• 제목/요약/키워드: Anemia, Iron-Deficiency

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Helicobacter pylori 감염과 관련된 철 결핍성 빈혈에서 Lactoferrin Sequestration의 역할 (Lactoferrin Sequestration and Its Contribution to Iron Deficiency Anemia in Helicobacter pylori Infected Gastric Mucosa)

  • 문광빈;강창규;최연호;한혜승;송순욱
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제5권1호
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    • pp.11-18
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    • 2002
  • 배경: Lactoferrin은 위장 점막에서 H. pylori의 철분의 공급원으로 알려져 있다. 본 연구는 H. pylori에 감염된 위장 점막의 조직검체에서 lactoferrin 값을 측정하고 철 결핍성 빈혈의 유무에 따라 lactoferrin 발현의 주요 위치를 정하는 방법을 이용하여 lactoferrin과 철 결핍성 빈혈을 동반한 H. pylori감염 사이의 연관성을 밝히기 위해 시행하였다. 방법: 상부 위장관 내시경을 시행한 55명의 환아를 세 군으로 분류하였다: 정상군(NL, n=19), H. pylori 감염군(HP, n=15), H. pylori 감염이 동반된 철 결핍성 빈혈군(IDA, n=21). 조직 병리학 소견은 Updated Sydney System을 이용하여 정도를 나누었다. 위장 점막의 lactoferrin 값은 면역 측정법으로 측정하였다. lactoferrin의 발현 위치와 양을 측정하는 것은 면역조직화학적 염색방법을 이용하였다. 결과: 위 전정부에서의 lactoferrin의 값은 조직 검체의 H. pylori 밀도나 다형핵세포의 침습정도, 만성 염증에 비례하여 의미있게 증가되었다. HP와 IDA군에서는 정상군에 비하여 lactoferrin의 수치가 통계학적으로 유의하게 증가되었다(p=0.0001). IDA군은 HP군에 비하여 lactoferrin의 수치가 높은 경향이 있었다(p=0.2614). 면역조직화학적 방법에 의한 lactoferrin 발현의 주요부위는 상피세포내의 분비샘과 호중구에 있었다. Lactoferrin은 정상군에서는 약하게 염색되었고 HP와 IDA군에서는 강하게 염색되었다. 결론: IDA군에서 위장 점막내 lactoferrin 격리가 현저하였으며 이 소견은 H. pylori 감염이 철 결핍성 빈혈에 영향을 미치는 기전을 밝히는데 중요한 단서로 작용할 것이다.

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Is It Possible to Predict the Iron Status from an Infant's Diet History?

  • Kim, Hyung Jin;Kim, Dong Hyun;Lee, Ji Eun;Kwon, Young Se;Jun, Yong Hoon;Hong, Young Jin;Kim, Soon Ki
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제16권2호
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    • pp.95-103
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    • 2013
  • Purpose: Iron deficiency remains a very common nutritional problem despite the improvement in nutrition and increased understanding of methods for its prevention. Thus, we try to create a new method for screening iron nutrition through infant nutrition history. Methods: Among the children who visited Inha University Hospital from March 2006 to July 2012, 181 children with iron deficiency anemia (IDA) and 52 children without IDA ranging from 6 to 36 months of age were reviewed in this study. We used the age when they began to wean food, the type of sort weaning foods, the time required for successful weaning, iron content in weaning foods, and the duration of breastfeeding for scoring infant nutrition history based on a questionnaire. Results: The mean score of the IDA group was $7.8{\pm}2.6$ points, which was significantly higher than that of the control group ($5.6{\pm}2.1$) (p=0.000). If we set up the cutoff value at 6 points, this screening has 86.8% sensitivity and 36% specificity. In addition, as the IDA score increased, there was a falling trend of hemoglobin. Conclusion: The IDA score does not have high specificity or high sensitivity. However, this study conveys that those patients who record a high score have low hemoglobin. Therefore, we suggest this score system for screening more IDA patients via nonpainful techniques.

