Property | Value |
Name | An update in the diagnosis of anemia and selection of basic laboratory tests |
Description | Research article:- Biochemistry Emila S1**, Revathy K1***, Anila Mathan2, Ebenezer William W3 & Swaminathan S1*.
Affiliation:- 1*Chief of Biochemistry, Central Lab, 1** Lab Technologist, Department of Biochemistry, Central Lab,1***Technical Supervisor, Department of Biochemistry, Central Lab,2Consultant in Hematology & Transfusion Medicine, Central Lab, 3Head of Biochemistry, SRM Medical College Hospital and Research Centre, Kattankulathur, Kancheepuram District. 603203, Tamil Nadu, India.
Abstract:- Aim: To review the upto date concepts on the laboratory diagnosis of anemia and to evaluate some basic laboratory tests to make them suitable for small level laboratories. Study design: 70 non hospitalized patients in the age of 18-80 years (31 males & 39 females) who are suspected of having anemia were enrolled for this study. Materials and methods: After thoroughly going through previously published papers and having done a mini review of anemia, its prevalence and the laboratory diagnosis followed, we selected few basic laboratory tests viz serum iron, UIBC and Hb, and measured these analytes in all the 70 patients and using established conversion formulae, 3 more parameters viz TIBC, % transferin saturation and absolute transferin concentration were calculated. State of art instrument and certified quality controls were used to validate the results obtained. Results: A total 6 parameters were studied in this project and all 6 are considered to be valuable. Highly significant correlations were observed between any two biochemical parameter compared, but we got only a moderate probability of < 0.05 when biochemical parameters are compared with Hb. Conclusion: The outcome of this study suggests that all 6 parameters will be useful for the diagnosis of anemia and they could easily be measured in any clinical laboratory with basic facilities.
Key Words: Anemia, WHO, IDA, IBD, CBC, Hb, RBCs, WBCs, Iron, UIBC, TIBC, % Saturation, TRF, Ferritin, r, t and p.
References: 1.Price EA, Schrier SL. Anemia in the elderly: introduction. Semin Hematol. 2008;45:207–9. 2.World Health Organization. The prevalence of anemia in women: a tabulation of available information. 2nd ed. Geneva, Switzerland; 1992. 3.Abor Zahr C and Rayston E. Maternal mortality: a global fact book. WHO. Geneva, Switzerland; 1991. 4.Evaluation of Anemia in Children JENNIFER JANUS, MD, Johns Hopkins Community Physicians, Hagerstown, Maryland .Am Fam Physician. 2010 Jun 15;81(12):1462-71. 5.Joosten E, Pelemans W, Hiele M, Noyen J, Verhaeghe R, Boogaerts MA. Prevalence and causes of anaemia in a geriatric hospitalized population. Gerontology. 1992;38:111–7. 6.Ania BJ, Suman VJ, Fairbanks VF, Rademacher DM, Melton LJ III. Incidence of anemia in older people: an epidemiologic study in a well defined population. J Am Geriatr Soc. 1997;45:825–31. 7.Gomollón F, Gisbert JP. Intravenous iron in inflammatory bowel diseases. Curr Opin Gastroenterol. 2012 Dec 27. [Epub ahead of print] 8.Kondo Y, Katsuta S, Kitagawa C, Kondo S. Association of anemia with nutrition in elderly patients. Gan To Kagaku Ryoho. 2012 Dec;39(12):92-4. 9.Ebnöther M. Anemia in the elderly - a diagnostic and therapeutic challenge? Ther Umsch. 2010 May;67(5):257-63. 10.Andrès E, Serraj K, Federici L, Vogel T, Kaltenbach G Anemia in elderly patients: New insight into an old disorder. Geriatr Gerontol Int. 2012 Dec 17. doi: 10.1111/ggi.12017. [Epub ahead of print] 11.Rutten EP, Franssen FM, Spruit MA, Wouters EF Anemia is Associated with Bone Mineral Density in Chronic Obstructive Pulmonary Disease. COPD. 2012 Dec 28. 12.Fernando Fernández-Bañares, Helena Monzón, and Montserrat Forné A short review of malabsorption and anemia World J Gastroenterol. 2009 October 7; 15(37): 4644–52. 13. Penninx BW, Cohen HJ, Woodman RC Anemia and cancer in older persons. J Support Oncol. 2007 Mar;5(3):107-13. 14.Aapro MS, Cella D, Zagari M. Age, anemia, and fatigue. Semin Oncol. 2002 Jun;29(3 Suppl 8):55-9. 