• Clinical and Experimental Pediatrics
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• v.58 no.1
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• pp.15-19
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• 2015

Purpose: Soluble transferrin receptor (sTfR) is a truncated extracellular form of the membrane transferrin receptor produced by proteolysis. Concentrations of serum sTfR are related to iron status and erythropoiesis in the body. We investigated whether serum sTfR levels can aid in diagnosis and treatment of iron deficiency anemia (IDA) in children. Methods: Ninety-eight patients with IDA were enrolled and were classified according to age at diagnosis. Group 1 comprised 78 children, aged 6-59 months, and group 2 comprised 20 adolescents, aged 12-16 years. Results: In group 1, patients' serum sTfR levels correlated negatively with mean corpuscular volume; hemoglobin (Hb), ferritin, and serum iron levels; and transferrin saturation and positively with total iron binding capacity (TIBC) and red cell distribution width. In group 2, patients' serum sTfR levels did not correlate with ferritin levels and TIBC, but had a significant relationship with other iron indices. Hb and serum sTfR levels had a significant inverse relationship in both groups; however, in group 1, there was no correlation between Hb and serum ferritin levels. In 30 patients of group 1, serum sTfR levels were significantly decreased with an increase in Hb levels after iron supplementation for 1 month. Conclusion: Serum sTfR levels significantly correlated with other diagnostic iron parameters of IDA and inversely correlated with an increase in Hb levels following iron supplementation. Therefore, serum sTfR levels can be a useful marker for the diagnosis and treatment of IDA in children.

• Clinical and Experimental Pediatrics
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• v.62 no.5
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• pp.173-178
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• 2019

Purpose: To determine whether Lactobacillus reuteri DSM 17938 plays a role in absorption of iron preparations given to children with iron deficiency anemia (IDA). Methods: We performed a quasi-experimental study involving pre- and postintervention tests using a control group in North Sulawesi province, Indonesia, between July and September 2017. We conducted a single-blind controlled trial that included primary school children who were diagnosed with IDA based on reticulocyte hemoglobin equivalent (Ret-He) levels <27.8 pg/L. Results: A total of 66 children were randomized into 2 groups. Thirty-four children received iron preparations with the addition of L. reuteri DSM 17938 (group 1), whereas the other 32 received iron preparations alone (group 2). The baseline Ret-He levels before intervention were similar in both groups. After 14 days of intervention, mean Ret-He level in group 1 changed from $24.43{\pm}1.64$ to $28.21{\pm}1.72pg/L$ (P=0.000). Mean Ret-He level in group 2 changed from $24.31{\pm}1.42$ to $27.03{\pm}2.14pg/L$ (P=0.000). Statistical analysis showed a significant increase in Ret-He levels in both groups; Ret-He levels were significantly higher in the experimental group than in the control group (P<0.05). Conclusion: Children with IDA receiving iron preparations with L. reuteri DSM 17938 for 14 days show higher Ret-He levels than those receiving iron preparations alone.

• The Journal of Korean Medicine
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• v.41 no.4
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• pp.112-119
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• 2020

Objectives: The present study reports a case of chronic anemia patient who was significantly improved after taking Nokyongdaebo-tang (NYDBT) Methods: A 48-year-old male patient diagnosed with iron deficiency anemia (IDA) visited the Daejeon Korean medicine Hospital of Daejeon University on June 2018. The patient was treated with Korean medicine for 23 months including acupuncture, herbal medicine and Sasang constitutional medicine prescription. Improvement of anemia was assessed by changes of Hemoglobin value. Laboratory analysis was used to evaluate the safety of treatment. Results: Chronic anemia has significantly improved since taking NYDBT on 9 days (2019.12.09-2019.12.17). The Hb value has been maintained in the normal range since it first entered the normal range on January 18, 2020. The patient had become transfusion-free and this condition persisted for 6 months after stopping the transfusion. Conclusion: This case demonstrates the therapeutic potential of Sasang constitutional medicine for chronic anemia as a personalized medicine.

• Journal of Yeungnam Medical Science
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• v.11 no.2
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• pp.381-387
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• 1994

Plummer-Vinson syndrome is a clinical entity characterized by dysphagia, iron deficiency anemia, cheilosis, glossitis, and cervical esophageal web, especially in middle aged women. Recently, the authors experienced a case of Plummer-Vinson syndrome. A 53-year-old female was admitted due to intermittent solid food dysphagia for 18 months. She had a 2 years history of iron deficiency anemia. On admission glossitis, fissures at the angle of the mouth, spoon nails, and iron deficiency anemia were noted. Esophagogram and esophagoscopic examination revealed thin walled concentric web at upper esophagus. Esophageal web was succefully teared by endoscopic balloon dilatation with subseguant improvement of dysphagia. Skin manifestations as well as anemia were markedly improved after oral iron replacement therapy.

