Intravenous iron-dextran: studies on unsaturated iron-binding capacity

Cox, J. S. G.; Moss, Gerald; Bremner, I.; Reason, Janet

doi:10.1136/jcp.21.5.611

Cited by 10 publications

(3 citation statements)

References 11 publications

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“…Szilagyi & Erslev (1970) give values for Imferon transfer of iron to transferrin varying from 0.5 76-2.0 % depending on concentration. Our values are similar although in a narrower range varying from 0.77 %-1.42 %, which accords with the findings of Henderson & Hillman (1969) and with the value for "loosely bound" ferrous iron in Imferon found by Cox et al ( 1968). Under the conditions tested the availability of Ferastral-iron to transferrin is markedly less than that of Jectofer and close to that of Imferon; it varied from 0.83 %-1.65 % after 60 minutes incubation from concentrations of 5000 pg/lOO ml and 1250 pg/lOO ml of the complex, respectively.…”

Section: Discussionsupporting

confidence: 93%

Transfer of Iron from Ferastral® and other Organic Complexes to Transferrin as Measured by Reticulocyte Uptake

Speyer

Doney

Fielding

1977

Scandinavian Journal of Haematology

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The transfer of iron from the iron carbohydrate complexes, FerastralB, ImferonB, and JectoferR, and from ferric chloride has been studied by the effect of such transfer in reducing reticulocyte uptake of 59Fe from labelled transferrin. There are plasma factors which augment the transfer of iron from complex to transferrin. The pattern of transfer from Ferastral and from Imferon are similar: at concentrations of 5000 Kg/lOO ml and 1250 &lo0 ml in pIasma these complexes tranefer about 0.8 "/. and 1.7 %, respectively. Jectofer transfers about four times these amounts under similar conditions. In the case of Ferastral there is evidence of an equilibrium between transferrin-bound and Ferastral-bound iron. The characteristics of Ferastral assessed in this way suggest that it may prove suitable for therapeutic use as a total dose infusion. Br J Haematol 20, 405-416. Henderson P A & Hillman R S (1969) Characteristics of iron-dextran utilization in man. Blood 34, 357-375. Scott J (1962) Toxicity of iron-sorbitol citrate. Br Med J 2, 481. Szilagyi G & Erslev A J (1970) Effect of organic iron compounds on the iron uptake of reticulocytes in vitro. J Lab Clin Med 75, 275-282. 32, 207-214.

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Section: Discussionsupporting

confidence: 93%

Transfer of Iron from Ferastral® and other Organic Complexes to Transferrin as Measured by Reticulocyte Uptake

Speyer

Doney

Fielding

1977

Scandinavian Journal of Haematology

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“…A similar mechanism has been proposed for the effect of many iron compounds in increasing bacterial virulence in experimental animals and for an increased incidence of bacterial infections in hyperferraemic states in man (Lancet, 1974;Weinberg, 1974). However, administration of irondextran may not saturate transferrin, even at the high serum-iron levels recorded in our patients (Cox et al, 1968;Henderson and Hillman, 1969). Therefore the effects of iron-dextran are more likely to be analogous to that of poorly ionized iron compounds, such as haem, which do not saturate transferrin but nevertheless increase the susceptibility of animals to Gram-negative infections (Bullen et al, 1968).…”

Section: Discussionsupporting

confidence: 71%

Intramuscular iron-dextran and susceptibility of neonates to bacterial infections. In vitro studies.

Becroft¹,

Dix²,

Farmer³

1977

Archives of Disease in Childhood

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SUMMARY An increased incidence of E. coli sepsis has been observed in neonates given intramuscular iron-dextran for prevention of iron deficiency. Mechanisms for this apparent effect on susceptibility to infection were investigated by comparing phagocytic and antibacterial functions in paired samples of venous blood from 7 infants, median age 5 days, before and after iron-dextran. Post-treatment sera had increased inhibitory effects on leucocyte chemotaxis and markedly reduced bacteriostatic effects against E. coli. The clinical relevance of the effects on chemotaxis is uncertain. The reduction in serum bacteriostasis is similar to that observed in other forms of hyperferraemia not associated with saturation of transferrin, and is a likely cause of the increased susceptibility to infection in vivo. We consider that prophylactic treatment with parenteral iron-dextran is contraindicated in early infancy.The prevention of iron deficiency in 'high risk' infant populations by giving iron-dextran intramuscularly to babies in maternity hospitals was advocated in New Zealand after favourable results were reported from pilot studies (Tonkin, 1970;Cantwell, 1972 Cellular.

