Thalassemia and iron deficiency in a group of northeast Thai school children: relationship to the occurrence of anemia

Panomai, Nichathorn; Sanchaisuriya, Kanokwan; Yamsri, Supawadee; Sanchaisuriya, Pattara; Fucharoen, Goonnapa; Fucharoen, Supan; Schelp, Frank Peter

doi:10.1007/s00431-010-1218-3

Cited by 13 publications

(18 citation statements)

References 21 publications

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“…The thalassemia trait generally does not affect serum ferritin. 10 In contrast; we found significantly lower serum ferritin levels in the thalassemia trait group (Table 4B). Although the reason for this association is unclear, as least it provided reassurance that the underlying trait did not cause high serum ferritin levels, and was therefore not deemed to be a confounding factor in the interpretation of the IDA.…”

Section: Discussionmentioning

confidence: 59%

“…13 IDA [3][4][5][6][7][8][9][10][11][12][13][14][15] was defined as anemia with (1) serum ferritin < 10 lg/ml if CRP was < 10 mg/liter or serum ferritin < 50 lg/ml if CRP was ‡ 10 mg/liter 16,17 and (2) having at least three of the following five parameters: (1) SI < 8.8 lmol/liter, (2) TIBC > 71.6 lmol/liter, (3) TS < 10%, (4) mean corpuscular volume (MCV) less than normal age-related values ( < 2 years = 78 fl, ‡ 2 years = 81 fl), or (5) mean corpuscular hemoglobin (MCH) less than normal age-related values ( < 2 years = 23 pg, 2-5 years = 24 pg, and ‡ 6 years = 25 pg). 14,15 Nonthalassemia was defined as having no common thalassemia mutations or deletions of a-and b-genes.…”

Section: Methodsmentioning

confidence: 99%

“…1 Gaps exist as to anemia prevalence and causes in HIV-infected children with mild disease status in Southeast Asian countries where thalassemia is common. [9][10][11] We evaluated the iron status, prevalence, and causes of anemia in antiretroviral therapy (ARV)-naive HIV-infected children without advanced HIV infection to determine the necessity of routine iron supplementation.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Anemia and Underlying Iron Status in Naive Antiretroviral Therapy HIV-Infected Children with Moderate Immune Suppression

Kosalaraksa

Bunupuradah

Saphonn³

et al. 2012

AIDS Research and Human Retroviruses

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Anemia is common in HIV-infected children and iron deficiency is thought to be a common cause. This study investigates the prevalence of anemia, thalassemia, and underlying iron status in Thai and Cambodian children without advanced HIV disease to determine the necessity of routine iron supplementation. Antiretroviral (ARV)-naive HIV-infected Asian children aged 1-12 years, with CD4 15-24%, CDC A or B, and hemoglobin (Hb) ‡ 7.5 g/dl were eligible for the study. Iron studies, serum ferritin, Hb typing, and C-reactive protein were assessed. Anemia was defined as Hb < 11.0 g/dl in children < 5 years of age or < 11.5 g/dl in children 5-12 years. We enrolled 299 children; 57.9% were female and the mean (SD) age was 6.3 (2.9) years. The mean (SD) CD4% and HIV-RNA were 20% (4.6) and 4.6 (0.6) log 10 copies/ml, respectively. The mean (SD) Hb and serum ferritin were 11.2 (1.1) g/dl and 78.3 (76.4) lg/liter, respectively. The overall iron deficiency anemia (IDA) prevalence was 2.7%. One hundred and forty-eight (50%) children had anemia, mostly of a mild degree. Of these, 69 (46.6%) had the thalassemia trait, 62 (41.8%) had anemia of chronic disease (ACD), 9 (6.1%) had thalassemia diseases, 3 (2.0%) had iron deficiency anemia, and 5 (3.4%) had IDA and the thalassemia trait. The thalassemia trait was not associated with increased serum ferritin levels. Mild anemia is common in ARV-naïve Thai and Cambodian children without advanced HIV. However, IDA prevalence is low; with the majority of cases caused by ACD. A routine prescription of iron supplement in anemic HIV-infected children without laboratory confirmation of IDA should be discouraged, especially in regions with a high prevalence of thalassemia and low prevalence of IDA.

