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Coexisting Iron Deficiency Anemia and Thalassemia Traits in Infants: Implication for an Anemia Screening Program
Journal of Tropical Pediatrics ( IF 2 ) Pub Date : 2022-06-16 , DOI: 10.1093/tropej/fmac044
Sasivara Boonrusmee 1 , Arunwan Thongkhao 1 , Malai Wongchanchailert 1 , Ladda Mo-Suwan 1 , Pasuree Sangsupawanich 1
Affiliation  

Objectives To study the prevalence of anemia among healthy infants, and outcomes of giving a therapeutic trial of iron to anemic infants in thalassemia-endemic area. Methods A cross sectional study was conducted in 6–9-month-old, full-term healthy infants who attended the well child clinics at 2 tertiary care centers in southern Thailand. Complete blood count and serum ferritin were performed in every infant, and hemoglobin typing was performed only in anemic cases. All anemic infants were given a therapeutic trial of iron and categorized into either; iron responder (hemoglobin increased ≥ 1 g/dL) or iron non-responder (hemoglobin increased <1 g/dL) groups after one month of the therapeutic trial. Mean levels of hematological parameters, including the Mentzer index, were compared within the groups. Results A total of 620 infants were included in the study. From this, 230 infants (37%) were anemic for which iron deficiency contributed for 80% of the etiology. The iron responder group showed significant improvement in hematological parameters after a trial of iron, while there was no improvement in the iron non-responder group. Among iron responders, there were 31 out of 186 infants (16.6%) who had coexisting abnormal hemoglobin typing, and their post-treatment complete blood count still showed a mean corpuscular volume < 70, with a Mentzer index < 13. Conclusion Iron deficiency remains a major cause of anemia among infants, and a therapeutic trial of iron is beneficial in this age group, even though thalassemia trait/hemoglobinopathy can co-exist.

中文翻译:

婴儿同时存在缺铁性贫血和地中海贫血特征:对贫血筛查计划的意义

目的了解健康婴儿贫血的患病率,以及对地中海贫血流行地区贫血婴儿进行铁治疗试验的结果。方法 对 6-9 个月大的足月健康婴儿进行横断面研究,这些婴儿在泰国南部 2 个三级保健中心的儿童诊所就诊。对每个婴儿进行全血细胞计数和血清铁蛋白检查,仅在贫血病例中进行血红蛋白分型。所有贫血婴儿都接受了铁治疗试验,并分为两种;治疗试验一个月后,铁反应组(血红蛋白增加≥ 1 g/dL)或铁无反应组(血红蛋白增加 < 1 g/dL)。在组内比较血液学参数的平均水平,包括 Mentzer 指数。结果共有620名婴儿被纳入研究。由此,230 名婴儿 (37%) 贫血,其中 80% 的病因是缺铁。铁反应组在铁试验后血液学参数有显着改善,而铁无反应组没有改善。在铁反应者中,186 名婴儿中有 31 名(16.6%)同时存在血红蛋白分型异常,他们的治疗后全血细胞计数仍显示平均红细胞体积<10%。70,具有 Mentzer 指数 < 13. 结论 缺铁仍然是婴儿贫血的主要原因,尽管地中海贫血特征/血红蛋白病可以共存,但铁的治疗试验对这个年龄组是有益的。230 名婴儿 (37%) 贫血,其中 80% 的病因是缺铁。铁反应组在铁试验后血液学参数有显着改善,而铁无反应组没有改善。在铁反应者中,186 名婴儿中有 31 名(16.6%)同时存在血红蛋白分型异常,他们的治疗后全血细胞计数仍显示平均红细胞体积<10%。70,具有 Mentzer 指数 < 13. 结论 缺铁仍然是婴儿贫血的主要原因,尽管地中海贫血特征/血红蛋白病可以共存,但铁的治疗试验对这个年龄组是有益的。230 名婴儿 (37%) 贫血,其中 80% 的病因是缺铁。铁反应组在铁试验后血液学参数有显着改善,而铁无反应组没有改善。在铁反应者中,186 名婴儿中有 31 名(16.6%)同时存在血红蛋白分型异常,他们的治疗后全血细胞计数仍显示平均红细胞体积<10%。70,具有 Mentzer 指数 < 13. 结论 缺铁仍然是婴儿贫血的主要原因,尽管地中海贫血特征/血红蛋白病可以共存,但铁的治疗试验对这个年龄组是有益的。而铁无反应组没有改善。在铁反应者中,186 名婴儿中有 31 名(16.6%)同时存在血红蛋白分型异常,他们的治疗后全血细胞计数仍显示平均红细胞体积<10%。70,具有 Mentzer 指数 < 13. 结论 缺铁仍然是婴儿贫血的主要原因,尽管地中海贫血特征/血红蛋白病可以共存,但铁的治疗试验对这个年龄组是有益的。而铁无反应组没有改善。在铁反应者中,186 名婴儿中有 31 名(16.6%)同时存在血红蛋白分型异常,他们的治疗后全血细胞计数仍显示平均红细胞体积<10%。70,具有 Mentzer 指数 < 13. 结论 缺铁仍然是婴儿贫血的主要原因,尽管地中海贫血特征/血红蛋白病可以共存,但铁的治疗试验对这个年龄组是有益的。
更新日期:2022-06-16
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