Serum Ferritin in Evaluation of Iron Status in Children

Madanat, Faris; El‐Khateeb, Mohammed; Tarawaneh, M.; Hijazi, Sa'ad

doi:10.1159/000206567

Cited by 15 publications

(9 citation statements)

References 8 publications

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“…According to peripheral blood film analyses 29.5% anemic children were having thalassemia trait with iron deficiency. Some studies even argue that serum ferritin should not be used alone to determine iron status [49]. Faulty estimation of S. Ferritin can occur due to variety of reasons also [50].…”

Section: Discussionmentioning

confidence: 99%

Factors associated with anemia among Sri Lankan primary school children in rural North Central Province

et al. 2017

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BackgroundDespite interventions, childhood anemia is still a major public health problem in low and middle income countries. Purpose of the present study is to determine factors associated with anemia among rural primary school children in Sri Lanka, a country undergoing rapid socioeconomic changes.MethodsMulti stage cluster sampling was used to select 100 rural schools in NCP and a maximum of 50 children aged 60–131 months were enrolled from each school. Self-administered questionnaires were sent to parents. Anthropometric measurements and blood samples were obtained by trained investigators. Blood reports were analyzed in a commercial laboratory with external quality control measures.ResultsTotal of 4412 children were included in the analysis. A Multiple regression was performed for hemoglobin. Only 4.2% of the change in hemoglobin could be explained by the model. District (p > 0.001), age (p > 0.001), timing of warm treatment(p = 0.026) and BMI for age (p = 0.002) uniquely contributed 1.12%, 1.19%, 0.13% and 0.26% to change in hemoglobin level respectively whereas, sex, monthly family income and frequency of meat and green leaf consumption didn’t contribute significantly.Peripheral blood film analyses were available for 146 anemic children. Blood film was reported as normal in 19.9% while evidence of iron deficiency (18.5%), early iron deficiency (32.5%) and thalassemia trait with iron deficiency (29.5%) were reported in the rest.Serum ferritin level was available for 417 children with hemoglobin less than 12 g/dl. Mean ferritin level was 63.7 microgram/l. Only 0.5% had depleted iron stores. A multiple regression was performed for serum ferritin and R2 was 0.123 (p < 0.001). Area under the curve for serum ferritin and anemia was 0.436.ConclusionAnemia among rural primary school children in NCP cannot be well explained by routinely assessed socioeconomic characteristics which mainly provide clues to access for food. Commonly used anemia related investigations have low validity in detecting and explaining anemia in this population. Since behavioral factors have been shown to affect nutrition of younger children in Sri Lanka, studying weather behaviors are related to anemia in primary school children is important. Possible etiologies including but not limited to nutritional deficiencies need to be studied further.

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Section: Discussionmentioning

confidence: 99%

Factors associated with anemia among Sri Lankan primary school children in rural North Central Province

et al. 2017

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“…The high rate of microcytosis supports the presence of iron deficiency, but its associated high prevalence of ferritin above cutoff values suggests that ferritin measurements may miss some children with iron deficiency and supports the need for multiple markers. 13 In conclusion, children with ASD represent a high risk group for iron deficiency, and need close monitoring, even at school-age, in accordance with the CDC 3 recommendation to screen populations at risk for iron deficiency.…”

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confidence: 80%

‘Ferritin as an indicator of suspected iron deficiency in children with autism spectrum disorder: prevalence of low serum ferritin concentration’

Dosman

Drmic²,

Brian

et al. 2006

Develop Med Child Neuro

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their BMI. Stress is also thought to affect menarche, but due to the highly subjective nature of this phenomenon, it is difficult to study. Given that our study included no clinical controls, our results could reflect stress associated with having a clinical condition. Females with cerebral palsy and females with severe cognitive impairment may also have delayed puberty. 7,8 However, females with Down syndrome experience menarche at an earlier age than the general population. Age of menarche shows no deviation in fragile X syndrome. 9 The factors producing this variation across conditions merit further study, but may include activity level (acting through BMI) as well as physiological factors specific to the conditions. Individuals with clinical conditions may have taken medications which alter their metabolic or endocrine status, thereby affecting timing of menarche.In conclusion we found a significant minority of women with autism have an extremely late onset of menarche. We have since been contacted by another woman with autism who, at the age of 26, has never experienced menarche. Even excluding these extreme cases, menarche was delayed in women with ASC compared with age-matched controls by 8 months. Whilst intriguing, our findings are limited in that they included only a single ethnic group and relied on participants recalling their age at menarche and self-reporting exclusionary clinical conditions; the study was also of a relatively small sample size. A comprehensive study of pubertal development, which takes account of nutritional status, medication, and other variables relevant to pubertal development in women with ASC, is needed before any strong conclusions can be drawn. Our results suggest that such a study would be worthwhile.

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“…At initial presentation, anemia was observed in 28 (80.0%) cases, of which 8 (22.9%) had severe anemia, in spite of blood having been administered, prior to referral, in most of them ( Figure 1). In the controls, 10 …”

Section: Parameters At Presentationmentioning

confidence: 99%

“…The rise in SF, incongruous to body iron stores, renders this investigation unreliable in malignant disorders, as a surrogate marker of body iron status. Madanat et al [10] has emphasized the need for evaluation of multiple parameters to accurately assess the iron status.…”

Section: Of These Children Continued To Be Anemic At Presentation Inmentioning

confidence: 99%

Iron Deficiency Anemia in Children Presenting with Lymphoreticular Malignancies and the Effect of Induction Therapy

Bhakhri¹,

Vaidya²,

Trehan³

et al. 2012

Pediatric Hematology and Oncology

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There is scant information regarding iron deficiency in children with malignant disorders. Serum iron status of children with lymphoreticular malignancies (LRMs) at onset and at the end of induction therapy, compared to the normal population, was evaluated. Prospective cohort study conducted between July 2002 and March 2004. Previously untreated children recently diagnosed with LRM were studied. Age-matched controls were enrolled from follow-up and growth monitoring clinics. Hematological (complete blood counts and red cell indices) parameters and markers of iron status (serum iron, serum ferritin, total iron binding capacity) were estimated at presentation and at the end of remission induction therapy, that is, 5 weeks after initial evaluation. Bone marrow iron store were only assessed in cases. Thirty-five children (31 with acute lymphoid leukemia, 2 with acute myeloid leukemia, and 2 with non-Hodgkin lymphoma; 27 boys and 8 girls; 2 to 12 years of age) were evaluated in the study cohort. Anemia was documented in 80% of children with LRM. Iron deficiency was an important etiological factor. In the majority of cases therapy resulted in significant improvement towards normalization of deranged hematological parameters. This phenomenon could be attributed to enhanced quantity and quality of erythropoietic activity and red cell transfusions. The observation suggests that therapeutic iron supplements are not indicated in the majority of children on therapy for malignant disorders. Various hematological and body iron status parameters should be assessed on a case-by-case basis.

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Serum Ferritin in Evaluation of Iron Status in Children

Cited by 15 publications

References 8 publications

Factors associated with anemia among Sri Lankan primary school children in rural North Central Province

Factors associated with anemia among Sri Lankan primary school children in rural North Central Province

‘Ferritin as an indicator of suspected iron deficiency in children with autism spectrum disorder: prevalence of low serum ferritin concentration’

Iron Deficiency Anemia in Children Presenting with Lymphoreticular Malignancies and the Effect of Induction Therapy

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