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An assessment of methods used in the investigation of iron status: findings in a population of young British South Asian children
  1. Roderick F Hinchliffe1,2,
  2. Ajay J Vora1,3,
  3. Lynne Lennard2
  1. 1Department of Paediatric Haematology, Sheffield Children's NHS Foundation Trust, Sheffield, UK
  2. 2Academic Unit of Clinical Pharmacology, Department of Human Metabolism, University of Sheffield Medical School, Sheffield, UK
  3. 3Academic Unit of Child Health, Department of Human Metabolism, University of Sheffield Medical School, Sheffield, UK
  1. Correspondence to Dr Lynne Lennard, Clinical Pharmacology Unit, Department of Human Metabolism, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX, UK; l.lennard{at}sheffield.ac.uk

Abstract

Aims To assess the value of laboratory tests available for the investigation of iron status in a population of young British South Asian children.

Methods Blood count, red cell distribution width (RDW), percentage hypochromic red cells (%hypo), concentrations of C-reactive protein (CRP), zinc protoporphyrin (ZPP), ferritin, soluble transferrin receptor, plasma iron measurements and incidence of deletional forms of α-thalassaemia were determined.

Results Haemoglobin, mean cell haemoglobin (MCH), ferritin and CRP values classified iron status in 151/205 (73.6%) consecutive children aged 4–43 months. Fifty-four could not be classified: 12 were anaemic with findings, other than normal CRP values, indistinguishable from those with anaemia of inflammation and 42 were non-anaemic with reduced MCH values. All 42 had normal ferritin concentration and 8 of 36 successfully tested had deletional α-thalassaemia trait. Despite apparent iron sufficiency the RDW, %hypo and ZPP values of these 42 were not significantly different from the 32 children classified with iron-deficient erythropoiesis. The gene frequency of deletional α-thalassaemia trait in the entire group was 8.6%.

Conclusions Among 205 British South Asian children aged 4–43 months with high incidences of anaemia, iron deficiency, infection and α-thalassaemia, 151 (73.6%) were classified using haemoglobin, MCH, ferritin and CRP values. In 42 non-anaemic, iron-sufficient children with subnormal MCH values, that is with a phenotype of α-thalassaemia trait, RDW, %hypo and ZPP values did not differ significantly from those with iron-deficient erythropoiesis. Raised RDW, %hypo and ZPP values should be interpreted with caution in non-anaemic young British South Asian children with microcytosis.

  • THALASSAEMIA
  • IRON METABOLISM
  • ERYTHROCYTE
  • PAEDIATRIC HAEMATOLOGY

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