Bioavailability of Iron-fortified Whey Protein Concentrate in Iron-deficient Rats

  • Nakano, Tomoki;Goto, Tomomi;Nakaji, Tarushige;Aoki, Takayoshi
    • Asian-Australasian Journal of Animal Sciences
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    • 제20권7호
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    • pp.1120-1126
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    • 2007
  • An iron-fortified whey protein concentrate (Fe-WPC) was prepared by addition of ferric chloride to concentrated whey. A large part of the iron in the Fe-WPC existed as complexes with proteins such as ${\beta}$-lactoglobulin. The bioavailability of iron from Fe-WPC was evaluated using iron-deficient rats, in comparison with heme iron. Rats were separated into a control group and an iron-deficiency group. Rats in the control group were given the standard diet containing ferrous sulfate as the source of iron throughout the experimental feeding period. Rats in the iron-deficiency group were made anemic by feeding on an Fe-deficient diet without any added iron for 3 wk. After the iron-deficiency period, the iron-deficiency group was separated into an Fe-WPC group and a heme iron group fed Fe-WPC and hemin as the sole source of iron, respectively. The hemoglobin content, iron content in liver, hemoglobin regeneration efficiency (HRE) and apparent iron absorption rate were examined when iron-deficient rats were fed either Fe-WPC or hemin as the sole source of iron for 20 d. Hemoglobin content was significantly higher in the rats fed the Fe-WPC diet than in rats fed the hemin diet. HRE in rats fed the Fe-WPC diet was significantly higher than in rats fed the hemin diet. The apparent iron absorption rate in rats fed the Fe-WPC diet tended to be higher than in rats fed the hemin diet (p = 0.054). The solubility of iron in the small intestine of rats at 2.5 h after ingestion of the Fe-WPC diet was approximately twice that of rats fed the hemin diet. These results indicated that the iron bioavailability of Fe-WPC was higher than that of hemin, which seemed due, in part, to the different iron solubility in the intestine.

Iron succinyl casein encapsulated alginate beads for the treatment of iron deficiency anemia

  • Ko, Hye-Ran;Oungbho Kwunchit;Park, Jeong-Sook;Kim, Chong-Kook
    • 대한약학회:학술대회논문집
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    • 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.2-2
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    • pp.247.1-247.1
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    • 2003
  • Iron deficiency is the most common nutritional problem worldwide. Oral iron supplementation programs have failed because of noncompliance and gastrointestinal toxicity. The purpose of this study was to explore the possibility of alginate gel bead as an oral controlled release system of iron supplements and increase the stability of iron succinyl casein (ISC). Alginate beads containing ISC were prepared by the gelation of sodium alginate with calcium cations. The release profiles of ISC were investigated according to the concentration of polymer, the drug/sodium alginate ratio, the concentration and type of cation, curing time and pH of calcium chloride solution. (omitted)

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모유수유아에서의 철결핍 빈혈과 비타민 D 결핍 (Iron Deficiency Anemia and Vitamin D Deficiency in Breastfed Infants)

  • 최은혜;정수호;전용훈;이유진;박지연;유정순;장경자;김순기
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제13권2호
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    • pp.164-171
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    • 2010
  • 목 적: 철결핍성 빈혈(iron deficiency anemia, IDA)은 영양상태의 개선에도 불구하고 여전히 발견되는 영양질환이다. 저자들은 영유아기에 IDA가 발생할 수 있는 위험 인자에 대해 알아보았고, IDA 환아의 영양 분석을 통하여 철분 및 비타민 D 영양 결핍에 대하여 알아 보았다. 방 법: 2006년 3월부터 2010년 3월까지 저자들의 병원에 내원한 6~36개월의 IDA 환아 103명을 대상으로 하였고, IDA가 없는 같은 연령의 영유아 123명을 비교군으로 혈액검사와 설문 조사를 하였다. IDA가 진단된 6~12개월 환아 중 식이력 작성이 구체적인 11명에 대해서는 Canpro를 이용하여 영양 분석하였다. 결 과: IDA군에서 모유수유 87.4%, 비교군에서는 모유수유 40.7%였다. 이유 시작 시기는 IDA군은 평균 6.4${\pm}$1.8개월이었고 비교군은 평균 5.9${\pm}$1.3개월이었다. 이유식을 잘 먹게 된 시기는 IDA군에서 4주 이내는 46.4%, 비교군에서 4주 이내는 53.5%였다. IDA군의 병원 방문 이유는 호흡기 질환이 36.2%로 가장 많았고, 빈혈 증상으로 방문한 경우는 18.6%였다. IDA 환아 11명의 Canpro 분석에서 철분은 권장섭취량의 40% 미만이었고, 비타민 D 섭취는 30% 미만이었다. 결 론: 모유수유를 하는 영아는 4~6개월에 이유식을 시작해야 한다. 위험 인자가 있는 영아에서 철결핍 빈혈과 비타민 D 결핍이 있을 수 있으므로, 선별검사와 비타민 D 영양 평가가 필요하다. 또한 철분강화 분유, 비타민 D 강화 분유나 이유식을 통한 영양 공급이 필요하다.