• Clinical and Experimental Pediatrics
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• v.54 no.7
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• pp.282-286
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• 2011

Breastfeeding is the best source of nutrition for every infant, and exclusive breastfeeding for 6 months is usually optimal in the common clinical situation. However, inappropriate complementary feeding could lead to a nutrient-deficient status, such as iron deficiency anemia, vitamin D deficiency, and growth faltering. The recent epidemic outbreak of obesity in Korean children emphasizes the need for us to control children's daily sedentary life style and their intakes of high caloric foods in order to prevent obesity. Recent assessment of breastfeeding in Korea has shown that the rate is between 63% and 89%; thus, up-to-dated evidence-based nutritional management of breastfeeding infants to prevent common nutrient deficiencies or excesses should be taught to all clinicians and health care providers.

• Journal of the East Asian Society of Dietary Life
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• v.9 no.3
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• pp.302-314
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• 1999

This study was conducted to evaluate nutrient intake, indices of anemia, serum lipids, and their correlations in 40 Korean female college students aged 21 to 25 years. Fasting blood samples were collected in October. 1997 Nutrient intake was investigated by 24-hour recall method for three days. Anthropometric measurements, blood pressure, iron status and serum lipids of the subjects were determined. The mean values for age. height, weight, BMI and blood pressure of the subjects were 22.1 years, 160.6cm, 54.4kg and 109.1/66.9mmHg, respectively. According to the body composition analysis, total body water, % body fat, lean body mass and WHR were 26.7L. 29.5%, 36.5kg and 0.8, respectively. Average daily intake of energy was 1,858.4kcal. Protein, phosphorus, vitamin B$_1$, vitamin B$_2$, niacin and vitamin C intakes were higher than the Korean recommended dietary allowence(RDA), whereas calcium, iron, vitamin A intakes were tower than that. Hemoglobin(Hb), hematocrit(Hct), serum iron(SI) and total iron binding capacity(TIBC) were measured and transferrin saturation (TS%) was calculated from serum. The mean values for Hb, Hct, SI, TIBC and TS were 13.6$\mu\textrm{g}$/㎗, 41.6%,97.8$\mu\textrm{g}$/㎗, 319.6$\mu\textrm{g}$/㎗ and 31.9%, respectively. The Prevalence rates of iron deficiency assessed by Hb and Hct were found to be 10% and 2.5%, respectively. However, when assessed with TIBC, the prevalence rate of iron deficiency was increased to 32.5%. The mean values for serum triglyceride(TG), total cholesterol(TC), HDL-Chol, LDL-Chol concentrations and atherogenic index(AI) were 154.7mg/㎗, 80.0mg/㎗, 47.4mg/㎗, 91.3mg/㎗ and 2.6, respectively. Correlations among indices of anemia. there were positive correlations between Hb and Hct, between SI and TS : negative correlations between TIBC and TS or SI. Correlations among serum lipids, there were positive correlations between TC and TG or LDL-cholesterol. Energy intakes were correlated positively with TIBC(p＜0.05), and vitamin C intakes negatively correlated with Hb(P＜0.05). And vitamin A intakes were negatively correlated with TG(p＜0.01). TC(p＜0.05) and LDL-Chol(p＜0.01). Hb negatively correlated with TG(P＜0.05). Body weights(p＜0.05), lean body mass(p＜0.05) and total body water(p＜0.01) werenegatively correlated with Hb. BMI and WHR correlated with TG and TC(p＜0.01). These results indicated that subjects with higher energy intake and overweight had a tendency to have iron deficiency. Increases in BMI and WHR were related to increases in serum lipids levels and decreases in TIBC. The results also showed that serum lipids were decreased when vitamin A and iron intakes were sufficient.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.2
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• pp.215-220
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• 2009

Purpose: Recently, the favorable merits of breast feeding have received widespread attention and the number of breast feeding children is increasing. We investigated the weaning practices between breast feeding infants and non-breast feeding infants with respect to iron deficiency anemia (IDA). Methods: Between March 2006 and January 2009, we surveyed 70 parents, the children of whom had been medically diagnosed with IDA, and 140 parents, the children of whom did not have IDA, about how they feed their children and how much they know about the weaning process. The infants and children were 6∼36 months of age and attended the Inha University hospital. Results: IDA patients started weaning later than non-IDA patients. Also, breast feeding in IDA patients was more frequent than in non-IDA patients (82% vs. 30%). The breast feeding group began weaning at approximately 6.4 months of age, which was statistically meaningfully compared to non-breast feeding infants. There were no differences in knowledge between the two groups of parents. Conclusion: According to our research, we assume that if weaning begins at 6 months, we cannot supply sufficient iron to meet the infant's needs, which increase sharply around 6 months of age because of depletion of stored iron. Thus, infants need to initiate weaning from breast feeding at 4 months of age to furnish an ample amount of iron or take iron-containing supplements. These methods would be expected to prevent IDA in breast feeding infants.

