1.Causes of Abnormal Hemoglobin Electrophoresis.
Xue-Li PANG ; Hong-Fei DU ; Yan YANG ; Xiao-Ping ZHOU ; Ning TANG ; Jia-Wei LIU ; Ying XU
Journal of Experimental Hematology 2023;31(3):830-836
OBJECTIVE:
To investigate the possible causes of abnormal hemoglobin electrophoresis results.
METHODS:
The hemoglobin electrophoresis results of 5 696 patients in the First Affiliated Hospital of Chengdu Medical College from September 2018 to July 2021 were collected, and the abnormal results and clinical significance were analyzed.
RESULTS:
The results of 486 patients (accounting for 8.53%) were abnormal, of which 300 cases had increased HbA2, 135 cases had decreased HbA2, 44 cases had increased F alone, and 7 cases had abnormal hemoglobin bands. Among the 486 patients, 246 patients were thalassemia gene positive (the positive rate was 50.62%), including 29 cases of α thalassemia, 208 cases of β thalassemia and 9 cases of αβ thalassemia. Among the patients with elevated HbA2, 68.67% were detected β thalassemia, 3.00% αβ thalassemia, 9.33% were suspected to be caused by macrocytosis, 6.33% by thyroid dysfunction, and 12.67% by uncertainty of the method. Among the patients with reduced HbA2, 21.48% were detected α thalassemia, 60.00% iron deficiency anemia, 8.15% were suspected to be caused by thyroid dysfunction, and 10.37% by uncertainty of the method. Among the patients with elevated F alone, the results of thalassemia gene detection were negative, 40.91% of them were suspected to be caused by macrocytosis, 27.27% by hereditary persistence of fetal hemoglobin, 29.55% by special physiological condition of pregnant women, and 2.27% by hyperthyroidism. Abnormal hemoglobin bands were detected in 7 patients, including 4 cases of hemoglobin D, 2 cases of hemoglobin E, and 1 case of hemoglobin J.
CONCLUSION
Thalassemia, iron deficiency anemia, macrocytosis such as megaloblastic anemia and non-severe aplastic anemia, thyroid dysfunction, hereditary persistence of fetal hemoglobin, abnormal hemoglobin diseases, the uncertainty of the method are all important causes of abnormal hemoglobin electrophoresis results. In clinical work, the patient's indicators should be comprehensively analyzed to determine the possible cause.
Humans
;
Female
;
Pregnancy
;
beta-Thalassemia/genetics*
;
Anemia, Iron-Deficiency
;
Fetal Hemoglobin/analysis*
;
alpha-Thalassemia
;
Blood Protein Electrophoresis
;
Hemoglobin A2/analysis*
;
Hemoglobins, Abnormal/analysis*
2.Relationship between Iron Metabolic Parameters and Platelet Counts in Blood Donors.
Wen-Juan ZHONG ; Qiu-Fang ZHANG ; Cheng-Yong HUANG ; Ying-Chun CHEN ; Ye-Ping ZHOU ; Jin-Ying CHEN ; Jia ZENG
Journal of Experimental Hematology 2023;31(5):1481-1485
OBJECTIVE:
To investigate the correlation of iron metabolic parameters with platelet counts in blood donors.
METHODS:
A total of 400 blood donors who met requirements of apheresis platelet donation were collected, and their hematological parameters were analyzed. The donors were divided into low ferritin group and normal group, the differences of hematological parameters between the two groups were compared, and the correlation of iron metabolic parameters and routine hematology parameters with platelet counts were analyzed.