Sequencing and Comparative Analysis of napA Genes from Helicobacter pylori Strains Associated with Iron-Deficiency Anemia

  • Hong, Myung-Hee;Choe, Yon-Ho;Cho, Yang-Je;Ahn, Bo-Young;Lee, Na-Gyong
    • Journal of Microbiology and Biotechnology
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    • 제15권4호
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    • pp.866-872
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    • 2005
  • H. pylori is known to cause severe gastric diseases, including peptic ulcers and gastric cancers, and a link has also been suggested with iron-deficiency anemia (IDA). However, little is known about the pathogenesis of H. pylori-associated IDA. In the present study, to determine whether H. pylori strains are correlated with the prevalence of IDA, we analyzed and compared the sequences of the napA genes encoding a bacterioferritin-like protein in H. pylori strains. A total of 20 H. pylori strains were isolated from antral biopsies of patients with and without IDA, and the napA genes amplified from the genomic DNA were sequenced. A comparison of the deduced amino acid sequences for NapA revealed two sites with major variations. At residue 70, five out of the 12 non-IDA strains ($41.7\%$) contained serine, while only one of the 8 IDA strains ($12.5\%$) contained serine, indicating a significantly higher frequency of serine in the non-IDA strains. In addition, the NapA proteins from all 17 Western strains available on Web sites were found to contain serine residues at this position. Meanwhile, the other major variation was located at residue 73, where all eight IDA strains ($100\%$) contained leucine, while this was only true for eight of the 12 non-IDA strains ($66.7\%$). Therefore, these results indicated that the strains within each group were more genetically related to each other than to strains in the other group. When the expression level of the napA genes in the H. pylori strains was measured using RT-PCR, no significant difference was observed between the two groups, suggesting a similar intensity for the inflammatory responses induced by the NapA protein among the strains. Consequently, when taken together, the present data suggest that the occurrence of H. pylori-associated IDA may be partly determined by the infecting H. pylori strain, and the non-IDA strains are more closely related to Western strains than the IDA strains.

부항으로 인해 발생한 철분결핍성빈혈 2례 (Two Cases of Iron Deficiency Anemia due to Negative Therapy)

  • 최지호;이상현
    • 정신신체의학
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    • 제7권2호
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    • pp.247-251
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    • 1999
  • 연구배경 : 철분결핍성빈혈은 매우 흔하며 그 원인이 다양하므로 근본 원인을 찾으려는 노력을 하여야만 한다. 저자는 소화기관 출혈, 임신, 과다월경 등의 원인 외에 우리 나라의 의료 특성상 빈번하게 이뤄지고 있는 부항에 의해 발생한 증례를 경험하였으므로 부항으로 인해 발생한 철분결핍성빈혈 2예를 보고하고자 한다. 이들의 행위는 설명모델로 이해될 수 있다. 증례 1 : 27세 여자 환자가 호흡곤란을 주소로 내원하였다. 환자는 10년 전부터 있었던 건선을 치료하기 위해 부항요법을 빈번하게 실시하였고 이로 인한 실혈로 철분결핍성빈혈이 발생하였다. 증례 2 : 70세 남자 환자가 식욕부진과 어지러움을 주소로 내원하였다. 환자는 내원 9개월 전에도 같은 증상이 있어 철분결핍성빈혈로 진단을 받고 치료 받았으나 5년 전부터 족부 무좀에 대해 실시한 부항요법을 지난 번 빈혈치료 후에도 반복해 실시한 결과 철분결핍성빈혈이 발생하였다. 결론 : 철분결핍성빈혈의 원인으로 우리나라 의료의 특성상 부항요법도 고려하여야 한다.

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장기간의 철 결핍 빈혈 및 성장부전으로 발현된 장문합부위 궤양 1예 (Perianastomotic ulceration presenting with long-term iron deficiency anemia and growth failure: A case report and review of the literature)

  • 강경지;김은하;정은영;박우현;강유나;김애숙;황진복
    • Clinical and Experimental Pediatrics
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    • 제53권1호
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    • pp.89-92
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    • 2010
  • 장문합부위 궤양은 영유아기에 장 절단과 문합 후 발생하는 합병증으로 발병기전은 아직 정확하게 밝혀져 있지 않으며, 효과적인 치료법도 아직 개발되어 있지 않다. 저자들은 10세 된 여아의 만성 철 결핍 빈혈과 성장부전의 원인을 찾기 위하여 실시한 대장 내시경검사에서 장문합부위 궤양을 발견하고, 궤양이 있는 부위의 수술적 제거와 문합부 재교정 이후 증상의 호전을 경험하였기에 문헌고찰과 함께 국내 처음으로 보고하는 바이다. 장 절단술 후 증상의 발현이 늦어 진단이 어렵기 때문에 영유아기에 수술을 받은 환자의 경우 추적관찰을 통해 장문합부위 궤양의 발병 가능성을 예의주시해야 한다.

