Abstract

Objective Typhoid fever is a common systemic bacterial infection in children with a complex interplay between serum hepcidin and iron. We investigated the relationship between iron deficiency anemia (IDA) and serum hepcidin level in children with acute typhoid fever.

Methods We conducted a preliminary case–control study in Mansoura University Children's Hospital, Egypt from April 2017 to May 2019 including 30 children aged 5 to 15 years with confirmed acute typhoid fever. We recruited 15 healthy nonanemic children, of comparable ages and sex as controls from the same hospital while attending for nonfebrile complaints. Typhoid fever cases were subdivided according to IDA existence into 16 cases with IDA and 14 non-IDA cases. We excluded all children having diseases which may affect serum iron and hepcidin levels, for example, liver, blood, gastrointestinal, and kidney diseases, and patients receiving drugs interfering with iron metabolism. All participants were subjected to complete blood count, serum ferritin, iron, hepcidin levels, and total iron-binding capacity (TIBC).

Results In non-IDA typhoid fever group, serum iron level was significantly low, while serum hepcidin level was significantly high when compared with controls (p < 0.001 and p = 0.02, respectively). In IDA typhoid fever group, no statistically significant difference existed as regards serum hepcidin level when compared with controls (p = 0.53). No significant correlations were detected between serum hepcidin levels and hemoglobin, serum iron, ferritin, and TIBC values in each group.

Conclusion Preexisting iron status could affect serum hepcidin level in patients with acute typhoid fever. Coexistence of IDA might oppose the up-regulatory effect of acute typhoid fever on serum hepcidin level.

Publication History

Received: 21 March 2020

Accepted: 20 July 2020

Publication Date:
04 September 2020 (online)

Georg Thieme Verlag KG
Stuttgart · New York

中文翻译：

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伤寒儿童铁缺​​乏症贫血和血清铁调素水平：病例对照研究

摘要

目的 伤寒是儿童中常见的全身细菌感染，血清铁调素与铁之间的相互作用复杂。我们调查了急性伤寒儿童铁缺​​乏性贫血（IDA）与血清铁调素水平之间的关系。

方法 我们于2017年4月至2019年5月在埃及曼苏拉大学儿童医院进行了一项初步的病例对照研究，研究对象包括30例确诊为急性伤寒的5至15岁儿童。我们从同一家医院招募了15名年龄和性别相仿的健康非贫血儿童作为对照，同时接受了非发热性投诉。根据IDA的存在将伤寒患者分为16例IDA患者和14例非IDA患者。我们排除所有患有可能影响血清铁和铁调素水平的疾病的儿童，例如肝脏，血液，胃肠道和肾脏疾病，以及接受药物干扰铁代谢的患者。所有参与者均接受全血细胞计数，血清铁蛋白，铁，铁调素水平和总铁结合能力（TIBC）。

结果 在非IDA伤寒组中，与对照组相比，血清铁水平显着较低，而血清铁调素水平显着较高（分别为p  <0.001和p  = 0.02）。在IDA伤寒组中，与对照组相比，血清hepcidin水平没有统计学上的显着差异（p  = 0.53）。在各组中，血清铁调素水平与血红蛋白，血清铁，铁蛋白和TIBC值之间未发现显着相关性。

结论 急性伤寒患者铁水平的存在可能会影响血清铁调素水平。IDA的共存可能会反对急性伤寒对血清铁调素水平的上调作用。

出版历史

收到：2020年3月21日已

接受：2020年7月20日

发布日期：
2020年9月4日（在线）

Georg Thieme Verlag KG
斯图加特·纽约