Performance Characteristics of Three Serum Iron and Total Iron-Binding Capacity Methods in Acute Iron Overdose

Roberts, William L.; Smith, P T; Martin, W J; Rainey, Petrie M.

doi:10.1093/ajcp/112.5.657

Cited by 12 publications

(10 citation statements)

References 9 publications

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“…Measurement of transferrin is the preferred test (1 mol of transferrin binds 2 mol of iron). If this test is not available, direct UIBC assays are less susceptible to falsely high results attributable to iron overdose (92 ). Some patients with an iron overdose are treated with deferoxamine.…”

Section: E Testing For Iron Toxicitymentioning

confidence: 99%

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Recommendations for the Use of Laboratory Tests to Support Poisoned Patients Who Present to the Emergency Department

et al. 2003

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Background: Exposure to drugs and toxins is a major cause for patients' visits to the emergency department (ED).Methods: Recommendations for the use of clinical laboratory tests were prepared by an expert panel of analytical toxicologists and ED physicians specializing in clinical toxicology. These recommendations were posted on the world wide web and presented in open forum at several clinical chemistry and clinical toxicology meetings. Results: A menu of important stat serum and urine toxicology tests was prepared for clinical laboratories who provide clinical toxicology services. For drugs-ofabuse intoxication, most ED physicians do not rely on results of urine drug testing for emergent management decisions. This is in part because immunoassays, although rapid, have limitations in sensitivity and specificity and chromatographic assays, which are more definitive, are more labor-intensive. Ethyl alcohol is widely tested in the ED, and breath testing is a convenient procedure. Determinations made within the ED, however, require oversight by the clinical laboratory. Testing for toxic alcohols is needed, but rapid commercial assays are not available. The laboratory must provide stat assays for acetaminophen, salicylates, co-oximetry, cholinesterase, iron, and some therapeutic drugs, such as lithium and digoxin. Exposure to other heavy metals requires laboratory support for specimen collection but not for emergent testing. Conclusions: Improvements are needed for immunoassays, particularly for amphetamines, benzodiazepines, opioids, and tricyclic antidepressants. Assays for new drugs of abuse must also be developed to meet changing abuse patterns. As no clinical laboratory can provide services to meet all needs, the National Academy of Clinical Biochemistry Committee recommends establishment of regional centers for specialized toxicology testing. © 2003 American Association for Clinical Chemistry PreambleThis is the ninth in the series of Laboratory Medicine Practice Guidelines sponsored by the National Academy Clinical Chemistry 49:3 357-379 (2003) Special Report 357of Clinical Biochemistry (NACB). 10 An expert Committee of emergency department (ED) physicians and clinical laboratory medicine toxicologists was assembled and prepared recommendations on the use of clinical laboratory tests to support the diagnosis and management of the poisoned patient who presents to the ED. Excluded from these discussions were drug testing conducted for the workplace, forensic and medical examiner toxicology, athletic drug testing, and testing for various compliance programs (e.g., criminal justice, psychiatric, and physician health). Many of these other programs are guided by other recommendations and regulations, such as the Substance Abuse and Mental Health Services Administration, the American Academy of Forensic Sciences, and the International Olympic Committee. Recommendations for detection of drugs in pregnant women and newborns exposed during the intrauterine period are discussed in a previous NACB guidelines (1 ). Som...

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Section: E Testing For Iron Toxicitymentioning

confidence: 99%

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Recommendations for the Use of Laboratory Tests to Support Poisoned Patients Who Present to the Emergency Department

et al. 2003

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“…On the other hand, DFX-Fe measurement of sFe was certainly influenced by [17,18]. Although there should be differences in the biological behavior of DFO and DFX, our present results indicated that careful attention should be paid when these markers are observed during iron chelation therapy with DFX.…”

Section: Discussionmentioning

confidence: 56%

Interference of deferasirox with assays for serum iron and serum unsaturated iron binding capacity during iron chelating therapy

