Latent iron deficiency
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| Latent Iron Deficiency | |
|---|---|
| Classification and external resources | |
| Specialty | Lua error in Module:Wikidata at line 446: attempt to index field 'wikibase' (a nil value). |
| ICD-10 | E61.1 |
| Patient UK | Latent iron deficiency |
Latent iron deficiency (LID), also called iron-deficient erythropoiesis,[1] is a medical condition in that there is evidence of iron deficiency without anemia (normal hemoglobin[2]). It is important to assess this condition because it is accepted that individuals with latent iron deficiency will develop iron-deficiency anemia in the weeks or months following diagnoses of LID if they are not treated with iron supplementation. In addition, there is some evidence of a decrease in vitality and an increase in fatigue among individuals that have Latent Iron Deficiency.[3] Another clinical study has shown an increase of ferritin levels in those taking iron compared with others receiving a placebo from persons with LID.[4]
Clinical features
The clinical features of Latent Iron Deficiency are in discussion, some studies have not shown a clear difference between individuals with LID and control a group of the same age, gender and origin without LID. But may be it is not wrong to say that the persons with LID have a mild decrease in vitality and increase of fatigue. What seems important for preventive healthcare is to detect this medical condition, because it will avoid the patient probably developing an Iron-Deficiency Anemia.
Analytical features
- Hematology
- Hemoglobin (Hgb) and mean corpuscular volume (MCV), being normal, are lower and RDW higher in individuals with LID compared with non-deficient individuals. This is the reason why some new parameters/functions combining the previoustly mentioned (Hgb,MCV, RDW), have been developed, as MAf (Hgb x MCV ÷ 100) and MAf-RDW (Hgb x MCV ÷ RDW ÷ 10) (Beckman Coulter.[5][6] It has been published that the percentage of hypochromic (< 28 g.dl-1) red blood cells measured with hematology automated analysers, as the Technicon H1(tm),[7] the Reticulocyte Hb content (CHr) (ADVIA(tm) Siemens),[8] Reticulocyte Hemoglobin equivalent (Ret-He)(Sysmex XE-2100)[9] can also detect LID.
- Immunochemistry
- Serum soluble transferrin receptor (sTfR) in combination with Serum Ferritin, in the parameter called TfR-F Index = sTfR ÷ Logarithm (Ferritin) has shown high performance in detecting Latent Iron Deficiency.[10]
Treatment
There is no consensus on how to treat Latent Iron Deficiency but one of the options is to treat it as an iron-deficiency anemia with ferrous sulfate (Iron(II) sulfate) at a dose of 100 mg x day in two doses (one at breakfast and the other at dinner)[11] or 3 mg x Kg x Day in children (also in two doses)[12] during two or three months. The ideal would be to increase the deposits of Body Iron, measured as levels of Ferritin in serum, trying to achieve a Ferritin value between 30 and 100 ng/mL. With Ferritin levels higher than 100 ng/mL an increase in Infections, etc. has been reported.[13] Another way to treat LID is with an iron rich diet and in addition Ascorbic acid or Vitamin C, contained in many types of fruits as oranges, kiwifruits, etc. that will increase 2 to 5-fold iron absorption.[14][15]
Epidemiology
There are many studies about LID and the frequency varies according to country of origin, diet, pregnancy status age, gender, etc. Depending on these previous conditions, the frequency can change from 11% in male athletes (Poland) to 44.7% in children less than 1 year old (China):
Frequency of LID in different countries and populations:
- Poland: 14 of LID (11%) in 131 male athletes and 31 of ID (26%) in 121 female athletes[16]
- India: 27.5% of LID amongst student nurses[17]
- Spain: 14.7% of LID in 211 women of child-bearing age in Barcelona[18]
- China: In 3591 pregnant women and 3721 premenopausal from 15 provinces. It was found: LID 42.6% in pregnant women (urban first-trimester (41.9%) (rural (36.1%)) while 34.4% of LID in premenopausal non-pregnant women(urban (35.6%)(rural 32.4%)).[19] Pediatric samples: In 9118 children from 31 provinces aged 7 months to 7 years, the global incidence of LID in children was 32.5%. Sub-classifying the cases according to age and origin (global/countryside): less than 1 y (7m to 12m) LID 44.7%(35.8% In countryside), 1 – 3 years LID 35.9%%(31% In countryside), 4 to 7 years (LID 26.5%)%(30.1% In countryside).[20]
References
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- ↑ Methods of determination of iron deficiency and hemochromatosis. Ramon Simon-Lopez. US Patent US 8154713 B2. https://docs.google.com/viewer?url=patentimages.storage.googleapis.com/pdfs/US8154713.pdf
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