Detection of iron deficiency in children with Down syndrome
| Autor: | Kanecia O. Zimmerman, Corinne M. Linardic, Kishore Vellody, Anna Pastore, Diletta Valentini, Sheila Cannon, Priya S. Kishnani, Sarah J. Hart, Vasiliki Patsiogiannis, Paolo Rossi, Amy Torres, Brian G. Skotko, Stephanie L. Santoro, Gordon Worley |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty Anemia Down syndrome Macrocytosis 030105 genetics & heredity Gastroenterology Article 03 medical and health sciences iron deficiency hemic and lymphatic diseases Internal medicine Medicine Red blood cell indices Mean corpuscular volume Genetics (clinical) iron deficiency anemia medicine.diagnostic_test biology business.industry Complete blood count Red blood cell distribution width medicine.disease Settore MED/38 trisomy 21 Ferritin 030104 developmental biology macrocytosis Iron-deficiency anemia biology.protein business |
| Zdroj: | Genet Med |
| ISSN: | 1098-3600 |
| Popis: | Purpose Current American Academy of Pediatrics guidelines for children with Down syndrome (DS) recommend a complete blood count (CBC) at birth and hemoglobin annually to screen for iron deficiency (ID) and ID anemia (IDA) in low-risk children. We aimed to determine if macrocytosis masks the diagnosis of ID/IDA and to evaluate the utility of biochemical and red blood cell indices for detecting ID/IDA in DS. Methods We reviewed data from 856 individuals from five DS specialty clinics. Data included hemoglobin, mean corpuscular volume, red cell distribution width (RDW), percent transferrin saturation (TS), ferritin, and c-reactive protein. Receiver operating characteristic curves were calculated. Results Macrocytosis was found in 32% of the sample. If hemoglobin alone was used for screening, all individuals with IDA would have been identified, but ID would have been missed in all subjects. RDW had the highest discriminability of any single test for ID/IDA. The combination of RDW with ferritin or TS led to 100% sensitivity, and RDW combined with ferritin showed the highest discriminability for ID/IDA. Conclusion We provide evidence to support that a CBC and ferritin be obtained routinely for children over 1 year old with DS rather than hemoglobin alone for detection of ID. |
| Databáze: | OpenAIRE |
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