RESULTS:
Whether male or female, low ferritin group had higher platelet counts than normal group (P < 0.01). Among the iron metabolic parameters, the platelet counts was negatively correlated with serum ferritin (SF), serum iron (SI), and transferrin saturation (TSAT) (r =-0.162, r =-0.153, r =-0.256), and positively correlated with total iron binding capacity (TIBC) and unsaturated iron binding capacity (UIBC) (r =0.219, r =0.294) in female blood donors. Platelet counts was also negatively correlated with SF, SI and TSAT (r =-0.188, r =-0.148, r =-0.224) and positively correlated with UIBC (r =0.220) in male blood donors. Among the routine hematology parameters, platelet counts was negatively correlated with mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and reticulocyte hemoglobin equivalent (Ret-He) in female blood donors (r =-0.236, r =-0.267, r =-0.213, r =-0.284). Platelet counts was also negatively correlated with MCH, MCHC and Ret-He in male blood donors (r =-0.184, r =-0.221, r =-0.209).
CONCLUSION
In blood donors with low C-reactive protein level, the lower the iron store capacity, the lower the iron utilization, and the platelet counts tends to rise.
Male
;
Humans
;
Female
;
Iron/metabolism*
;
Blood Donors
;
Platelet Count
;
Anemia, Iron-Deficiency
;
Hemoglobins
;
Ferritins
3.Glycosylated Hemoglobin in Subjects Affected by Iron-Deficiency Anemia
Jari INTRA ; Giuseppe LIMONTA ; Fabrizio CAPPELLINI ; Maria BERTONA ; Paolo BRAMBILLA
Diabetes & Metabolism Journal 2019;43(4):539-544
Previous studies have suggested that iron-deficiency anemia affects glycosylated hemoglobin (HbA1c) measurements, but the results were contradictory. We conducted a retrospective case-control study to determine the effects of iron deficiency on HbA1c levels. Starting with the large computerized database of the Italian Hospital of Desio, including data from 2000 to 2016, all non-pregnant individuals older than 12 years of age with at least one measurement of HbA1c, cell blood count, ferritin, and fasting blood glucose on the same date of blood collection were enrolled. A total of 2,831 patients met the study criteria. Eighty-six individuals were diagnosed with iron-deficiency anemia, while 2,745 had a normal iron state. The adjusted means of HbA1c were significantly higher in anemic subjects (5.59% [37.37 mmol/mol]), than those measured in individuals without anemia (5.34% [34.81 mmol/mol]) (P<0.0001). These results suggest that clinicians should be cautious about diagnosing prediabetes and diabetes in individuals with anemia.
Anemia
;
Anemia, Iron-Deficiency
;
Blood Glucose
;
Case-Control Studies
;
Diabetes Complications
;
Fasting
;
Ferritins
;
Hemoglobin A, Glycosylated
;
Humans
;
Iron
;
Prediabetic State
;
Retrospective Studies
4.Expression of COX-1 and COX-2 in the Platelet of Iron Deficiency Anemia Women at Childbearing Age and Its Clinical Significance.
Ying ZHANG ; Ying CHU ; Yong-Hua YAO ; Wen-Juan YE ; Yu-Qin SHEN ; Lian-Hong XU
Journal of Experimental Hematology 2018;26(4):1162-1166
OBJECTIVETo detect the expression level of cyclooxygenase-1(COX-1) and cyclooxygenase-2(COX-2) in the platelet of iron deficiency anemia(IDA)women at childbearing age and to explore its correlation with the different indexes of anemia and platelets.
METHODSForty female IDA patients at childbearing age and 35 healthy controls were enrolled in this study. The Flow cytometry was used to detect the expression of platelet COX-1 and COX-2,the platelet aggregation function as examined by turbidimetric method,and the levels of serum ferritin were analyzed by electrochemical luminescence method,the leval of serum iron was determined by ELISA,and the correlation of different indexes was analyzed.
RESULTSCompared with healthy controls,the levels of platelet COX-1 and COX-2 were significantly lower in female IDA patients at Childbearing age(P<0.05),but platelet count(Plt),mean platelet volume(MPV) and platelet aggregation rate(PAgT)were not statistically different between the 2 groups(P > 0.05). The expression level of platelet COX-1 positively correlated with those of Hb(r =0.623,P<0.01),serum iron(r =0.321,P<0.05) and HCT(r=0.305,P<0.05). but the platelet COX-2 expression did not corelate with these indexs.