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Section: Discussionmentioning

confidence: 59%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Anemia and Underlying Iron Status in Naive Antiretroviral Therapy HIV-Infected Children with Moderate Immune Suppression

Kosalaraksa

Bunupuradah

Saphonn³

et al. 2012

AIDS Research and Human Retroviruses

View full text Add to dashboard Cite

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“…However, such cases appear to be rare. Based on our data collected independently from several communities Sanchaisuriya et al 2006;Savongsy et al 2008;Panomai et al 2010;Tritipsombut et al 2012;Wongprachum et al 2016), only 0.09% (2/2329) of individuals with normal MCV had elevated Hb A 2 . Nonetheless, our study provides evidence supporting the remarkably high Hb CS in ethnic minority groups in Central Vietnam.…”

Section: Discussionmentioning

confidence: 94%

“…Other α-thalassemic Hb variants commonly found in this region include hemoglobin Constant Spring (Hb CS) and hemoglobin Paksé (Hb Ps). The prevalence of these two forms has been well established in northeast Thailand and in Vientiane, the capital city of Laos, with a prevalence of approximately 5-10% for Hb CS, and approximately 1-2% for Hb Ps Sanchaisuriya et al 2006;Savongsy et al 2008;Panomai et al 2010;Tritipsombut et al 2012). Interactions of these thalassemia genes could result in many complex thalassemia syndromes with varying severities.…”

Section: Introductionmentioning

confidence: 99%

Thalassemia and hemoglobinopathies in an ethnic minority group in Central Vietnam: implications to health burden and relationship between two ethnic minority groups

Nguyen

Sanchaisuriya

et al. 2017

J Community Genet

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Thalassemia is a genetic condition that can result in long and expensive treatments, and severe thalassemia may lead to death if left untreated. Couples contributing two genes for thalassemia place their children at particular risk for severe thalassemia. Gene frequency of thalassemia varies in Vietnam, but presents remarkably high levels among some ethnic minority groups. Limited information about thalassemia frequency makes prevention and control of thalassemia difficult. This study aimed to determine gene frequency of certain types of thalassemia among 390 women of reproductive age of the Ta-Oi ethnic minority. Hemoglobin and DNA analyses were carried out to diagnose thalassemia and hemoglobinopathies. Of the total participants, 56.1% (95% CI = 51.1-61.1) carried thalassemia genes. A remarkably high frequency of hemoglobin Constant Spring (Hb CS) of 23.8% (95% CI = 19.7-28.4) was noted. The frequency of α + -thalassemia (−3.7 kb deletion) was 26.4% (95% CI = 22.1-31.1), while hemoglobin E (Hb E) and hemoglobin Paksé (Hb Ps) were identified at frequencies of 14.6 (95% CI = 11.2-18.5) and 2.6% (95% CI = 1.4-5.0), respectively. Further analysis of α-globin gene haplotype revealed the same Hb CS haplotype (+ − M + + −) as of the Co-Tu minority, a neighboring minority of the Ta-Oi, indicating that these two minorities may share the same ancestors. This information will be helpful for further studies in population genetics, as well as the development prevention and control program in the region.

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Iron deficiency anemia interfering the diagnosis of compound heterozygosity for Hb constant spring and Hb Paksé: The first case report

Chiasakul

Uaprasert

2017

Clinical Laboratory Analysis

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Background Diagnosis of thalassemia or hemoglobinopathy concomitant with iron deficiency anemia (IDA) is challenging. Method We report a case of 43‐year‐old female whose diagnosis of compound heterozygosity for hemoglobin Constant Spring (HbCS) and Hb Paksé became apparent after the treatment of IDA. Results Prior to treatment, Hb analysis using isoelectric focusing (IEF) showed HbA 95.6%, HbA2 2.7%, and HbCS 1.7% compatible with heterozygous HbCS. After 4 months of oral iron therapy resulting in an improved Hb level, her HbCS level was substantially increased to 8.7% on IEF suggesting homozygous HbCS. Subsequent DNA analysis using multiplex amplification refractory mutation system analysis revealed compound heterozygosity for HbCS and Hb Paksé. Conclusion This case demonstrated that IDA can significantly reduce HbCS/Hb Paksé levels and probably mask the diagnosis of homozygous HbCS, homozygous Hb Paksé or the compound heterozygosity for both hemoglobinopathies by hemoblogin analysis. The test should be repeated after resolution of IDA, or molecular testing should be performed to confirm the diagnosis.

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Thalassemia and iron deficiency in a group of northeast Thai school children: relationship to the occurrence of anemia

Abstract: The results suggest that thalassemia and hemoglobinopathies may be major contributing factors to the occurrence of anemia in this area among the children's population.

Cited by 13 publications

References 21 publications

Prevalence of Anemia and Underlying Iron Status in Naive Antiretroviral Therapy HIV-Infected Children with Moderate Immune Suppression

Prevalence of Anemia and Underlying Iron Status in Naive Antiretroviral Therapy HIV-Infected Children with Moderate Immune Suppression

Thalassemia and hemoglobinopathies in an ethnic minority group in Central Vietnam: implications to health burden and relationship between two ethnic minority groups

Iron deficiency anemia interfering the diagnosis of compound heterozygosity for Hb constant spring and Hb Paksé: The first case report

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