1. Haemoglobin variants, iron status and anaemia in Sri Lankan adolescents with low red cell indices: A cross sectional survey
- Author
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Angela Allen, Anuja Premawardhena, Rexan Rodrigo, Chris Fisher, Aresha Manampreri, David J. Weatherall, Stephen Allen, and Luxman Perera
- Subjects
Adult ,Erythrocyte Indices ,Male ,0301 basic medicine ,Adolescent ,Genotype ,Cross-sectional study ,Iron ,Physiology ,Biology ,Haemoglobin variants ,Hemoglobins ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,alpha-Thalassemia ,medicine ,Increased iron ,Humans ,Public Health Surveillance ,Child ,Molecular Biology ,Sri Lanka ,Hematologic Tests ,Anemia, Iron-Deficiency ,RED-CELL INDICES ,Anemia ,Cell Biology ,Hematology ,Iron deficiency ,medicine.disease ,Cross-Sectional Studies ,030104 developmental biology ,030220 oncology & carcinogenesis ,Molecular Medicine ,Female ,Iron status ,Sri lanka ,Biomarkers - Abstract
Iron deficiency complicates the use of red cell indices to screen for carriers of haemoglobin variants in many populations. In a cross sectional survey of 7526 secondary school students from 25 districts of Sri Lanka, 1963 (26.0%) students had low red cell indices. Iron deficiency, identified by low serum ferritin, was the major identifiable cause occurring in 550/1806 (30.5%) students. Low red cell indices occurred in iron-replete students with alpha-thalassaemia including those with single alpha-globin gene deletions. Anaemia and low red cell indices were also common in beta-thalassaemia trait. An unexpected finding was that low red cell indices occurred in 713 iron-replete students with a normal haemoglobin genotype. It is common practice to prescribe iron supplements to individuals with low red cell indices. Since low red cell indices were a feature of all forms of α thalassaemia and also of iron deficiency, in areas where both conditions are common, such as Sri Lanka, it is imperative to differentiate between the two, to allow targeted administration of iron supplements and avoid the possible deleterious effects of increased iron availability in iron replete individuals with low red cell indices due to other causes such as α thalassaemia.
- Published
- 2018