Journals / Çocuk Dergisi / 2007 / Cilt: 7 - Sayı: 1
Extent of changes in the blood parameters in relation with the intensity of the iron deficiency anemia
- Journal
- Çocuk Dergisi
- Pages
- 46–50
- DOI
- —
Abstract
In order to be able to distinguish iron deficiency anemia (DEA) from other types of anemia, all blood parameters should be evaluated. In this respect, DEA in respect of severeness levels, we wanted to investigate the change between blood parameters and compare with thalassemia minor (TM). Methods: In this study, we have investigated 248 patients with a diagnosis of DEA (n: 217 cases) and TM (n: 31 cases). The patients were divided into three groups according to the severity of anemia. Group 1 children had Hb values 10.1-11.0 g/dL (mild anemia), Group 2, 8.1 to 10.0 g/dL (moderate anemia); and Group 3, 8.0 g/dL or less (severe anemia). Red blood cell (RBC) count of >5.0x106/µL was defined as erythrocytosis, platelet count (PLT) of >600,000/mm3 as thrombocytosis, and PLT of <100,000/mm3 was regarded as thrombocytopenia, respectively. Results: 22.2 % of the patients had mild anemia, 30.8% had medium, and 47.0 % severe anemia. In the mild DEA group the results were mean red blood cell (RBC): 4.5 million/mm3, Hb: 10.3 g/dL, mean corpusculer volume (MCV): 69.3 fl, red cell distribution width (RDW): 16.6 %, platelet count (PLT): 347.000/mm3, mentzer index (MI) (MCV/RBC): 15.7, serum iron (SI): 30.6 µg/dL, total iron binding capacity (TIBC): 356.5 µg/dL, transferrin saturation (TS): 8.7 %, and ferritin (F): 5.9 ng/mL. In the medium DEA group mean RBC: 4.4 million/mm3, Hb: 9.2 g/dL, MCV: 67.0 fl, RDW: 18.2 %, PLT: 366.000/mm3, MI: 15.3, SI: 29.4 µg/dL, TIBC: 367.8 µg/dL, TS: 8.2 %, F: 6.4 ng/mL, and the severe DEA group mean RBC: 3.4 million/mm3, Hb: 6.2 g/dL, MCV: 55.8 fl, RDW: 25.0 %, PLT: 501.000 /mm3, MI: 16.5, SI: 13.7 µg/dL, TIBC: 417.5 µg/dL, TS: 3.4 %, and F: 2.6 ng/mL. Values of RBC: 5.6±0.5 million/mm3, mean Hb: 10.7±0.9 g/dL, MCV: 59.8±6.7 fl, RDW: 16.0±1.7 %, PLT: 386.000±126.000/mm3, MI: 10.7±2.1, SI: 74.4±38.5 g/dL, TIBC 304.6±60.2 µg/dL, TS: % 25.3±14.7, and F: 69.0±71.9 ng/mL was found in TM. Erythrocytosis was identified in 11.9 % of the patients with DEA while in 93.5 % of the patients with TM. The rate of erythrocytosis was 22.9 % and 22.4 % in patients with mild and moderate DEA, respectively. Thrombocytosis was identified in 28.4 % of the patients with severe DEA. The rates of thrombocytosis were 14.3 % and 6.4 % in patients DEA and TM, respectively. There was a difference in the rates of erythrocytosis and thrombocytosis between DEA and TM patients. Conclusion: As the level of the DEA increases, RBC, Hb, MCV, SI, TS and F decreases, however, RDW, PLT, MI and TIBC increases.
Özet
Demir eksikliği anemisi (DEA)’ni diğer anemilerden ayırt edebilmek için tüm kan parametreleri değerlendirilmelidir. Bu yönüyle, DEA’nin ağırlık düzeyine göre; kan parametrelerindeki değişimin varlığı araştırılmak ve talasemi minör (TM) ile karşılaştırılmak istendi. Yöntem: Çalışmaya DEA (n: 217 vaka) ve TM (n: 31 vaka) tanısı alan toplam 248 hasta alındı. Hastalar aneminin ağırlığına göre 3 gruba bölündü. Grup 1, Hb değeri 10.1-11.0 g/dL (hafif anemi), Grup 2, 8.1 ile 10.0 g/dL (orta anemi) ve Grup 3, 8.0 g/dL ya da daha az (ağır anemi) olan çocuklardı. Eritrosit (RBC) sayısının ?5.0x106/µL olması eritrositoz, trombosit sayısı (PLT)’nın ?600.000/mm3 olması trombositoz ve PLT’nin <100,000/mm3 olması trombositopeni olarak belirlendi. Bulgular: Vakaların % 22.2’si hafif, % 30.8’i orta ve % 47.0’ı ağır DEA idi. Hafif DEA grubunda ortalama RBC: 4.5 milyon/mm3, ortalama Hb: 10.3 g/dL, ortalama eritrosit volümü (MCV): 69.3 fl, eritrosit dağılım aralığı (RDW): % 16.6, PLT: 347.000/mm3 ve mentzer indeksi (MI) (MCV/RBC): 15.7, serum demiri (SI): 30.6 µg/dL, total demir bağlama kapasitesi (TIBC): 356.5 µg/dL, transferrin saturasyonu (TS): % 8.7 ve ferritin (F): 5.9 ng/mL olarak bulundu. Orta DEA grubunda ortalama RBC: 4.4 milyon/mm3, Hb: 9.2 g/dL, MCV: 67.0 fl, RDW: % 18.2, PLT: 366.000/mm3, MI: 15.3, SI: 29.4 µg/dL, TIBC: 367.8 µg/dL, TS: % 8.2, F: 6.4 ng/ml ve ağır DEA grubunda ortalama RBC: 3.4±0.6 milyon/mm3, Hb: 6.2 g/dL, MCV: 55.8 fl, RDW: % 25.0, PLT: 501.000/mm3, MI: 16.5, SI: 13.7 µg/dL, TIBC: 417.5 µg/dl, TS: % 3.4 ve F: 2.6 ng/mL olarak bulundu. TM’de RBC: 5.6±0.5 milyon/mm3, ortalama Hb: 10.7±0.9 g/dL, MCV: 59.8±6.7 fl, RDW: % 16.0±1.7, PLT: 386.000±126.000/mm3, MI: 10.7±2.1, SI: 74.4±38.5 µg/dL, TIBC 304.6±60.2 µg/dL, TS: %25.3±14.7 ve F: 69.0±71.9 ng/mL idi. Eritrositoz DEA’da % 11.9 iken TM’de % 93.5 oranında saptanmıştır. Hafif ve orta DEA’da sırasıyla % 22.9 ve % 22.4 seviyesinde eritrositoz saptanmıştır. Trombositoz ağır DEA’da % 28.4 oranında saptanmıştır. DEA’da % 14.3 olan trombositoz oranı, TM’de % 6.4 olarak saptanmıştır. DEA ve TM arasında eritrositoz ve trombositoz oranları farklı saptanmıştır. Sonuç: DEA’nın ağırlık düzeyi arttıkça RBC, Hb, MCV, SI, TS ve F azalmakta oysa RDW, PLT, MI ve TIBC ise artmaktadır.