CONCLUSIONThe expression of platelet COX-1 and COX-2 in female IDA patients at Childbearing age markedly decrease,and the expression level of platelet COX-1 closely relates with the severity of anemia,that possesses reference value for clinical diagnosis of female IDA patients at Childbearing age..
Anemia, Iron-Deficiency ; Blood Platelets ; Cyclooxygenase 1 ; Cyclooxygenase 2 ; Female ; Ferritins ; Humans ; Platelet Aggregation ; Platelet Count
5.Hepcidin and iron parameters in children with anemia of chronic disease and iron deficiency anemia.
Gunjan MAHAJAN ; Sunita SHARMA ; Jagdish CHANDRA ; Anita NANGIA
Blood Research 2017;52(3):212-217
BACKGROUND: Anemia of chronic disease (ACD) and iron deficiency anemia (IDA) are the two most prevalent forms of anemia having interrelated characteristics. Hepcidin, a newly introduced biomarker for assessment of iron status, is a homeostatic regulator of iron metabolism. We investigated the role of hepcidin and other conventional iron parameters to assess iron status among children with ACD and IDA. We also identified children with ACD who developed iron deficiency (ID). METHODS: The study was undertaken in anemic children with 30 cases each of ACD and IDA along with 30 age and sex-matched controls. The ACD cases were subdivided into pure ACD and ACD with coexistent ID. All cases were subjected to following tests: complete blood count with peripheral smear, serum C-reactive protein, serum interleukin-6, iron studies, serum soluble transferrin receptor (sTfR), and serum hepcidin. RESULTS: The mean serum hepcidin concentration was significantly increased in pure ACD patients (143.85±42.76 ng/mL) as compared to those in IDA patients (6.01±2.83 ng/mL, P < 0.001) and controls (24.96±9.09 ng/mL, P <0.001). Also, compared to pure ACD patients [normal sTfR levels (<3 µg/mL)], the serum hepcidin concentration was reduced significantly in ACD patients with ID [high sTfR levels (≥3 µg/mL)] with a mean of 10.0±2.97 ng/mL. CONCLUSION: Hepcidin measurement can provide a useful tool for differentiating ACD from IDA and also help to identify an iron deficiency in ACD patients. This might aid in the appropriate selection of therapy for these patients.
Anemia*
;
Anemia, Iron-Deficiency*
;
Blood Cell Count
;
C-Reactive Protein
;
Child*
;
Chronic Disease*
;
Hepcidins*
;
Humans
;
Interleukin-6
;
Iron*
;
Metabolism
;
Receptors, Transferrin
6.Hookworm Infection: A Neglected Cause of Overt Obscure Gastrointestinal Bleeding.
Kun Yan WEI ; Qiong YAN ; Bo TANG ; Shi Ming YANG ; Peng Bing ZHANG ; Ming Ming DENG ; Mu Han LÜ
The Korean Journal of Parasitology 2017;55(4):391-398
Hookworm infections are widely prevalent in tropical and subtropical areas, especially in low income regions. In the body, hookworms parasitize the proximal small intestine, leading to chronic intestinal hemorrhage and iron deficiency anemia. Occasionally, hookworms can cause overt gastrointestinal bleeding, but this is often ignored in heavily burdened individuals from endemic infectious areas. A total of 424 patients with overt obscure gastrointestinal bleeding were diagnosed by numerous blood tests or stool examinations as well as esophagogastroduodenoscopy, colonoscopy, capsule endoscopy or double-balloon enteroscopy. All of the patients lived in hookworm endemic areas and were not screened for hookworm infection using sensitive tests before the final diagnosis. The patients recovered after albendazole treatment, blood transfusion, and iron replacement, and none of the patients experienced recurrent bleeding in the follow-up. All the 31 patients were diagnosed with hookworm infections without other concomitant bleeding lesions, a rate of 7.3% (31/424). Seventeen out of 227 patients were diagnosed with hookworm infections in the capsule endoscopy (CE), and 14 out of 197 patients were diagnosed with hookworm infections in the double balloon enteroscopy (DBE). Hookworm infections can cause overt gastrointestinal bleeding and should be screened in patients with overt obscure gastrointestinal bleeding (OGIB) in endemic infectious areas with sensitive methods. Specifically, the examination of stool specimens is clinically warranted for most patients, and the proper examination for stool eggs relies on staff's communication.
