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Day-to-day variations in serum iron, serum iron binding capacity, serum ferritin and erythrocyte protoporphyrin concentrations in anaemic subjects.

Day-to-day variations in serum iron, serum iron binding capacity, serum ferritin and erythrocyte protoporphyrin were determined on 2 successive days in 48 patients with anaemia. The correlation coefficients between the paired determinations were 0.86, 0.89, 0.95 and 0.95, and the day-to-day coefficients of variation (in per cent) were 33, 11, 12 and 13 for serum iron, serum iron binding capacity, erythrocyte protoporphyrin and serum ferritin, respectively. Thus, in patients with anaemia, day-to-day variations in serum iron, serum iron binding capacity, erythrocyte protoporphyrin and serum ferritin are at least as high as in healthy controls. The results indicate important limitations in the use, particularly, of serum iron in the clinical investigation of anaemia.

Adolescent↗

Serum iron, serum transferrin and transferrin saturation in healthy children without iron deficiency.

Serum iron, serum transferrin and transferrin saturation were studied in 253 healthy, non-anaemic children 4, 8 and 13 years old, and in 60 healthy, non-anaemic adults having serum ferritin values greater than or equal to 15 micrograms/l. One hundred and ninety-six children had serum ferritin values greater than or equal to 15 micrograms/l (i.e. replete iron stores), 35 had intermediate ferritin values from 10-14 micrograms/l and 22 had ferritin values less than 10 micrograms/l (i.e. depleted iron stores). Iron replete children showed a gradual rise in serum iron and transferrin saturation values with age. Serum iron and transferrin saturation values were lower (P less than 0.001, P less than 0.0001) and transferrin values higher (P less than 0.0001) in iron replete children compared to adults. Iron replete children had a 2.5 centile transferrin saturation value of 5%; 19.9% of these children had saturation values less than 15% and 8.2% had values less than 10%. In iron depleted children a transferrin saturation value less than 7% yielded the highest diagnostic efficiency as regards exhausted iron stores, although with a low predictive value of a positive test. The transferrin saturation is unsuitable as a single diagnostic criterion in the evaluation of iron deficiency in children and should always be combined with other indicators of iron status.

Adolescent↗

Effects of exercise on haematologic parameters, serum iron, serum ferritin, red cell 2,3-diphosphoglycerate and creatine contents, and serum erythropoietin in long-distance runners during basal training.

We studied 18 well-trained male long-distance runners during the basal training. Haematologic parameters, serum iron and ferritin, red cell 2,3-diphosphoglycerate (2,3-DPG) and creatine contents, serum erythropoietin were investigated before and after the daily training and were compared with a group of healthy untrained controls. Red blood cell parameters did not change with the training, even though they were significantly lower than in controls. However, a true anaemic state cannot be suggested because the haemoglobin values fell into the lower limit of the normal range, even before the exercise. A slight but significant increase of neutrophils was found after the exercise, while no alteration of platelet count was observed. Serum iron and ferritin ranged normally. No increase of red cell 2,3-DPG was observed after the exercise, but it was significantly higher than in controls. After the exercise red creatinine was slightly increased. The athletes' erythropoietin was higher than that of controls, and showed a further increase after the training.

2,3-Diphosphoglycerate↗

Serum iron, serum ferritin and tissue ferritin during development in ducks.

Serum ferritin and tissue ferritin from kidney, heart, small intestine, spleen and liver from ducks during development from 16 to 112 days of age were measured by radioimmunoassay using rabbit anti-duck liver ferritin antibodies and goat second antibody. Serum iron concentration and tissue ferritin iron content are given. Serum ferritin concentration, tissue ferritin and ferritin iron content increase gradually during development. The decrease in all these parameters at 8 weeks of age might be due to molting.

Aging↗

Association of serum iron, serum transferrin saturation, and serum ferritin with survival in acute lymphocytic leukemia.

The present investigation was motivated from the consideration that a host environment rich in iron, represented by high serum transferrin saturation (TS) and high serum iron and serum ferritin levels might offer favorable growth conditions for leukemic cells in addition to infection, thus affecting survival. Serum measurements were obtained on 113 pediatric patients with acute lymphoblastic leukemia (ALL), seen at Memorial Sloan-Kettering Cancer Center between May 20, 1981 and August 8, 1983. A significant difference (p less than 0.001) was found between the survival of patients according to whether their first measured TS was greater than 36% or less than 36%, with fewer deaths in the group with TS less than 36. The relationship between TS and survival was still observed when patients were stratified according to length of time from diagnosis, risk group, French-American-British (FAB) classification, or presence of organomegaly at diagnosis (p less than 0.001). Similar differences were observed between survival of patients grouped according to their first measured serum ferritin. These results independently confirm and extend observations presented earlier and support the consideration that motivated this study. The value of serum iron-related measurements as prognostic variables cannot be established from this type of study; however, these findings suggest the need for a prospective study.

