Characterization of acquired anemia in children by iron metabolism parameters

Sci Rep. 2022 Feb 17;12(1):2721. doi: 10.1038/s41598-022-06574-0.

Abstract

Inflammatory states are associated with anemia of chronic disease and acute infection. Hepcidin, a regulator of iron metabolism, is involved in iron pathophysiology during inflammation. We investigated biochemical characteristics in children with anemia from different causes. Four patient groups (n = 38; mean age: 12.44 ± 4.35 years) were studied: (1) inflammatory bowel disease (IBD, 10 patients); (2) iron deficiency anemia (IDA, 12); (3) celiac disease (CD, 8); (4) acute infection (AI, 8). Laboratory measurements were evaluated at diagnosis: blood count, serum iron, transferrin, ferritin, vitamin B12, folic acid, CRP, erythropoietin, hepcidin and soluble transferrin receptor (sTfR). IDA patients had the lowest Hgb (6.9 ± 1.7 g/dL), MCV (63.2 ± 7.2 fL), iron (16.8 ± 13.5 µg/dL), ferritin (4.5 ± 4.5 ng/mL) and hepcidin (3.1 ± 0.8 ng/mL) values, and the highest transferrin and sTfR values. AI patients had the highest ferritin (156.2 ± 124.5 ng/mL), CRP (144.6 ± 94 mg/L) and hepcidin (74.67 ± 12.3 ng/ml) values. Overall, hepcidin levels correlated with CRP and with ferritin (r = 0.83 and 0.85, respectively). Elucidating specific etiology-related biochemical profiles in pediatric patients with anemia from different causes using a combination of laboratory biomarkers, including hepcidin, can help physicians treat the anemia.

MeSH terms

  • Adolescent
  • Anemia / blood*
  • Anemia / complications
  • Anemia / diagnosis*
  • Anemia, Iron-Deficiency / blood
  • Anemia, Iron-Deficiency / complications
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Celiac Disease / blood
  • Celiac Disease / complications
  • Child
  • Erythropoietin / blood
  • Female
  • Ferritins / blood
  • Folic Acid / blood
  • Hemoglobins / metabolism
  • Hepcidins / metabolism
  • Humans
  • Infections / blood
  • Infections / complications
  • Inflammatory Bowel Diseases / blood
  • Inflammatory Bowel Diseases / complications
  • Iron / analysis
  • Iron / blood
  • Male
  • Receptors, Transferrin / blood
  • Transferrin / metabolism
  • Vitamin B 12 / blood

Substances

  • Biomarkers
  • EPO protein, human
  • Hemoglobins
  • Hepcidins
  • Receptors, Transferrin
  • Transferrin
  • Erythropoietin
  • C-Reactive Protein
  • Ferritins
  • Folic Acid
  • Iron
  • Vitamin B 12