2003
DOI: 10.1079/bjn2003936
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Effect of iron supplementation on mild to moderate anaemia in pulmonary tuberculosis

Abstract: Anaemia is a common complication of pulmonary tuberculosis. The precise mechanism of anaemia in pulmonary tuberculosis is not clearly known, but anaemia of inflammation as well as of Fe deficiency has been implicated. Both are common in developing countries. It is extremely difficult to distinguish anaemia of Fe deficiency from anaemia of inflammation with the haematological indices used routinely. Therefore, Fe preparations are usually prescribed for all anaemic patients irrespective of the aetiology. This ap… Show more

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Cited by 52 publications
(42 citation statements)
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“…Concerns have been raised about the safety of iron supplementation and iron overload in the context of infectious diseases, but the available evidence is conflicting [10], [36], [37], [38]. While our results are not conclusive, they are in agreement with the hypotheses that iron imbalance at both ends of the continuum exist in TB patients and may contribute to disease progression and poor clinical outcomes.…”
Section: Discussionsupporting
confidence: 68%
“…Concerns have been raised about the safety of iron supplementation and iron overload in the context of infectious diseases, but the available evidence is conflicting [10], [36], [37], [38]. While our results are not conclusive, they are in agreement with the hypotheses that iron imbalance at both ends of the continuum exist in TB patients and may contribute to disease progression and poor clinical outcomes.…”
Section: Discussionsupporting
confidence: 68%
“…While iron deficiency, anemia of inflammation, and hemoptysis are all contributors to TB-associated anemia [102], hemolysis due to the activity of ESAT-6 (and possibly other ESAT-6-like proteins), could potentially also contribute to driving anemia in HIV+ TB patients with bacteremia. Interestingly, TB-associated hemolytic anemia is resolved by successful treatment with ATT in the absence of transfusions, corticosteroids, or iron supplementation indicating that TB alone was the cause of anemia [103].…”
Section: Resultsmentioning
confidence: 99%
“…It can be speculated, based on the low BMI and hypoalbuminemia, that unbalanced or insufficient nutrition partly explains the iron deficiency identified in the current study. Considering that iron supplementation in mild to moderate PTB-associated anemia previously showed increased Fe saturation of transferrin [11], we recommend systematic assessment, wherever it is possible, of iron profile, and subsequent iron supplementation at early stage of TB treatment in PTB patients with iron-responsive anemia in Kinshasa. The multifactorial nature of Journal of Tuberculosis Research anemia is not easy to establish in Congolese setting and was not assessed here.…”
Section: Discussionmentioning
confidence: 99%
“…Of interest, patients with iron-responsive anemia (iron deficiency anemia (IDA), and multifactorial anemia (IDA + AI)) [4] [9] do not show spontaneous resolution of anemia with TB treatment. Rather, iron-responsive anemia in TB tends to recover quickly after 2 or 3 months of iron supplement in addition to TB treatment [4] [11]. Based on the observation that anemia is generally multifactorial in Sub-Saharan Africa (SSA) [8], it can be speculated that majority of TB-patients would need iron supplement.…”
Section: Introductionmentioning
confidence: 99%