Serum transferrin receptor in children with respiratory infections.

OBJECTIVE: To study the effect of infection on iron status in children suffering from acute, mild or severe respiratory infections and to determine the nature of anemia in infection using serum transferrin receptor (sTfR) levels. DESIGN: Forty-three children aged between 3 and 5 y with no evidence of infection and receiving iron supplements in the preceding 100 days served as controls. Twenty-one children with mild upper respiratory infection and 94 children hospitalized for acute pneumonia constituted the experimental group. Hemoglobin (Hb), sTfR and serum ferritin were estimated in all the children at the time of diagnosis and again on the 15th and 30th days after the infection in those who were available for follow-up. RESULTS: Mean (95% CI) sTfR was 6.08 (5.1-7.1) mg/l in healthy non-anemic children. Upper respiratory infection had no impact on Hb or sTfR but it significantly elevated serum ferritin levels. Eighty-three percent of the children with pneumonia had Hb less than 110 g/l at the time of diagnosis and had elevated mean sTfR, 18.0 (15.7-20.3) mg/l. There was a decline in mean sTfR by the 15th day of infection to 14.3 (11.3-17.4) mg/l with further rise to 22.9 (13.0-31.9) mg/l by 30 days. Serum ferritin was significantly elevated at the time of diagnosis (85.9; 71.1-100.8 micro g/l) as well as at 15 days (89.1; 68-110.1 micro g/l) with a decline by 30 days. CONCLUSIONS: Severe lower respiratory infection exaggerates iron-deficient erythropoiesis by blocking release of iron from the storage pools. sTfR may not be a sensitive and specific tool of assessing true iron status of children exposed to severe infections.

Assessment of vitamin A status in pregnant women as reflected by in vitro destruction of vitamin A by hemolysates and urinary ammonium nitrogen to creatinine ratio.

To investigate the significance of the lowered plasma vitamin A during the last few weeks of pregnancy, the capacity of erythrocyte lysates to destroy vitamin A in vitro and the alteration in ammonium nitrogen to creatinine ratio (Am N/Cr) in random urine samples was followed up at different gestational ages in women from low income groups. One group received no supplementation and the other received supplements of 1800 retinol equivalents (RE) and at most points the number of observations were not less than 12. In the unsupplemented women there was a significant increase in the capacity of erythrocytes to destroy vitamin A in vitro, which reflects an increased oxidative stress as compared to the supplemented group. While differences in mean Am N/Cr did not follow any consistent pattern, there was a strong association between lowered plasma vitamin A (< 35 micrograms/dl) and increased Am N/Cr ratio (> 0.5). This was true only when combined data of both groups were considered till 26 weeks of gestation and not beyond. As expected in supplemented women there was no significant fall in the plasma vitamin A during term. These data reveal that the lowered plasma vitamin A levels are suggestive of greater risk of hypovitaminosis A during pregnancy as indicated by the oxidative stress in erythrocytes.

Effect of vitamin A supplementation of plasma progesterone and estradiol levels during pregnancy.

The effect of vitamin A supplementation on plasma estrogen and progesterone were studied in pregnant women. While there was no change in the estrogen concentration, the mean increment in plasma progesterone in the supplemented group was significant when compared to the unsupplemented group. It is suggested that vitamin A supplementation to undernourished pregnant women may have beneficial effect on feto-placental function.