Changes in Hemoglobin Level and Mean Corpuscular Volume During the Convalescent Phase of Acute Febrile Illness in Children: A Study of the Possible Role of Hemolysis
Abstract
Fever is one of the most common clinical manifestations in children. During the early days of acute febrile illness, some decrease in hemoglobin levels occurs due to unspecified cause. 64 children aged 6 months to 12-year-old with a fever higher than 38° for more than one day and with a diagnosis of acute febrile illness were admitted. The values of MCV, ESR, CRP, and hepcidin were measured at baseline and then 7 to 10 days after the improvement of the fever. The levels of reticulocytes, LDH, and bilirubin were also measured in two stages. Data analysis was done using SPSS software. The mean hemoglobin level in the acute phase of febrile illness was significantly increased 7-10 days after discontinuation of the fever by 12.87±1.09 g/dl (P<0.001). The MCV level also significantly increased (P<0.001), and levels of CRP, ESR, LDH, bilirubin, and hepcidin showed significantly decreased during the convalescent phase compared to acute febrile phase, but the level of erythrocyte increased. The present study confirmed the decrease in hemoglobin in children with acute febrile illness. Increasing of bilirubin, LDH, hepcidin, level, and no bleeding was observed during acute febrile infection in children.
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28. Shinoda N, Sullivan KM, Tripp K, et al. Relationship between markers of inflammation and anaemia in children of Papua New Guinea. Public Health Nutr 2013;16:289-95.
29. Kossiva L, Soldatou A, Gourgiotis DI, et al. Serum hepcidin: indication of its role as an "acute phase" marker in febrile children. Ital J Pediatr 2013;39:25.
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31. Duru NS, Seval H, Çivilibal M, et al. Serum hepcidin, iron metabolism and infection parameters in children with anemia of inflamation and with iron deficiency anemia. Turk J Biohem 2014;39:529-33.
32. Choi HS, Song SH, Lee JH, et al. Serum hepcidin levels and iron parameters in children with iron deficiency. Korean J Hematol 2012;47:286-92.
2. Sulivan JE, Farrer HC. Clinical report- Fever and antipyretic use in children. Pediatrics 2011;127:580-7.
3. Lorenzi OD, Gregory CJ, Santiago LM, et al. Acute febrile illness surveillance in a tertiary hospital emergency department: comparison of influenza and dengue virus infections. Am J Trop Med Hyg 2013;88:472-80.
4. Jansson LT, Kling S, Dallman PR. Anemia in children with acute infections seen in a primary care pediatric outpatient clinic. Pediatr Infect Dis 1986;5:424-7.
5. Bruno de Benoist, Erin McLean, Ines Egli et al. Worldwide prevalence of anaemia 1993–2005: WHO global database
Hemoglobin level and corpuscular volume and acute febrile illness on anaemia. World Health Organization. Available at:http://www.who.int/nutrition/publications/micronutrients/anaemia_iron_deficiency/9789241596657 [accessed on 25/10/2013].
6. Ngesa O, Mwambi H. Prevalence and risk factors of anaemia among children aged between 6 months and 14 years in Kenya. PLoS One 2014;9: e113756.
7. Jigalur PS, Giriyan S. Prevalence of pediatric anemia in Dhaward district. Int J Biomed Res 2015;6:563-6.
8. Aljomah G, Baker SS, Schmidt K, et al. Anemia in Pediatric Inflammatory Bowel Disease. J Pediatr Gastroenterol Nutr 2018;67:351-5.
9. Hussain SQ, Ashraf M, Wani JG, et al. Low Hemoglobin Level a Risk Factor for Acute Lower Respiratory Tract Infections (ALRTI) in Children. J Clin Diagn Res 2014;8: 1-3.
10. Shakya H, Singh S, Lakhey A. Anemia as a risk factor for acute lower respiratory tract infection in children below five years of age. Nep Med J 2018;1:5-8.
11. Mourad S, Rajab M, Alameddine A, et al. Hemoglobin level as a risk factor for lower respiratory tract infections in Lebanese children. N Am J Med Sci 2010;2: 461-6.