Ikuta

Ito

Tanaka

et al. 2011

Clinica Chimica Acta

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AuthorBackground Deferasirox (DFX) is an oral iron chelator that is used worldwide for the treatment of iron overload. Although serum ferritin level is usually measured as a marker of the efficacy of DFX, we sometimes experienced unexplainable changes in other serum markers for iron. We hypothesized that photometric assays for serum iron (sFe) and unsaturated iron binding capacity (UIBC) might be affected by DFX. Methods Measurement of sFe and UIBC was performed using 4 different assay systems. The samples were prepared by adding 0–300 μM DFX to pooled human serum or 15 randomized human serum samples. In some experiments, DFX-iron complex (DFX-Fe) was prepared by mixing iron ammonium citrate solution and DFX solution. Results Measurement of sFe was influenced by DFX-Fe, while iron-free DFX showed no effect on the value of sFe; DFX-Fe was measured as sFe, undistinguishable from transferrin-bound iron. On the other hand, measurement of serum UIBC was influenced by DFX itself; DFX might have been bound to iron in the reagent used for the assay, leading to an increase in UIBC values. Conclusions DFX affected the sFe and UIBC assay systems. We must be careful in observing these markers during iron chelation therapy with DFX

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“…The total iron-binding capacity (TIBC) is to measure the concentration of transferrin of serum because the free iron binds with some proteins. Low TIBC causes inflammatory disorders (Feldman et al, 1981;Ottenjann et al, 2006;Smith and Cipriano, 1987;White et al, 2012), while its increased level indicates due to excess iron overload (Kasvosve and Delanghe, 2002;Moosavian et al, 2010;Roberts et al, 1999) if patients with chronic hepatopathy (Jacobs et al, 2000). Production of antioxidants could be function for the prevention of proteolysis by accommodating the free cations including iron.…”

Section: Resultsmentioning

confidence: 99%

Comparative study of β-thalassemia major among the patients from urban and rural population in Hyderabad region

2018

Int. J. Biosci.

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The thalassemia is a common etiological, microcytic and hypochromic anemia. It is an autosomal genetic disorder caused by mutations in α and β globin genes. In this experiment, hematological study conducted among the β-thalassemia major patients selected from urban (n=20) and rural (n=20) areas of Hyderabad. Patients from both regions were arranged into two age-groups (group I=2-7 years and group II= 5-11 years). Each group comprised on 10 males and 10 females (half rural and half city) in total 20 of confirmed β-thalassemia major patients. With hematological analysis showed significant variation, like as lowest red blood cells (RBCs) measured in male patients of both groups from urban and rural patients than all females. The hemoglobin (HB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCH), mean corpuscular hemoglobin concentration (MCHC) and platelets (PLT) showed variable (p≥0.05) abnormal values in all patients over normal reference values. The Hb also observed as reduced in all patients especially in 5-11 years aged male patients (p≥0.05). Meanwhile total iron contents and iron binding capacity (TIBC) noted reversed to Hb contents in all β-thalassemia major. In conclusion, rises in hematological parameters and iron overload causes to enhance antioxidant activity (AOA). The AOA may be beneficial for lowering the stringency of developed oxidative stress due to iron overload. It could be dependent on the type of AOA as well as their sources. Growth failure is common in thalassemia patients, while it is achievable with blood transfusion and optimal balanced nutritional status.

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Performance Characteristics of Three Serum Iron and Total Iron-Binding Capacity Methods in Acute Iron Overdose

Abstract: A b s t r a c tAccurate serum iron and total iron binding capacity (TIBC)

Cited by 12 publications

References 9 publications

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Recommendations for the Use of Laboratory Tests to Support Poisoned Patients Who Present to the Emergency Department

National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Recommendations for the Use of Laboratory Tests to Support Poisoned Patients Who Present to the Emergency Department

Interference of deferasirox with assays for serum iron and serum unsaturated iron binding capacity during iron chelating therapy

Comparative study of β-thalassemia major among the patients from urban and rural population in Hyderabad region

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