Albendazole
;
Ancylostoma
;
Ancylostomatoidea*
;
Anemia, Iron-Deficiency
;
Blood Transfusion
;
Capsule Endoscopy
;
Colonoscopy
;
Diagnosis
;
Double-Balloon Enteroscopy
;
Eggs
;
Endoscopy, Digestive System
;
Follow-Up Studies
;
Hematologic Tests
;
Hemorrhage*
;
Hookworm Infections*
;
Humans
;
Intestine, Small
;
Iron
;
Necator americanus
;
Ovum
7.Increased neutrophil-to-lymphocyte ratio: is it really diagnostic of restless legs syndrome?
Singapore medical journal 2017;58(2):112-112
Anemia, Iron-Deficiency
;
blood
;
Area Under Curve
;
Dopamine
;
metabolism
;
Humans
;
Hydrocortisone
;
blood
;
Immunity, Humoral
;
Inflammation
;
Leukocyte Count
;
Lymphocyte Count
;
Lymphocytes
;
cytology
;
Neutrophils
;
cytology
;
ROC Curve
;
Restless Legs Syndrome
;
blood
;
Sympathectomy
;
Time Factors
8.Clinical Significance of Hepcidin in the Diagnosis of Infant Iron Deficiency Anemia.
Hua-Ju CAI ; Ning-Ling WANG ; Kang-Kang LIU ; Jin-Hua CHU ; Yan WANG ; Lin-Hai YANG ; Zheng-Yu WU
Journal of Experimental Hematology 2016;24(2):546-550
OBJECTIVETo explore the clinical diagnostic value and significance of hepciden level by detecting the expression of serum hepcidin before and after treatment of infant iron deficiency anemia (IDA) with or without vitamin D deficiency.
METHODSA total of 60 cases of infamt IDA were divided into A and B groups, the group A consisted of 20 IDA infants with vitamin D deficiency, group B consisted of 48 IDA infants without vitamin D deficiency and the control group included 26 healthy infants. Blood examination including HGB, MCV, MCH and MCHC was performed by hematological analyzer, the level of serum ferritin was assayed by chemiluminescence immunoassay, the levels of hepcidin and 25- (OH) D were assayed by ELISA.
RESULTSThe levels of serum hepcidin in group A, B and control group before treatment were (29.16 ± 7.50), (27.11 ± 7.10) and (29.25 ± 8.39) ng/ml, respectively (P > 0.05). The level of serum hepcidin in group A and B after treatments was significantly higher than that in control group [ (36.21 ± 5.68) ng/ml vs (29.25 ± 8.39) ng/ml, P < 0.01; (34.16 ± 4.54) ng/ml vs (29.25 ± 8.39) ng/ml, P < 0.01]; but there were no significantly difference between group A and B (P > 0.05). The serum ferritin positively correlated with hepcidin in group B both before and after treatments (r = 0.352 and 0.367, P < 0.05, P < 0.05).
CONCLUSIONThe level of serum hepcidin has an important significance in poccess of evaluatng for therapeutic effect in infant iron deficiency anemia, but the interference effect of vitamin D deficience should be eliminated when the expression level of hepcidin is applicated for diagnosis and differential diagnosis.