12. Mava Y, Ambe JP, Bello M, et al. Urinary tract infection in febrile children with sickle cell anaemia. West Afr J Med 2011;30:268-72.
13. Roy CN. Anemia of inflammation. Hematology Am Soc Hematol Educ Program 2010;2010:276-80.
14. Ballin A, Lotan A, Serour F, et al. Anemia of acute infection in hospitalized children-no evidence of hemolysis. J Pediatr Hematol Oncol 2009;31: 750-2.
15. Ballin A, Senecky Y, Rubinstein U, et al. Anemia associated with acute infection in children. Isr Med Assoc J 2012;14: 484-7.
16. Viana MB. Anemia and infection: a complex relationship. Rev Bras Hematol Hemoter 2011;33:90-2.
17. Kim A, Fung E, Parikh SG, et al. Isocitrate treatment of acute anemia of inflammation in a mouse model. Blood Cells Mol Dis 2016;56:31-6.
18. Grotto HZ. Metabolismo do ferro: uma revisão sobre os principais mecanismos envolvidos em sua homeostase. Rev Bras Hematol Hemoter 2008;30:390-7.
19. Wieringa FT, Dijkhuizen MA, West CE, et al. Estimation of the effect of the acute phase response on indicators of micronutrient status in Indonesian infants. J Nutr
2002;132:3061-6.
20. Grover A, Mittal H, Faridi M, et al. Utility of C-reactive protein in febrile children with clinically undetectable serious infection. J Glob Infect Dis 2013;5:34.
21. Jain S, Gautam V, Naseem S. Acute-phase proteins: As diagnostic tool. J Pharm Bioallied Sci 2011;3:118-27.
22. Markanday A. Acute Phase Reactants in Infections: Evidence-Based Review and a Guide for Clinicians. Open Forum Infect Dis 2015;2:ofv098.
23. Sales MC, de Queiroz EO, Paiva Ade A. Association between anemia and subclinical infection in children in Paraiba State, Brazil. Rev Bras Hematol Hemoter 2011;33: 96-9.
24. Barcellini W, Fattizzo B. Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia. Dis Markers 2015;2015:635670.
25. Barcellini W, Fattizzo B, Zaninoni A, et al. Clinical heterogeneity and predictors of outcome in primary autoimmune hemolytic anemia: a GIMEMA study of 308 patients. Blood 2014;124:2930-6.
26. Abshire TC, Reeves JD. Anemia of acute inflammation in children. J pediatr 1983;103:868-71.
27. Ballin A, Hussein A, Vaknine H, et al. Anemia associated with acute infection in children: an animal model. J Pediatr Hematol Oncol 2013;35:14-7.
28. Shinoda N, Sullivan KM, Tripp K, et al. Relationship between markers of inflammation and anaemia in children of Papua New Guinea. Public Health Nutr 2013;16:289-95.
29. Kossiva L, Soldatou A, Gourgiotis DI, et al. Serum hepcidin: indication of its role as an "acute phase" marker in febrile children. Ital J Pediatr 2013;39:25.
30. Muller KF, Lorenz L, Poets CF, et al. Hepcidin concentrations in serum and urine correlate with iron homeostasis in preterm infants. J Pediatr 2012;160:949-53 e2.
31. Duru NS, Seval H, Çivilibal M, et al. Serum hepcidin, iron metabolism and infection parameters in children with anemia of inflamation and with iron deficiency anemia. Turk J Biohem 2014;39:529-33.
32. Choi HS, Song SH, Lee JH, et al. Serum hepcidin levels and iron parameters in children with iron deficiency. Korean J Hematol 2012;47:286-92.
| Files | ||
| Issue | Vol 58, No 1 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/acta.v58i1.3701 | |
| Keywords | ||
| Hemoglobin Mean corpuscular volume (MCV) Acute febrile illness | ||
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How to Cite
1.
Fekri K, Kianpour F, Kheiri S, Khoshdel N, Khoshdel A. Changes in Hemoglobin Level and Mean Corpuscular Volume During the Convalescent Phase of Acute Febrile Illness in Children: A Study of the Possible Role of Hemolysis. Acta Med Iran. 2020;58(1):9-14.
