• Clinical and Experimental Pediatrics
• /
• 제58권1호
• /
• pp.15-19
• /
• 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
• /
• 제62권5호
• /
• pp.173-178
• /
• 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.

• 대한한의학회지
• /
• 제41권4호
• /
• pp.112-119
• /
• 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
• /
• 제11권2호
• /
• pp.381-387
• /
• 1994

저자틀은 53세 여자로써 연하곤란, 철 결핍성 빈혈, 구각순증, 설염, 스푼형 조갑과 경부식도 막양구조를 특징으로 하고, 내시경적 풍선확장술에 의한 막양구조의 제거와 경구 철제 투여 후 현저한 증상의 호전을 보인 전형적인 Plummer-Vinson 증후군 환자를 경험하였다. 병력상 연하곤란이 나타나기 전부터 빈혈이 발견되었고, 철제 투여 후 피부와 점막의 병변도 호전된 점등을 고려해 볼 때 철 결핍이 본 질환의 발생에 중요한 역할을 한 것으로 추측할 수 있었다.

• Clinical and Experimental Pediatrics
• /
• 제54권7호
• /
• pp.282-286
• /
• 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.

• 동아시아식생활학회지
• /
• 제9권3호
• /
• pp.302-314
• /
• 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
• /
• 제12권2호
• /
• pp.215-220
• /
• 2009

목 적: 최근 모유수유의 장점이 알려지며 모유수유 아들이 늘고 있다. 이유기 영유아의 가장 흔한 영양장애인 IDA (Iron deficiency anemia)가 모유수유아와 다른 형태의 수유아에서 어떻게 나타나고 있는지 알아보고 IDA와 대조군의 이유식 진행 상황 및 이유지식 등에 대해 알아보았다. 방 법: 2006년 3월부터 2009년 1월까지 인하대병원에 내원한 6~24개월의 영유아 중 IDA를 진단받은 70명과 IDA가 없는 140명의 보호자에게 수유 형태, 이유식 진행 상황 및 이유지식을 묻는 설문을 시행하였다. IDA군의 자료와 함께 IDA가 없는 군을 대조군으로 하여 분석하였다. 결 과: IDA군은 IDA가 없는 군에 비해 이유식을 늦게 시작하며 IDA군에의 모유수유아 비율이 대조군에 비해 높은 것으로 나타났다(p<0.01). 모유수유군은 다른 형태의 수유군에 비해 의미 있게 늦은 6.4개월에 이유식을 시작하는 것으로 나타났다. 이유식을 완성하기 까지 58.1%가 1개월 정도 걸렸으며 4개월 이상 걸린 경우도 19.8%나 되었다. 이유 지식 정도에서 두 군은 의미 있는 차이를 보이지 않았다(p=0.32). 결 론: 생후 6개월경에 체내 저장철이 떨어지며 철의 요구량이 급증하게 된다. 일반적으로 영유아가 이유식에 익숙해지기까지 시간이 걸리고, 초기 이유식 내에는 철분 함량이 적으므로 이 시기 철분 필요량을 충분히 공급할 수 없을 것으로 생각한다. IDA 또는 철결핍을 예방하기 위해 이유식을 좀 더 일찍 권장 해 6개월에는 체내 필요량만큼의 철분이 공급될 수 있게 해야할 것으로 보인다.

• Journal of Nutrition and Health
• /
• 제38권7호
• /
• pp.533-543
• /
• 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
• /
• 제53권3호
• /
• pp.392-396
• /
• 2010

목 적 : 철 결핍 빈혈과 열성경련은 6개월-2세 사이에 호발하며 철 결핍 빈혈은 영아에서 다양한 신경학적 장애를 일으키고 열성경련은 간질과 관련이 될 수 있다. 그러나 이들의 연관관계에 대해서는 상반된 보고가 있어 그 관련성을 규명하고자 본 연구를 시행하였다. 방 법 : 2007년 1월 1일부터 2009년 7월 31까지 원광대학교병원 소아청소년과에 입원치료 받은 9개월에서 2세사이의 발달 지연이나 신경학적 결함 및 중추신경계 감염이 없는 열성 경련 환아 100명과 열성 경련이나 이전의 경련 병력이 없이 발열 증세를 보인 100명을 대조군으로 선정하여 의무 기록지를 이용하여 후향적으로 조사하였다. 결 과 : 열성경련 군과 대조군, 단순 열성경련 군과 복합 열성 경련 군 사이의 평균 연령, 성별, 원인질환별 차이는 없었다. 복합 열성경련 군에서 단순 열성경련 군에 비해 총 경련 횟수, 내원시 경련 시간과 횟수가 의의 있게 높았으며, 경련 시 최고 체온과 전체 열 발생 기간은 높았으나 통계적 차이는 없었다. 철 결핍 빈혈은 열성경련 군에서 39%로 대조군의 28%에 비해 많았으나 의미 있는 차이는 없었다. 평균 적혈구 용적, 평균 적혈구 혈색소는 열성경련 군에서 높았으나 차이는 없었고, 열성경련 군에서 평균 적혈구 혈색소 농도는 의미 있게 높고 적혈구 분포 폭은 낮았다. 단순 열성경련 군과 복합 열성경련 군 사이에는 혈액학적 소견의 차이는 없었다. 단변량 분석에서 P 값 0.010 미만인 몇가지 인자들의 다변량 로지스틱 회귀분석을 시행한 결과 열성경련 군에서 빈혈의 빈도가 의미 있게 높았다. 결 론 : 열성경련과 철 결핍 빈혈이 상호 관련성이 비록 단변량 분석 시에는 의미가 없었으나 다변량 분석에서 밀접한 관련성을 보여 주어 열성경련의 재발이나 악화를 막기 위해 적극적인 빈혈에 대한 평가와 치료가 필요할 것으로 사료된다.

• 대한핵의학회지
• /
• 제32권1호
• /
• pp.114-119
• /
• 1998

반복적인 수혈을 받은 급성전격성간염 환자에서 Ga-67 체내분포의 양상을 추적하였다. 급성기에 시행한 갈륨스캔에서 간의 악성종양을 의심하게 하는 간섭취증가와 신장, 뼈섭취증가가 관찰되었다. 간섭취증가는 철운반단백질에 결합하지 않은 Ga-67이 염증이 일어난 간세포에 섭취되었기 때문으로 해석되었다. 신장과 뼈섭취증가는 반복적인 수혈에 의한 철운반단백질의 포화에 따른 Ga-67의 세포내운반저하에 의한 것으로 생각되었다. 10개월 후에 다시 시행한 갈륨스캔에서 간섭취는 더욱 증가되었으며 골수섭취의 증가가 관찰되었다. 반면 신장섭취는 정상화되었다. 이러한 소견은 철결핍성 빈혈에 의한 것으로 해석되었다. 이 증례는 체내 철의 양과 이에 따른 철운반단백질 포화도의 변화에 의한 Ga-67의 체내분포의 변화를 예시해 준다.