESULTS: For the normal control group, the mean values of IRF, CHr, MCVr and HDWr were higher in neonates when compared to older children. The mean values of IRF and RDWr were significantly higher, and the mean values of CHr and CHCMr were significantly lower in the IDA group when compared to the control group. The mean value of IRF was significantly higher, and the mean value of CHDWr was significantly lower in the AAI group when compared to the control group. The mean values of IRF, CHr and CHCMr were significantly lower in the IDA group when compared to the AAI group. CONCLUSION: We could determine the normal mean values of IRF and RCI in healthy children classified according to age for understanding of hematopoietic response differences according to age. The evaluation of IRF and RCI by automated reticulocyte analyzer seemed to be accurate and clinically useful for the early diagnosis of anemia and the differentiation of IDA from AAI.
Anemia* ; Anemia, Iron-Deficiency ; Blood Cells ; Child ; Early Diagnosis ; Humans ; Infant, Newborn ; Iron ; Reticulocyte Count ; Reticulocytes*

Hemochromatosis is a disorder caused by excessive iron deposition in parenchymal cells that leads to cellular damage and organ dysfunction. The excessive iron overload of secondary hemochromatosis is associated with chronic disorders of erythropoiesis that are treated with prolonged repeated blood transfusions. We experienced two cases of transfusional hemochromatosis involving the pituitary gland, and we report the findings of the MR imaging.
Blood Transfusion ; Erythropoiesis ; Hemochromatosis* ; Humans ; Iron ; Iron Overload ; Magnetic Resonance Imaging* ; Pituitary Gland*