Correspondence and Reprint requests : Dr. M.Atiar Rahman
Assistant Professor, Pulmonary, Department of Pediatric, Room
No. 307, D-Block, BSMMU, Shahbagh, Dhaka-1000, Bangladesh.
[DOI- -10.1007/s12098- -009- -0098- -x]
[Received April 12, 2008; Accepted July 24, 2008]
Influence of Infection on Iron Profile in Severely
M. Atiar Rahman, M.A.Mannan and Md Hamidur Rahman
Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
Objective. To study the iron profile and find out an accurate diagnostic tool which reflects iron status in different types of
infection in severely malnourished children aged 12 months to 71 months.
Methods. Hundred and Eight (108) children of whom 72 children were infected and 36 non infected severely malnourished
children according to WHO criteria in the age group of 12-71 months were interrogated. 36 healthy control in the same age
group were also interrogated.
Results. Mean serum iron, total iron binding capacity (TIBC), ferritin concentration in normal children were significantly
higher (P<0.001) than non-infected severely malnourished children. On the other hand mean serum ferritin concentration
was significantly higher (P<0.001) in infected group than non-infected group but still lower than normal. Mean serum TIBC
concentration significantly reduced in severely malnourished children than normal children but no significant difference was
observed between non-infected and infected group. Mean serum iron, and transferrin saturation were significantly reduced
(P<0.05) in parasitic infestation.
Conclusion. Severely malnourished children had reduced mean serum iron profile. Parasitic infestation influenced the
marked reduction of mean serum iron concentration and transferrin saturation level. Mean serum iron concentration was
reduced in acute respiratory infection(ARI) and parasitic infestation than other infections. Serum ferritin concentration was
elevated in all types of infection as acute phase protein but still lower than normal. So Iron, TIBC and Transferin saturation
<16% constitute good evidence for iron deficiency in both infected and non-infected severely malnourished children. [Indian
J Pediatr 2009; 76 (9) : 907-911] E-mail: firstname.lastname@example.org
Key words: Iron; TIBC; Ferritin; Infection; Malnourished children
Malnutrition associated with infections are the leading
cause of death in children in developing countries1.
Poverty, illiteracy and infections are major risk factors
for both malnutrition and iron deficiency. 2-5 Infection
and malnutrition have a synergistic relationship.
Malnutrition leads to infection and vice versa. Infection
or inflammation is a common cause of mild iron
deficiency especially respiratory tract infection, diarrhea,
urinary tract infection and parasitic infestation. 6-7
The diets of a poor earning family contain mainly
whole grains, cereals and legumes which contain
relatively poor iron. This poor iron containing diet is
poorly absorbed which may be one of the reasons for
high prevalence of iron deficiency in malnourished
children.8 Currently available confirmatory tests for
iron deficiency include the serum iron serum ferritin,
total iron binding capacity (TIBC), transferrin saturation
and the free erythrocyte protoporphyrin. 9-11 But infection
or inflammation can influence iron status and thus
complicates the accurate detection of iron deficiency.
Serum ferritin is a new tool, appears to be the most
reliable test, it is depressed only in iron deficiency;
indeed, infection or inflammation raised serum ferritin
So the aim of this study was to estimate and observe
iron profile and find out an accurate diagnostic tool
which reflects iron status in different types of infection
in severely malnourished children.
MATERIALS AND METHODS
This descriptive study was carried out on 144 children
with age range of 12-71 months. The places of study
Indian Journal of Pediatrics, Volume 76—September, 2009907