Child↗

Relation between bone marrow hemosiderin iron, serum iron status markers, and chemical and histochemical liver iron content in 82 patients with alcoholic and nonalcoholic hepatic disease.

Bone marrow hemosiderin iron was assessed in 48 patients with alcoholic, and in 34 patients with nonalcoholic liver disease (53 men, 29 women, median age 55 years, range 18-84) and correlated to serum (S)-iron status markers (iron, transferrin, ferritin), as well as to histochemical hepatocyte iron and chemical liver iron content. In a control group of 53 healthy subjects (23 men, 30 women, median age 28 years, range 18-90) marrow hemosiderin iron and iron status markers were evaluated as well. Among liver patients, the marrow iron grade was higher in men than in women (p = 0.03). Correlations were found between marrow iron and histochemical liver iron (rho = 0.38, p = 0.0001) as well as chemical liver iron (rho = 0.33, p = 0.01). Marrow iron was correlated to S-ferritin (rho = 0.53, p = 0.0001), mean red cell volume (rho = 0.34, p = 0.003), and S-transferrin (rho = -0.24, p = 0.02). Alcoholics had a higher marrow iron grade than nonalcoholics (p = 0.001) and controls (p = 0.0001). Among controls, the marrow iron grade was likewise higher in men than in women (p = 0.01). Correlations were found between marrow iron and ferritin (rho = 0.64, p = 0.0001), transferrin saturation (rho = 0.56, p = 0.001), transferrin (rho = 0.53, p = 0.001), S-iron (rho = 0.37, p = 0.01), and hemoglobin in women (rho = 0.38, p = 0.05). The results indicate that alcoholics either have increased marrow hemosiderin iron stores, or display a redistribution of iron in reticuloendothelial cells from soluble ferritin-bound iron to insoluble hemosiderin iron. Among patients with absent marrow hemosiderin iron, 81% had absent hepatocyte hemosiderin iron as well. Among patients with absent hepatocyte hemosiderin iron, 23% had absent and 77% normal or increased marrow hemosiderin iron. Therefore, in patients with iron depletion, assessment of marrow hemosiderin iron yields more relevant information of iron status than assessment of hepatocyte hemosiderin iron.

Adolescent↗

Effects of transfusion on serum iron, serum lactate dehydrogenase and platelets in megaloblastic anemia.

In 11 patients with megaloblastic anemia, transfusion of packed erythrocytes or washed erythrocytes invariably resulted in a decline in plasma iron concentration to a range of 20-90 microgram/dl (3.6-16 mumol/l) after 36 to 48 hours. The same phenomenon was observed in two of six cases of ineffective erythropoiesis without megaloblastosis and in none of five cases of aplastic anemia. The observed changes did not result from a specific hematinic response or from iron uptake by a non-erythroid compartment. In megaloblastic anemia, alteration in marrow function in response to transfusion was reflected by plasma iron kinetics and serum lactate dehydrogenase values, which indicated marked reductions in both marrow hyperplasia and ineffective erythropoiesis. Transfusion in megalobastic anemia was also responsible for a 50% reduction in platelet count after 2 to 6 days. The significance of these changes is discussed.

Adult↗

When is a serum iron really a serum iron? The status of serum iron measurements.

Although serum iron determinations play an important role in the diagnostic process, the accuracy of routine methods is suspect. The poor performance of currently used methods is well documented in the quarterly College of American Pathologists survey reports. Compared with the 1990 method of the International Committee for Standardization in Haematology (ICSH), the 1978 ICSH Reference Method shows a +3.4% bias and the standard method of the National Committee for Clinical Laboratory Standards shows a -17.8% bias for iron results. All routine methods checked--DuPont aca, Abbott TDx, Kodak Ektachem (except one lot), BM/Hitachi 717, and Synermed--show a negative bias over the entire analytical range, a significant negative intercept, and extremely poor correlation with the 1990 ICSH method for iron values < 750 micrograms/L. Individual discrepancies of several hundred percent were observed. Imprecision of the methods is not the reason for these discrepancies. We question whether most routine methods measuring low iron concentrations provide results sufficiently reliable for confirmation of iron deficiency.

Autoanalysis↗

[Serum iron and serum copper in patients with lymphogranulomatosis].

The serum iron and serum copper level was determined in fifteen patients with lymphogranulomatosis before and during the course of the therapy. While the serum copper was increased in all stages, for the serum iron only in the stages III and IV a tendency to diminution was found. With obtaining the remission a significant increase of the serum iron and a significant decrease of the serum copper developed. The normalization of serum iron and serum copper suggests a remission, the dissociation of the two parameters an activity of the lymphogranulomatosis.

Adolescent↗