Prevalence and pattern of iron deficiency and its correlation with different hematological parameters in a segment of patients coming to a tertiary care hospital in Lahore

Authors

  • Ambereen Anwar Imran Punjab Institute of Cardiology, Lahore
  • Sadaf Farzand Punjab Institute of Cardiology, Lahore
  • Muhammad Ali Huzaifa School of Allied Health Sciences, PIC, Lahore
  • Maham Naseem Allied School of Health Sciences, PIC, Lahore

DOI:

https://doi.org/10.55958/jcvd.v19i2.133

Keywords:

Serum iron levels, Complete Blood Count, iron deficiency, platelet count

Abstract

Background: Iron is an essential micronutrient, abundantly present in nature. Very low quantities of iron are required in our daily diet to prevent its deficiency. But paradoxically, its deficiency is very common all around the world. In keeping with its wide and varied functions in the body, the deficiency of iron also has multiple manifestations. This study aimed to study the prevalence and pattern of iron deficiency in a segment of our population. The effect on various hematological parameters was also studied.

Materials and Methods: Fifty cases including both genders and all ages were included in the study. The parameters analyzed were iron status and hematological indices. The status of serum iron levels was compared with total iron binding capacity (TIBC). Blood examination included total leukocyte count, differential leukocyte count, hemoglobin level, total RBC count, hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and platelet count. The correlation of serum iron levels with the different hematological indices was analyzed.

Results: Iron deficiency was even more prevalent than previously reported (70%). It was seen in both genders and all age groups. Only the elderly male group showed a mean that was in the normal range. Females were affected more severely than males in all age groups. Red cell indices showed expected correlation with serum iron levels. Platelet counts showed an increase with falling iron levels.

Discussion: Iron deficiency continues to be rampant despite decades of public health measures to correct it. Iron deficiency anemia impacts multiple body functions with a myriad of health consequences. The ensuing symptoms are those classically related to anemia as well as some that are both unexpected and hard to explain. Increase in platelet count seen in iron deficiency carries the risk of creation of a thrombogenic state. The factors contributing to iron deficiency need to be identified and addressed.

Key words: Serum iron levels, Complete Blood Count, iron deficiency, platelet count.

Author Biographies

Ambereen Anwar Imran, Punjab Institute of Cardiology, Lahore

Professor of Pathology

Sadaf Farzand, Punjab Institute of Cardiology, Lahore

Consultant Pathologist

Muhammad Ali Huzaifa, School of Allied Health Sciences, PIC, Lahore

Student Medical Lab Technologist

Maham Naseem, Allied School of Health Sciences, PIC, Lahore

Student Medical Lab Technologist

References

Camaschella C, Nai A, Silvestri L. Iron metabolism and iron disorders revisited in the hepcidin era. Haematologica. 2020 Jan 31;105(2):260-272.

Ems T, St Lucia K, Huecker MR. Biochemistry, Iron Absorption. In: StatPearls. Treasure Island (FL): StatPearls Publishing 2022; Available from: https://www.ncbi.nlm.nih.gov/books/NBK448204/

National Nutritional Survey 2018. Government of Pakistan. Available from: https://www.unicef.org/pakistan/media/2861/file/NNS&hx0025;20KFR.pdf

Mawani M, Ali SA, Bano G, Ali SA. Iron Deficiency Anemia among Women of Reproductive Age, an Important Public Health Problem: Situation Analysis. Reproductive System & Sexual Disorders: Current Research 2016; 5(3): 1-6.

Kumar A, Sharma E, Marley A, Samaan MA, Brookes MJ. Iron deficiency anaemia: pathophysiology, assessment, practical management. BMJ Open Gastroenterol 2022; 9(1): e000759.

Aslam H, Khan AN, Chaudhary AJ, Iqbal S, Ismail R. A Rare Case of Recurrent Arterial Thrombosis Secondary to Iron Deficiency Anemia. Cureus 2022; 14(2): e22117.

Arnett JJ, Žukauskien? R, Sugimura K. The new life stage of emerging adulthood at ages 18-29 years: implications for mental health. Lancet Psychiatry 2014; 1(7):569-76.

Watson KB, Carlson SA, Loustalot F, Town M, Eke PI, Thomas CW, Greenlund KJ. Chronic Conditions Among Adults Aged 18?34 Years - United States, 2019. Morb Mortal Wkly Rep 2022; 71(30):964-970.

Coelho-Junior HJ, Calvani R, Azzolino D, Picca A, Tosato M, Landi F, Cesari M, Marzetti E. Protein Intake and Sarcopenia in Older Adults: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health 2022; 19(14):8718.

Wolf M, Koch TA, Bregman DB. Effects of iron deficiency anemia and its treatment on fibroblast growth factor 23 and phosphate homeostasis in women. J Bone Miner Res 2013; 28(8):1793-803.