15.Ross SD, Fahrbach K, Frame D, Scheye R, Connelly JE, Glaspy J. The effect of anemia treatment on selected health-related quality-of-life domains: a systematic review. Clin Ther. 2003 Jun;25(6):1786-805. 16.Moliterno AR, Spivak JL. Anemia of cancer. Hematol Oncol Clin North Am. 1996 Apr;10(2):345-63. 17.Westendorp RG, Izaks GJ. Reference values for anaemia in the elderly. Ned Tijdschr Geneeskd. 2006 May 6;150(18):1002-6. 18.Eisenstaedt RS. The prevalence of anemia in primary care. Postgrad Med. 2004 Nov;116(5 Suppl Anemia):7-11. 19. Price EA, Mehra R, Holmes TH, Schrier SL. Anemia in older persons: etiology and evaluation. Blood Cells Mol Dis. 2011 Feb 15;46(2):159-65. 20.Pang WW, Schrier SL. Anemia in the elderly. Curr Opin Hematol. 2012 May;19(3):133-40. 21.Bager P, Befrits R, Wikman O, Lindgren S, Moum B, Hjortswang H, Dahlerup JF. The prevalence of anemia and iron deficiency in IBD outpatients in Scandinavia. Scand J Gastroenterol. 2011 Mar;46(3):304-9. 22.Voegtlin M, Vavricka SR, Schoepfer AM, Straumann A, Voegtlin J, Rogler G, Ballabeni P, Pittet V, Buser A, Fried M, Beglinger C; Swiss IBD Cohort Study. Prevalence of anaemia in inflammatory bowel disease in Switzerland: a cross-sectional study in patients from private practices and university hospitals. J Crohns Colitis. 2010 Dec;4(6):642-8. 23.Sanghvi TG, Harvey PW, Wainwright E. Maternal iron-folic acid supplementation programs: evidence of impact and implementation. Food Nutr Bull. 2010 Jun;31. 24.Galloway R, Dusch E, Elder L, Achadi E, Grajeda R, Hurtado E, Favin M, Kanani S, Marsaban J, Meda N, Moore KM, Morison L, Raina N, Rajaratnam J, Rodriquez J, Stephen C. Women's perceptions of iron deficiency and anemia prevention and control in eight developing countries. Soc Sci Med. 2002 Aug;55(4):529-44. 25.Janus J, Moerschel SK. Evaluation of anemia in children. Am Fam Physician. 2010 Jun 15; 81(12):1462-71. 26.Jain S, Kamat D. Evaluation of microcytic anemia. Clin Pediatr (Phila). 2009 Jan;48(1):7-13. 27.Brown RG. Determining the cause of anemia. General approach, with emphasis on microcytic hypochromic anemias. Postgrad Med. 1991 May 1;89(6):161-4, 167-70. 28.Cook JD. Clinical evaluation of iron deficiency. Semin Hematol. 1982 Jan;19(1):6-18. 29.Lanzkowsky P. Problems in diagnosis of iron deficiency anemia. Pediatr Ann. 1985 Sep;14(9):618, 622-3, 627 passim. 30.Kushang V. Patel and Jack M. Guralnik. Prognostic implications of anemia in older adults. Haematologica. 2009 January; 94(1): 1–2. 31.Kushang V. Patel, PhD, MPH1 Epidemiology of Anemia in Older Adults. Semin Hematol 2008 October; 45(4): 210–2. 32.Jack M. Guralnik, Richard S. Eisenstaedt, Luigi Ferrucci, Harvey G. Klein, and Richard C. Woodman. Prevalence of anemia in persons 65 years and older in the United States: evidence for a high rate of unexplained anemia. Blood, 15 October 2004 ; 104(8) :2263 - 8. 33.Brenda W. J. H. Penninx 1 , Marco Pahor, Richard C. Woodman and Jack M. Guralnik . Anemia in Old Age Is Associated With Increased Mortality and Hospitalization . Journal of Gerontology: Medical sciences 2006, 61A(5):474–9. 34.Roy CN. Anemia of inflammation. Hematology Am Soc Hematol Educ Program.2010; 2010:276-80. 35.Sears DA. Anemia of chronic disease. Med Clin North Am. 1992 May;76(3):567-79. 36.Ganz T, Nemeth E. Iron sequestration and anemia of inflammation. Semin Hematol. 2009 Oct; 46(4):387-93. 37.S. Patra , S. Pasrija, S.S. Trivedi, M. Puri. Maternal and perinatal outcome in patients with severe anemia in pregnancy. International Journal of Gynecology & Obstetrics. November 2005;91(2):164–5. 38.Bizzarro MJ, Colson E, Ehrenkranz RA Differential diagnosis and management of anemia in the newborn. Pediatr Clin North Am. 2004 Aug; 51(4):1087-107. 39. Dong Gyu Jang, Yun Sung Jo, Sung Jong Lee, Gui Se Ra Lee Risk Factors of Neonatal Anemia in Placenta Previa. Int J Med Sci 2011; 8(7):554-7. 40.Geltman PL, Meyers AF, Mehta SD, et al. Daily multivitamins with iron to prevent anemia in high-risk infants: a randomized clinical trial. Pediatrics 2004 Jul; 114(1) :86-93. 41.M Meznar, R Pareznik and G Voga. Effect of anemia on tissue oxygenation saturation and the tissue deoxygenation rate during ischemia. Critical Care 2009, 13(Suppl 1):P238 . 