Anemia, Iron-Deficiency ; diagnosis ; Case-Control Studies ; Diagnosis, Differential ; Enzyme-Linked Immunosorbent Assay ; Hepcidins ; blood ; Humans ; Infant ; Vitamin D Deficiency ; blood
9.Prevalence and Relationships of Iron Deficiency Anemia with Blood Cadmium and Vitamin D Levels in Korean Women.
Young Ju SUH ; Ji Eun LEE ; Dae Hyung LEE ; Hyeon Gyu YI ; Moon He LEE ; Chul Soo KIM ; Jeung Weon NAH ; Soon Ki KIM
Journal of Korean Medical Science 2016;31(1):25-32
Anemia, iron deficiency (ID), and iron deficiency anemia (IDA) are common disorders. This study was undertaken to determine the prevalence of anemia, ID, and IDA in Korean females. We examined the associations between IDA, heavy metals in blood, vitamin D level and nutritional intakes. The study was performed using on data collected from 10,169 women (aged > or =10 yr), including 1,232 with anemia, 2,030 with ID, and 690 with IDA during the fifth Korea National Health and Nutrition Examination Survey (KNHANES V; 2010-2012). Prevalence and 95% confidence intervals were calculated, and path analysis was performed to identify a multivariate regression model incorporating IDA, heavy metals in blood, vitamin D level, and nutritional intakes. The overall prevalence of anemia, ID and IDA was 12.4%, 23.11%, and 7.7%, respectively. ID and IDA were more prevalent among adolescents (aged 15-18 yr; 36.5% for ID; 10.7% for IDA) and women aged 19-49 yr (32.7% for ID; 11.3% for IDA). The proposed path model showed that IDA was associated with an elevated cadmium level after adjusting for age and body mass index (beta=0.46, P<0.001). Vitamin D levels were found to affect IDA negatively (beta=-0.002, P<0.001). This study shows that the prevalence of anemia, ID, and IDA are relatively high in late adolescents and women of reproductive age. Path analysis showed that depressed vitamin D levels increase the risk of IDA, and that IDA increases cadmium concentrations in blood. Our findings indicate that systematic health surveillance systems including educational campaigns and well-balanced nutrition are needed to control anemia, ID, and IDA.
Adolescent
;
Adult
;
Aged
;
Anemia, Iron-Deficiency/*blood/*epidemiology
;
Body Mass Index
;
Cadmium/*blood
;
Cross-Sectional Studies
;
Female
;
Humans
;
Immunoradiometric Assay
;
Middle Aged
;
Nutrition Surveys
;
Prevalence
;
Regression Analysis
;
Republic of Korea/epidemiology
;
Risk
;
Vitamin D/*blood
;
Young Adult
10.Cut-off Values of Diagnostic Indices to Detect Iron Deficiency in Chinese Breast-fed Infants.
Qin WU ; Jie REN ; Li Chen YANG ; Jie LIU ; Jun WEI ; Wei ZHANG ; Na LI ; Yue Jiao WANG ; Li Huang YAN ; Jian Rong MA ; Xiao Guang YANG
Biomedical and Environmental Sciences 2016;29(11):829-833
Iron deficiency anemia is one of the most prevalent nutritional deficiency worldwide. The commonly used cut-off values for identifying iron deficiency are extrapolated from older children and may not be suitable for infants. Therefore, our study aimed to establish appropriate cut-off values for the evaluation of iron status in Chinese infants. Pregnant women who delivered at ⋝37 gestational weeks with normal iron status were recruited. Later, infants with normal birth weight and who were breastfed in the first 4 months were selected. Blood samples were collected to assess hemoglobin, serum ferritin, soluble transferrin receptor, mean corpuscular volume and free erythrocyte protoporphyrin. Cut-offs of all iron indices were determined as the limit of 95% confidence interval.
Anemia, Iron-Deficiency
;
blood
;
diagnosis
;
Breast Feeding
;
China
;
Humans
;
Infant
;
Reference Values

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