Park K, Kersey M, Geppert J, Story M, Cutts D, Himes JH. Household food insecurity is a risk factor for iron-deficiency anaemia in a multi-ethnic, low-income sample of infants and toddlers. Public Health Nutr 2009; 12(11):2120-8.

Killip S, Bennett JM, Chambers MD. Iron deficiency anemia. Am Fam Physician 2007; 75(5):671-8. Erratum in: Am Fam Physician 2008; 78(8):914.

Coad J, Pedley K. Iron deficiency and iron deficiency anemia in women. Scand J Clin Lab Invest Suppl 2014; 244:82-9.

Eder AF, Yau YY, West K. The effect of iron balance on platelet counts in blood donors. Transfusion 2017; 57(2):304-312.

Mhadgut H, Galadima H, Tahhan HR. Thrombocytosis in Iron Deficiency Anemia. Blood 2018; 132: 4985.

Chaker S, Very S, Helley D, Gaussem P, Pouchot J, Darnige L, Fischer AM, et al. Thrombopénie ferriprive: undiagnostic différentiel rare du purpura thrombopénique auto-immun [Thrombocytopenia associated with iron deficiency: a rare differential diagnosis of auto-immune thrombocytopenic purpura]. Rev Med Interne 2010; 31(9):631-6.

Holbro A, Volken T, Buser A, Sigle JP, Halter JP, Passweg JR, Tichelli A, et al. Iron deficiency and thrombocytosis. Vox Sang. 2017; 112(1):87-92.

Akan H, Güven N, Aydogdu I, Arat M, Beksaç M, Dalva K. Thrombopoietic cytokines in patients with iron deficiency anemia with or without thrombocytosis. Acta Haematol 2000; 103(3):152-6.

Jimenez K, Leitner F, Leitner A, Scharbert G, Schwabl P, Kramer AM, Krnjic A, et al. Iron deficiency-induced thrombocytosis increases thrombotic tendency in rats. Haematologica 2021;106(3):782-794.

Maryala S, Vaddiparti A. Reactive Thrombocytosis Related Cerebral Venous Thrombosis: A Rare Complication of Untreated Iron Deficiency Anemia. Cureus 2021; 13(10): e19064.

Venugopalan PD, Henry RA, Joseph J, Oomen AT, Janardhanan Kakkra J. Severe Iron Deficiency Anemia Leading to Thrombocytosis with Arterial and Venous Thrombosis. Cureus 2021; 13(9):e17893.

Aslam H, Khan AN, Chaudhary AJ, Iqbal S, Ismail R. A Rare Case of Recurrent Arterial Thrombosis Secondary to Iron Deficiency Anemia. Cureus 2022; 14(2): e22117.

Vinnakota RD, Brett AS. Iron Deficiency Anemia Associated with Acid-Modifying Medications: Two Cases and Literature Review. Am J Med Sci 2019; 357(2):160-163.

Dado DN, Loesch EB, Jaganathan SP. A Case of Severe Iron Deficiency Anemia Associated with Long-Term Proton Pump Inhibitor Use. Current Therapeutic Research 2017; 84: 1-3.

Freeman HJ. Iron deficiency anemia in celiac disease. World J Gastroenterol 2015; 21(31):9233-9238.

Akhter P, Din M, Orfi SD, Ahmad N, Rehman K. Assessment of daily iron intake for the Pakistani population. Nutrition & Food Science 2005; 35: 109-117.

Khokhar J, Akbar A, Akhtar S, Layla A, Lazarte C, Abbas MA, Asif M. Prevalence and determinants of anemia among resident female university students from Southern Punjab, Pakistan. Women & Health 2022; 62: 488-501.

Morck TA, Lynch SR, Cook JD. Inhibition of food iron absorption by coffee. Am J Clin Nutr 1983; 37(3):416-20.

Ziegler EE. Consumption of cow's milk as a cause of iron deficiency in infants and toddlers. Nutr Rev 2011; 69 Suppl 1:S37-42.

Sung ES, Choi CK, Kim NR, Kim SA, Shin MH. Association of Coffee and Tea with Ferritin: Data from the Korean National Health and Nutrition Examination Survey (IV and V). Chonnam Med J 2018; 54(3):178-183.

Gibson RS, Raboy V, King JC. Implications of phytate in plant-based foods for iron and zinc bioavailability, setting dietary requirements, and formulating programs and policies. Nutr Rev 2018; 76(11):793-804.

Kumar A, Sharma E, Marley A, Samaan MA, Brookes MJ. Iron deficiency anaemia: pathophysiology, assessment, practical management. BMJ Open Gastroenterol 2022; 9(1): e 000759.

Published

2023-09-02

Issue

Section

Articles