42.Dirk J. van Veldhuisen, Stefan D. Anker, Piotr Ponikowski & Iain C. Macdougall. Anemia and iron deficiency in heart failure: mechanisms and therapeutic approaches. Nature Reviews Cardiology 8, 485-93. 43.Arema A Pereira and Mark J Sarnak. Anemia as a risk factor for cardiovascular disease. Kidney International (2003) 64, S32–S39. 44.Alleyne M, Horne MK, Miller JL. Individualized treatment for iron-deficiency anemia in adults. Am J Med. 2008 Nov; 121(11):943-8. 45.Langley GR, Langley JM. The diagnosis of anemia and its cause. Can Fam Physician. 1984 Sep;30:1881-8. 46.Brown AC, Lutton JD, Pearson HA, Nelson JC, Levere RD, Abraham NG. Heme metabolism and in vitro erythropoiesis in anemia associated with hypochromic microcytosis. Am J Hematol. 1988 Jan;27(1):1-6. 47.Masatsugu OHTA Management of Anemia in the Elderly. JMAJ 2009; 52(4): 219–223. 48.Ralph O. Wallerstein, Jr, MD West J. Laboratory Evaluation of Anemia West J. Med. 1987 April; 146(4): 443–51. 49.Allan Platt PA-C, MMSc. Effective Laboratory Diagnosis of Anemia. March 22, 2010. 50.Jožica Ježek, Jože Starič, Marija Nemec, Tomaž Zadnik, Martina Klinkon . Relationship between blood haemoglobin and serum iron concentrations and heart girth in pre-weaned dairy calves. Ital.J.Anim.Sci 2009;8 (Suppl. 3), 151-3. 51.Hyun-Cheol AHN1, Kyu-Yoon HWANG2, Yong-Bae KIM1, Gap-Soo LEE1, Sung-Soo LEE1, Kyu-Dong AHN1 and Byung-Kook LEE1. Different Effects of Serum Iron Status on the Relationship between Blood Lead and Zinc Protoporphyrin in Lead Workers in Korea. J Occup Health 1999; 41: 166–71. 52.Marilyn Chaloupka, Ruth M. Leverton and Ethel Diedrichsen. Serum Iron and Hemoglobin Values of 275 Healthy Women. Exp Biol Med August 1951;77 (4): 677-80. 53.Carl C. SELTZER, PH.D., Barbara J. WENZEL, M.D., and Jean MAYER, PH.D., D.SC. Serum Iron and Iron-Binding Capacity in Adolescents. Am J Clin Nutr December 1963; 13(6): 343-53. 54.Amal A Hegazy, Manal M Zaher, Manal A Abd el-hafez, Amal A Morsy and Raya A Saleh. Relation between anemia and blood levels of lead, copper, zinc and iron among children. BMC Res Notes. 2010 May 12; 3:133. 55.Thomas C, Kobold U, Thomas L. Serum hepcidin-25 in comparison to biochemical markers and hematological indices for the differentiation of iron-restricted erythropoiesis. Clin Chem Lab Med 2011 Feb;49(2):207-13. 56.Matsuda A, Bessho M, Mori S, Takeuchi T, Abe T, Yawata Y, Mori H, Omine M, Nakamura Y, Furusawa S, Maeda T, Haginosita S, Hirasawa Y, Kinugasa E,Akizawa T, Kawakami N, Nagata A, Hirashima K. Diagnostic significance of serum soluble transferrin receptors in various anemic diseases: the first multi-institutional joint study in Japan. Haematologia (Budap) 2002; 32(3):225-38. 57.Ho CH. The diagnostic role of serum transferrin receptor in patients with various anemia. Zhonghua Yi Xue Za Zhi (Taipei). 2002 Feb;65(2):55-60. 58.Schade, A., Ogama, J., Reinhart, R., and Miller, J., Proc. Soc. Exp. Biol. Med 1954; 87: 442. 59.Goodwin, J., Murphy, B., and Guillemette, M., Direct measurement of serum iron and binding capacity. Clin. Chem 1966; 12:47. 60.Diehl, H., and Smith, G.F., “The Iron Reagents, Bathophenanthroline, 2,4,6-Tripyridyl-s-triazine, Phenyl-2-pyridylocine”, GF Smith Chem Co, 1960. 61.Woo J, Henry JB. Metabolic intermediates and inorganic ions. In: Henry JB. Clinical diagnosis and manegement by laboratory methods. Philadelphia: W.B. Saunders; 1996. p 190-2. Tietz NW, ed. Clinical guide to laboratory tests 3rd ed. Philadelphia: WB Saunders Company, 1995: 376-7. 62.Fairbanks VF, Klee GG. Biochemical aspects of hematology. In: Burtis CA, Ashwood ER, editors. Tietz Textbook of Clinical Chemistry. 3rd ed. Philadelphia: W.B Saunders company, 1999. 1698 – 1703.
*Correspondence address:
|
Filename | Swaminathan S et al.(951-966).pdf |
Filesize | 203.39 kB |
Filetype | pdf (Mime Type: application/pdf) |
Creator | admin |
Created On: | 05/06/2013 00:00 |
Viewers | Everybody |
Maintained by | Editor |
Hits | 2414 Hits |
Last updated on | 06/02/2013 05:57 |
Homepage | |
CRC Checksum | |
MD5 Checksum |