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Trace Mineral Deficiencies – Diagnosis and Treatment
Published in Jennifer Doley, Mary J. Marian, Adult Malnutrition, 2023
Kavitha Krishnan, Julianne Werner
The major iron-transport protein in the blood is transferrin. During iron deficiency the ratio between iron and transferrin decreases because there is less iron to transport. Transferrin saturation is calculated by the formula: (serum iron × 100)/ total iron binding capacity (TIBC). TIBC is a marker for circulating transferrin. Transferrin saturation less than 18% indicates iron deficiency with a normal range from 18% to 50%. Mean corpuscular volume (MCV) is a measure of the size and volume of red blood cells. A low MCV defined as 80 fL or less may indicate iron deficiency; however, other causative factors, such as blood loss, should be ruled out.16
Haematological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
Microcytic anaemia is defined as anaemia associated with a low MCV (less than 78 fL) and is due to the shortage of one of the building blocks of haemoglobin: iron deficiency, globin chain deficiency (thalassaemia, inherited, common) or haem deficiency (lead poisoning,).
The Patient with Anemia and Iron Deficiency
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Haye H. van der Wal, Peter van der Meer
In routine clinical practice, anemia is diagnosed using hemoglobin or hematocrit levels as surrogate markers for a reduced red cell mass, which is the strict definition of anemia. The most commonly used definition for anemia is a hemoglobin concentration <12 g/dL (7.5 mmol/L) for women and <13 g/dL (8.1 mmol/L) for men.29 A distinction should be made between “true” anemia (i.e., reduced hemoglobin and erythrocyte count) and pseudo-anemia caused by fluid overload, leading to hemodilution (i.e., reduced hemoglobin with normal erythrocyte count).10,30,31 Therefore, hemoglobin levels should ideally be measured when the patient is in a euvolemic state. In patients with acute decompensated HF, the absolute change in hemoglobin during intravenous diuretic therapy—indicating hemoconcentration—is an independent predictor of mortality.1 Other hematological parameters, such as mean corpuscular volume (MCV), red cell distribution width, and reticulocyte count may be normal in anemic patients. In a large, observational cohort of chronic HF patients, MCV was often within the normal range and not significantly associated with either vitamin B12 or folate levels. Therefore, MCV should be used cautiously in the differential diagnosis of anemia in chronic HF patients.6
Significance of mild thrombocytopenia in maintenance hemodialysis patients; a retrospective cohort study
Published in Platelets, 2022
Yukiko Toyoda, Kaoru Tateno, Yorinobu Takeda, Yoshio Kobayashi
To investigate confounding factors, we first screened for correlations among continuous variables. As expected, metabolic indices such as albumin, phosphate, and calcium had positive correlations (Table S1). We also found that hematologic indices correlated with each other (Figure 2a,b). Although age was a confounder of the metabolic or hematologic index (Table S1), significant correlations remained between lower platelet count and lower WBC or larger MCV even after age adjustment (Figure 2c, Table S2). A larger MCV could possibly result from erythropoietin use or vitamin deficiency, which are commonly due to malnutrition or gastric resection in HD patients. However, nearly all patients were taking erythropoietin, whereas larger MCV did not correlate with low serum albumin levels (Tables S1 and S2), and only a few patients had a history of gastric resection (data not shown). Subsequently, we conducted multivariate Cox proportional hazards regression analysis (Table IV). Candidate variates were chosen from the top five Wald values (i.e., age, platelet count, serum albumin, MCV, and diabetes mellitus). We confirmed that older age and a lower platelet count remained independent and robust predictive factors associated with CVE.
Relation of hematologic inflammatory markers and obesity in otherwise healthy participants in the National Health and Nutrition Examination Survey, 2011–2016
Published in Baylor University Medical Center Proceedings, 2021
Subhanudh Thavaraputta, Jeff A. Dennis, Somedeb Ball, Passisd Laoveeravat, Kenneth Nugent
Although the correlations between most CBC parameters and BMI were statistically significant, the overall variance explained by BMI was not particularly high. BMI accounted for the highest variation in WBC, similar to what was found in a 2003–2006 NHANES study.4 The negative correlation with MCV was also noted in that same study, and the investigators concluded that the finding could be secondary to iron deficiency anemia. Prior studies have shown that obesity can lead to iron and other micronutrient deficiencies, which might explain this association.11 Several studies have investigated the potential association of RDW with waist circumference,4 metabolic syndrome,12 cardiovascular disease,13 and obesity.14 The underlying pathophysiology of these relationships is still unknown. Some investigators have suggested that inflammation affects the hepatic production of the iron regulatory peptide hormone (hepcidin), causing abnormal iron absorption, thereby affecting the MCV and RDW.15
CO2 permeability of the rat erythrocyte membrane and its inhibition
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2021
Samer Al-Samir, Maximilian Prill, Claudiu T. Supuran, Gerolf Gros, Volker Endeward
Blood samples were taken from 3 months old Lewis rats from the Central Animal Facility of the Hannover Medical School by tail venipuncture in accordance with local regulations for animal experimentation9. The blood was spun down at 5000 g for 20 min, plasma removed and cells washed three times in 0.9% NaCl. Haematocrit, cell count, and haemoglobin concentration were determined by standard techniques. Mean corpuscular volume (MCV) was ∼63 fl, which is in agreement with previous reports10,11. Rat erythrocyte surface area, which was needed in addition to mean corpuscular volume for calculation of PCO2 and PHCO3−, was estimated from an established relation between red cell area and volume12 to be 100 µm2. This may be compared to the published red cell surface areas published for mice and humans (90 µm2 or 147 µm2, respectively13). Neither of the transport inhibitors specified below and acting on membrane CO2 permeability, namely phloretin and DIDS, had a significant effect on MCV after an exposure period of ∼5 min; all MCV values varied between 62 and 65 fl. No spherocytes were observed either in controls or with inhibitors, all red blood cells exhibited the regular biconcave shape.