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“…Iron dextran treated group (13) Control group (15) Serum: Opsonisation-bactericidal method 2-5% serum (% organisms killed) 84-4 ± 10-4 94-8 ± 8-24* 10% serum (% organisms killed) 97 9 + 1 79 99 3 ± 0-39t…”

Section: Tp<0001mentioning

confidence: 99%

Impaired bacteriological responses in babies after maternal iron dextran infusion.

Webster¹,

Waitkins²,

Stott³

1981

J Clin Pathol

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SUMMARY The effect of a total dose infusion of iron dextran in pregnancy on 15 mothers and their babies was compared with 19 controls. The bacteriostatic effect and opsonising ability of the sera, of babies born to the treated mothers, were considerably impaired. This was associated with a significantly lower transferrin concentration in these mothers. Although these in vitro tests were not associated with an increase in overt infection during the perinatal period, they suggest the need for caution in the use of total dose infusions in pregnancy.Recent reports by Becroft, Dix, and Farmer' and Barry and Reeve2 have suggested that babies treated with iron dextran (Imferon) by injection, for prevention of anaemia, are more susceptible to infection by Escherichia coli (E coli). It was considered that a similar problem might possibly occur with babies born to mothers who had received a single total dose infusion (TDI) of iron dextran. A study was therefore implemented to examine the effects of maternal TDI on the haemoglobin (Hb), serum iron, and transferrin concentrations of mother and baby and also on in vitro tests of bacteriological competence of the baby. Subjects and methodsA group of 15 mothers who had received a TDI and their babies were compared with 19 control pairs. All were caucasians, managed by the same obstetric teams and tested during a four month period. TDI was given for persistently low maternal'Hb and serum iron concentrations, and failure to respond to oral iron supplements. Controls were selected to match for maternal parity, baby's sex and gestational age. All babies were term by dates and clinical assessment, although one in the treated group was light for dates. Consent for investigation was obtained from the mother, before or as soon as possible after labour began. Blood was taken from her at this time, for Hb, serum iron, and transferrin. Samples of cord blood were taken from all babies for the same tests. In addition 13 babies of the treated group and 17 of the control group had cord blood collected for the Accepted for publication 29 October 1980 bacteriological tests set out below.At three to five days of age capillary blood was collected from all babies for a nitroblue tetrazolium test and stools taken for culture. HAEMATOLOGY AND BIOCHEMISTRYHaemoglobin concentrations were measured using a Coulter S counter. Serum iron concentrations were determined on a Technicon AA11 AutoAnalyzer using a modification of the method of Young and Hicks.3 The normal range for adult females is ,umol/l (28-168 p,g/100 ml), and for cord blood is 14-43 ,tmol/l (78-240 L,g/100 ml).4Transferrin was measured using an automated immuno-precipitin method,5 with polyethylene glycol to accelerate the antigen-antibody reaction. The normal range for adults is 2-0-4-0 g/l and for cord blood is 1-47-2-12 g/1.4 Total iron binding capacity was calculated from the serum transferrin, by multiplying the figure by 1-254 and the percentage saturation of transferrin was calculated from the concentrations of serum iron and t...

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Intravenous iron-dextran: studies on unsaturated iron-binding capacity

Cited by 10 publications

References 11 publications

Transfer of Iron from Ferastral® and other Organic Complexes to Transferrin as Measured by Reticulocyte Uptake

Transfer of Iron from Ferastral® and other Organic Complexes to Transferrin as Measured by Reticulocyte Uptake

Intramuscular iron-dextran and susceptibility of neonates to bacterial infections. In vitro studies.

Impaired bacteriological responses in babies after maternal iron dextran infusion.

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