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Annals of Intensive Care
Published in: Annals of Intensive Care 1/2018

Open Access 01-12-2018 | Research

Iron metabolism in critically ill patients developing anemia of inflammation: a case control study

Authors: Margit Boshuizen, Jan M. Binnekade, Benjamin Nota, Kirsten van de Groep, Olaf L. Cremer, Pieter R. Tuinman, Janneke Horn, Marcus J. Schultz, Robin van Bruggen, Nicole P. Juffermans, Molecular Diagnosis and Risk Stratification of Sepsis (MARS) Consortium

Published in: Annals of Intensive Care | Issue 1/2018

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Abstract

Background

Anemia occurring as a result of inflammatory processes (anemia of inflammation, AI) has a high prevalence in critically ill patients. Knowledge on changes in iron metabolism during the course of AI is limited, hampering the development of strategies to counteract AI. This case control study aimed to investigate iron metabolism during the development of AI in critically ill patients.

Methods

Iron metabolism in 30 patients who developed AI during ICU stay was compared with 30 septic patients with a high Hb and 30 non-septic patients with a high Hb. Patients were matched on age and sex. Longitudinally collected plasma samples were analyzed for levels of parameters of iron metabolism. A linear mixed model was used to assess the predictive values of the parameters.

Results

In patients with AI, levels of iron, transferrin and transferrin saturation showed an early decrease compared to controls with a high Hb, already prior to the development of anemia. Ferritin, hepcidin and IL-6 levels were increased in AI compared to controls. During AI development, erythroferrone decreased. Differences in iron metabolism between groups were not influenced by APACHE IV score.

Conclusions

The results show that in critically ill patients with AI, iron metabolism is already altered prior to the development of anemia. Levels of iron regulators in AI differ from septic controls with a high Hb, irrespective of disease severity. AI is characterized by high levels of hepcidin, ferritin and IL-6 and low levels of iron, transferrin and erythroferrone.
Appendix
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Metadata
Title
Iron metabolism in critically ill patients developing anemia of inflammation: a case control study
Authors
Margit Boshuizen
Jan M. Binnekade
Benjamin Nota
Kirsten van de Groep
Olaf L. Cremer
Pieter R. Tuinman
Janneke Horn
Marcus J. Schultz
Robin van Bruggen
Nicole P. Juffermans
Molecular Diagnosis and Risk Stratification of Sepsis (MARS) Consortium
Publication date
01-12-2018
Publisher
Springer International Publishing
Published in
Annals of Intensive Care / Issue 1/2018
Electronic ISSN: 2110-5820
DOI
https://doi.org/10.1186/s13613-018-0407-5

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