The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration?

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

The diagnosis of anemia is an important aspect of the practice of hematology. The first step is to decide whether the patient is, in fact, anemic. Unless earlier blood counts are available, and they often are not, the physician must make his or her decision on the basis of the population distribution of hemoglobin values. How likely is it that the patient's hemoglobin value lies below the normal distribution; that is, “the lower limit”?

Related collections

Most cited references 9

Record: found
Abstract: found
Article: not found

The quantitative assessment of body iron.

B S Skikne, Bruce Cook, Lisa Flowers (2003)

Current initiatives to reduce the high prevalence of nutritional iron deficiency have highlighted the need for reliable epidemiologic methods to assess iron status. The present report describes a method for estimating body iron based on the ratio of the serum transferrin receptor to serum ferritin. Analysis showed a single normal distribution of body iron stores in US men aged 20 to 65 years (mean +/- 1 SD, 9.82 +/- 2.82 mg/kg). A single normal distribution was also observed in pregnant Jamaican women (mean +/- 1 SD, 0.09 +/- 4.48 mg/kg). Distribution analysis in US women aged 20 to 45 years indicated 2 populations; 93% of women had body iron stores averaging 5.5 +/- 3.35 mg/kg (mean +/- 1 SD), whereas the remaining 7% of women had a mean tissue iron deficit of 3.87 +/- 3.23 mg/kg. Calculations of body iron in trials of iron supplementation in Jamaica and iron fortification in Vietnam demonstrated that the method can be used to calculate absorption of the added iron. Quantitative estimates of body iron greatly enhance the evaluation of iron status and the sensitivity of iron intervention trials in populations in which inflammation is uncommon or has been excluded by laboratory screening. The method is useful clinically for monitoring iron status in those who are highly susceptible to iron deficiency.

0 comments Cited 82 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Hematologic differences between African-Americans and whites: the roles of iron deficiency and alpha-thalassemia on hemoglobin levels and mean corpuscular volume.

Ernest Beutler, Carol West (2005)

The average results of some laboratory measurements, including the hemoglobin, mean corpuscular volume (MCV), serum transferrin saturation (TS), serum ferritin, and white blood cell count of African-Americans differ from those of whites. Anonymized samples and laboratory data from 1491 African-American and 31 005 white subjects, approximately equally divided between men and women, were analyzed. The hematocrit, hemoglobin, MCV, TS, and white blood cell counts of African-Americans were lower than those of whites; serum ferritin levels were higher. When iron-deficient patients were eliminated from consideration the differences in hematocrit, hemoglobin, and MCV among women were slightly less. The -3.7-kilobase alpha-thalassemia deletion accounted for about one third of the difference in the hemoglobin levels of African-Americans and whites and neither sickle trait nor elevated creatinine levels had an effect. Among all subjects, 19.8% of African-American women would have been classified as "anemic" compared with 5.3% of whites. Among men, the figures were 17.7% and 7.6%. Without iron-deficient or thalassemic subjects, the difference had narrowed to 6.1% and 2.77% and to 4.29% and 3.6%, respectively. Physicians need to take into account that the same reference standards for hemoglobin, hematocrit, MCV, and TS and the white blood cell count do not apply to all ethnic groups.

0 comments Cited 81 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Penetrance of 845G--> A (C282Y) HFE hereditary haemochromatosis mutation in the USA.

Terri Gelbart, Vincent Felitti, STEFFAN N. HO … (2002)

There has been much interest in screening populations for disease-associated mutations. A favoured candidate has been the HFE gene, mutations of which are the most common cause of haemochromatosis in the European population. About five people in 1000 are homozygotes for the 845G-->A mutation, but little is known of how many have mutation-caused clinical manifestations. We screened 41038 individuals attending a health appraisal clinic in the USA for the 845G--> A and 187C-->G HFE mutations, and analysed laboratory data and data on signs and symptoms of haemochromatosis as elicited by questionnaire. The most common symptoms of haemochromatosis, including poor general health, diabetes, arthropathies, arrhythmias, impotence, and skin pigmentation were no more prevalent among the 152 identified homozygotes than among the controls. The age distribution of homozygotes and compound heterozygotes did not differ significantly from that of controls: there was no measurable loss of such individuals from the population during ageing. However, there was a significantly increased prevalence of a history of hepatitis or "liver trouble" among homozygotes and in the proportion of homozygotes with increased concentrations of serum aspartate aminotransferase and collagen IV; these changes were not related to iron burden or to age. Only one of the 152 homozygotes had signs and symptoms that would suggest a diagnosis of haemochromatosis. The normal age distribution of people with the haemochromatosis genotype, and the lack of symptoms in patients of all ages, indicate that the penetrance of hereditary haemochromatosis is much lower than generally thought. The clinical penetrance of a disorder is an essential consideration in screening for genetic disease; disorders with low penetrance are more expensive candidates for screening than disorders with high penetrance. Our best estimate is that less than 1% of homozygotes develop frank clinical haemochromatosis.

0 comments Cited 34 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Journal

Title: Blood

Publisher: American Society of Hematology

ISSN (Print): 0006-4971

ISSN (Electronic): 1528-0020

Publication date Created: March 01 2006

Publication date (Print): March 01 2006

Volume: 107

Issue: 5

Pages: 1747-1750

Affiliations

[1 ]From the Department of Molecular and Experimental Medicine, The Scripps Research Institute, La Jolla, CA.

Article

DOI: 10.1182/blood-2005-07-3046

PMC ID: 1895695

PubMed ID: 16189263

SO-VID: 188269a6-3302-4c45-b100-bcc7ed41d4ac

History

Data availability:

Comments

Comment on this article

scite_

Cited by 224

See all cited by

Most referenced authors 284

See all reference authors

- Version 1
- Version 1

The definition of anemia: what is the lower limit of normal of the blood hemoglobin concentration?

Read this article at

Abstract

Related collections

CRISPR/Cas9 editing in human blood

Most cited references 9

The quantitative assessment of body iron.

Hematologic differences between African-Americans and whites: the roles of iron deficiency and alpha-thalassemia on hemoglobin levels and mean corpuscular volume.

Penetrance of 845G--> A (C282Y) HFE hereditary haemochromatosis mutation in the USA.

Author and article information

Journal

Affiliations

Article

History

Comments

Comment on this article

Similar content 38

Cited by 224

Most referenced authors 284