• Journal of Nutrition and Health
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• v.38 no.7
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• pp.533-543
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• 2005

The purpose of this study was to determine the iron status of preschool children in Ulsan, Korea. The study was con-ducted using 95 children aged 3 to 6 years by investigating the anthropometric indices and assessing the dietary intakes and biochemical analysis. A questionnaire for dietary intakes using 24-hr recall method were carried out by the mothers of the 95 subjects. And also a study was conducted to assess hematological and biochemical status of iron and prevalence of iron deficiency. The average height and weight were 105.4 $\pm$ 7.0 cm, 18.7 $\pm$ 3.2 kg in boys, 103.8 $\pm$ 6.7 cm, 17.6 $\pm$ 2.7 kg in girls. These were lower than the body growth standard values of Korean pediatrics. There was not a significant difference in both between boys and girls. For the daily nutrient intake, energy was 1201.5 $\pm$ 280.9 kcal (79.3$\%$RDA), protein was 63.8 $\pm$ 28.2 g (219.4$\%$RDA), iron was 11.9 $\pm$ 4.5 mg (133.2$\%$RDA). The iron nutritional status by hematological assay found that Hct was 34.7 $\pm$ 2.0 ($\%$), Hb was 12.0 $\pm$ 0.8 g/dl, RBC was 4.3 $\pm$ 0.3 ($10^6/{\mu}l$), MCV was 80.5 $\pm$ 3.0 fL, MCH was 27.8 $\pm$ 1.1 pg and MCHC was 34.6 $\pm$ 0.6 g/dl. The biochemical measurement of serum iron was 75.6 $\pm$ 30.3 ${\mu}g$/dl, TIBC was 320.3 $\pm$ 34.1 ${\mu}g$/dl, serum ferritin was 30.0 $\pm$ 14.8 ${\mu}g$/dl, Zinc-Protophor-phyrin (ZPP) was 32.7 $\pm$ 8.0 ${\mu}g$/dl, and ZPP/Heme was 71.1 $\pm$ 19.5 ($\mu$mole/mol heme). The prevalence with Hct, Hb, TS and serum ferritin less than cut-off value was $8.4\%,\;9.5\%,\;12.6\%$ and $4.4\%$ respectively. But the prevalence of iron deficiency estimated with ZPP and ZPP/Heme criteria were $25.3\%$ and $27.4\%$, and were higher than in case of any other indices. The prevalence of iron deficiency anemia ((low Hb (< 11.0 g/dl) and low serum ferritin (< 10 ${\mu}g$/L) or low TS (3-4 yews: < $12\%$, 5-6 years: < $14\%$)) was found in only one 3 year old girl. The prevalence of iron deficiency except Hct and Hb was the highest in 3 year group, but the prevalence by Hct and Hb was the highest in 5 year group. Iron deficiency and iron deficiency anemia do not seem to be a major public health problem in preschool children in Ulsan.

• Clinical and Experimental Pediatrics
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• v.53 no.3
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• pp.392-396
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• 2010

Purpose : The association between iron deficiency anemia and febrile convulsion in infants has been examined in several studies with conflicting results. Therefore, the authors aimed to evaluate the precise relationship involved. Methods : In this case-control study, the authors assessed 100 children with a diagnosis of febrile convulsion, aged between 9 months and 2 years, during January 2007 to July 2009. The control group consisted of 100 febrile children without convulsion; controls were closely matched to the cases by age, gender, and underlying disease. Results : The mean ages of the febrile convulsion and control group were $16.3{\pm}7.4$ and $15.8{\pm}6.1$ months, respectively, and the two groups had no differences in clinical features. Iron deficiency anemia (Hb <10.5 gm/dL) was more frequent in the febrile convulsion group than in the control group, although there was no statistical significance. Unexpectably, the RDW (red blood cell distribution width) was significantly lower and the MCNC (mean corpuscular hemoglobin concentration) was significantly higher among seizure cases than among the controls (P <0.05). There is no statistical difference between simple and complex febrile groups in the clinical and laboratory profiles. On multiple logistic regression analysis, iron deficiency anemia was more frequent, but the RDW was lower, among the cases with febrile convulsion, compared with the controls. Conclusions : Our study suggests that the iron deficiency anemia is associated with febrile convulsion, and screening for iron deficiency anemia should be considered in children with febrile convulsions.

• The Korean Journal of Nuclear Medicine
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• v.32 no.1
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• pp.114-119
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• 1998

We present a case of a young female patient with fulminant hepatitis who showed an altered biodistribution of Ga-67, after being scanned twice at 10 month intervals. On initial scan, uplake of Ga-67 was increased in the liver, kidneys, and skeletons. Increased hepatic Ga-67 uptake may be explained by increased transferrin unbound Ga-67 that was taken up by the inflamed liver. The saturation of iron-binding proteins due to multiple transfusions may lead to increased renal and skeletal Ga-67 uptake. On follow-up scan hepatic Ga-67 uptake was markedly increased. Also increased Ga-67 uptake in the axial skeleton and normalized renal uptake were shown. The findings were consistent with iron deficiency anemia. This case demonstrates altered Ga-67 biodistribution associated with multiple transfusions, fulminant hepatitis, and iron deficiency anemia.