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History and Consequences
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
The use of serum albumin as an indicator of nutritional status was first described by Blackburn and colleagues in 1977.14 Those investigators also discussed the use of serum transferrin and total iron-binding capacity as nutrition assessment tools. In 1996, Mears15 reported that serum prealbumin was a more sensitive indicator of nutrition status than serum albumin. At about the same time, Charney16 noted that the synthesis and degradation of hepatic proteins were significantly altered during critical illness, and that those factors made the use of these proteins as nutrition assessment indicators challenging at best. In 2004, Fuhrman et al.15 reported that hepatic proteins were correlated with severity of illness, morbidity and mortality, and were useful as prognostic indicators for the development of malnutrition, but not indicators of malnutrition per se or of the success of nutritional repletion.
Cellular Components of Blood
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
Iron is transported in plasma bound to transferrin, which is synthesized in the liver. Transferrin binds two atoms of iron per molecule, has a half-life of 8–10 days and is recycled. Plasma transferrin is normally 30% saturated with iron, and the total iron binding capacity of plasma is approximately 40–75 μmol/L. Transferrin gains most of its iron from the macrophages of the reticuloendothelial system. When the plasma iron concentration is raised, transferrin is saturated and iron is transferred to parenchymal cells.
Biochemical Parameters and Childhood Nutritional Anemia
Published in Anil Gupta, Biochemical Parameters and the Nutritional Status of Children, 2020
Transferrin saturation is the ratio between serum iron concentration and the total iron binding capacity of transferrin. It is presented as a percentage. Its reference value lies between 20% and 50%. It signifies the saturation ability of transferrin. Transferrin saturation level below 20% is indicative of a deficiency of iron in the body. The normal value of transferrin saturation is between 15% and 50% in males, and between 12% and 45% in females (Camaschella 2015).
Kwashiorkor on the south shore
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Samuel T. Arcieri, Szeya Cheung, Alexander Belkin, Ajish Pillai, Ravi Gupta
Vital signs revealed an oral temperature of 98.0°F, BP 142/105 mmHg, heart rate 139 bpm, respiratory rate 30/min, saturating at 89% on room air, and a BMI of 20.1 kg/m2. Physical exam revealed altered mental status; cachexia with sunken orbits, poor oral hygiene, extensive abdominal distention, hypoactive bowel sounds, diffuse tenderness to palpation, and a positive fluid wave. There was no evidence of gastrointestinal bleeding. 3+ pitting edema of the bilateral lower extremities was noted. Initial laboratory studies were significant for hemoglobin 10.0 g/dL, creatinine 1.5 mg/dL, lactic acid 4.4 mmol/L, HCO3 15 mEq/L, ammonia 65 µmol/L and albumin 1.8 g/dL; liver function tests were within normal limits, INR was 1.2. Subsequent iron studies revealed iron of 25 ug/dL, with a total iron binding capacity of 133 ug/dL, a ferritin of 75 ng/mL, and a percent saturation of 18.8%. The vitamin B12 level was 1447 pg/mL, and folate was 4.44 ng/mL. A CT of the chest, abdomen, and pelvis without contrast showed extensive abdominal and pelvic ascites along with bilateral infiltrates and consolidation of the right lower lung lobe. An abdominal ultrasound revealed a large amount of ascites and a lower extremity venous ultrasound demonstrated deep vein thromboses (DVT) Figure 1 in the common femoral veins bilaterally. A computer tomography angiogram (CTA) was negative for acute pulmonary embolism.
Ferritin L-subunit gene mutation and hereditary hyperferritinaemia cataract syndrome (HHCS): a case report and literature review
Published in Hematology, 2021
Yunfan Yang, Ting Lin, Pu Kuang, Xinchuan Chen
In August 2020, she visited the outpatient department of Hematology of West China Hospital for further assessment due to persistently raised serum ferritin. Repeated examination indicated that her serum ferritin concentration was significantly increased (1652 ng/ml, reference value 24–336 ng/ml). Further laboratory examination indicated that, except for a slight decrease in transferrin (2.26 g/L, reference value 2.5–4.3 g/L), other iron metabolism parameters including soluble transferrin receptor (1.16 mg/L, reference value: 0.76–1.76 mg/L), serum iron (22.4 umol/L, reference value: 7.8–32.2 umol/L), total iron-binding capacity (TIBC) (51.25 umol/L, reference value: 48.3–68.0 umol/L) and transferrin saturation (43.7%, reference value: 20%∼55%) were all normal. Evaluation of magnetic resonance imaging (MRI) of the heart and liver showed no evidence of parenchymal iron overload. She had no other aetiologies such as malignancy, inflammation, obesity, and alcohol abuse that could cause hyperferritinemia. Consequently, genetic testing was carried out on the patient.
General characteristics of anemia in postmenopausal women and elderly men
Published in The Aging Male, 2020
Tuba Taslamacioglu Duman, Gulali Aktas, Burcin Meryem Atak, Mehmet Zahid Kocak, Ozge Kurtkulagi, Satilmis Bilgin
The MCV of women and men was 76 ± 11 fL and 86 ± 14 fL, respectively. The MCV difference between women and men was statistically significant (p < .001). The PLT of women and men was 289 (69–571) k/mm3 and 191 (89–424) k/mm3, respectively. The PLT difference between women and men was statistically significant (p = .01). The total iron binding capacity of women and men was 417 (75–544) µg/dL and 354 (90–526) µg/dL, respectively. The total iron binding capacity difference between women and men was statistically significant (p = .02). The ferritin of women and men was 6.14 (2–2000) µg/L and 12 (3–173) µg/L, respectively. The ferritin difference between women and men was statistically significant (p = .02). The folate of women and men was 6.3 (2.6–15.8) µg/L and 5.4 (2.2–13.7) µg/L, respectively. The folate difference between women and men was statistically significant (p = .048). The serum creatinine of women and men was 0.72 (0.6–1.7) mg/dL and 1.1 (0.7–2) mg/dL, respectively. The creatinine difference between women and men was statistically significant (p < .001). The ESR of women and men was 20 (5–118) mm/h and 32 (5–124) mm/h, respectively. The ESR difference between women and men was statistically significant (p = .006). Table 1 shows general characteristics and the laboratory data of the study population.