Should asymptomatic young men with iron deficiency anemia necessarily undergo endoscopy?

  • Kim, Nam Hee;Park, Jung Ho;Park, Dong Il;Sohn, Chong Il;Choi, Kyuyong;Jung, Yoon Suk
    • The Korean journal of internal medicine
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    • 제33권6호
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    • pp.1084-1092
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    • 2018
  • Background/Aims: There has been no evidence for the necessity of endoscopy in asymptomatic young men with iron deficiency anemia (IDA). To determine whether endoscopy should be recommended in asymptomatic young men with IDA, we compared the prevalence of gastrointestinal (GI) lesions between young men (< 50 years) with IDA and those without IDA. Methods: We conducted a case-control study on asymptomatic young men aged < 50 years who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health checkup between 2010 and 2014. Results: Of 77,864 participants, 128 (0.16%) had IDA and 512 subjects without IDA were matched for several variables including age. Young men with IDA had a significantly higher proportion of colorectal cancer (CRC) (0.8% vs. 0.0%, p = 0.045), villous adenoma (0.8% vs. 0.0%, p = 0.045), and inflammatory bowel disease (IBD; 2.3% vs. 0.4%, p = 0.025) than those without IDA. Additionally, the prevalence of advanced colorectal neoplasia (ACRN) tended to be higher in subjects with IDA than in those without IDA (3.1% vs. 1.0%, p = 0.084). The prevalence of significant lower GI lesions including ACRN and IBD was higher in subjects with IDA than in those without IDA (5.5% vs. 1.4%, p = 0.011). Regarding upper GI lesions, a positive association with IDA was observed only for gastric ulcer (4.7% vs. 1.0%, p = 0.011). Conclusions: GI lesions including CRC, villous adenoma, IBD, and gastric ulcer were more common in asymptomatic young men with IDA. Our results suggest that EGD and particularly colonoscopy should be recommended even in asymptomatic young men with IDA.

철결핍빈혈에 대한 당귀보혈탕의 효과와 안전성 : 체계적 문헌 고찰과 메타분석 (The Effectiveness and Safety of Danggui Buxue Decoction for Iron Deficiency Anemia: A Systematic Review and Meta-Analysis)

  • 김채은;김미경;선승호
    • 대한한방내과학회지
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    • 제45권4호
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    • pp.549-567
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    • 2024
  • Objectives: This study was aimed at evaluating the effectiveness and safety of Danggui buxue decoction (DBD) for iron deficiency anemia (IDA) by systematic review and meta-analysis of the randomized controlled trials (RCTs). Methods: Randomized controlled trials on the treatment of DBD for IDA patients were selected from among the literature published from the beginning of each database to May 30, 2023 in nine domestic and foreign databases (PubMed, EMBASE, Cochrane, Chinese Academic Journals (CAJ), CiNii Research, J-STAGE, Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), and ScienceON). The quality of the literature was evaluated using the Cochrane ROB tool 2.0 (ROB2) and GRADE method. The meta-analysis was conducted using RevMan5.4. Results: A total of 636 patients with IDA were finally selected from the 7 RCTs. The meta-analysis showed that the treatment groups that underwent both DBD and conventional treatment were statistically higher than the control groups that performed only conventional treatment in all indicators that showed effectiveness of DBD such as red blood cell (mean difference (MD) 0.38×1012/L, 95% CI: 0.16-0.60), hemoglobin (MD 12.45 g/L, 95% CI: 10.27-14.63), serum ferritin (MD 3.50 ㎍/L, 95% CI: 1.71-5.29), and total effective rate (relative risk (RR) 1.13, 95% CI: 1.05-1.21). The incidence of adverse events was 0.39 times lower in the DBD group than in the conventional group (RR 0.39, 95% CI: 0.22-0.70). Conclusion: This study demonstrated the effectiveness and safety of DBD with conventional treatment and further provided a basis for administering DBD to patients with IDA in clinical treatment.