Serum iron

Iron salts, such as ferrous sulfate or ferrous gluconate, are used in the treatment of iron deficiency anemia, which occurs when there is a loss of iron that is greater than the available iron stored in the body. Iron preparations act by elevating the serum iron concentration, which replenishes hemoglobin and depleted iron stores. 

The absorption of oral iron is decreased when tlie agent is administered with antacids, tetracyclines, penicillamine, and the fluoroquinolones. When iron is administered with levothyroxine, there may be a decrease in tlie effectiveness of levothyroxine When administered orally, iron deceases the absoqition of lev-odopa. Ascorbic acid increases tlie absoqition of oral iron. Iron dextran administered concurrently with chloramphenicol increases serum iron levels. 

Hematological Methods. Hematological analyses can Include the determination of the total hemoglobin concentration (In g%), the packed cell volume (PCV In %), the red blood cell count (In 10 /mm ) and reticulocytes count (In %), calculation of the red cell Indices, examination of a blood film, tests to demonstrate the presence of Inclusion bodies and of sickle cells, tests to evaluate the distribution of fetal hemoglobin (Hb-F) Inside the red cells, the red cell osmotic fragility, the concentration of serum Iron (SI), total Iron binding capacity (TIBC), and the survival time of the red cells. Details of all... 

Fischl, J Serum iron determination using direct color... 

Decreased RBC count, Hgb, and Hct Decreased serum iron level, TIBC, serum ferritin, and TSAT Decreased erythropoietin levels relative to the degree of hypoxia that is present... 

Carbamazepine Manufacturer recommends CBC and platelets (and possibly reticulocyte counts and serum iron) at baseline, and that subsequent monitoring be individualized by the clinician (e.g., CBC, platelet counts, and liver function tests every 2 weeks during the first 2 months of treatment, then every 3 months if normal). Monitor more closely if patient exhibits hematologic or hepatic abnormalities or if the patient is receiving a myelotoxic drug discontinue if platelets are less than 100,000/mm3, if white blood cell (WBC) count is less than 3,000/mm3 or if there is evidence of bone marrow suppression or liver dysfunction. Serum electrolyte levels should be monitored in the elderly or those at risk for hyponatremia. Carbamazepine interferes with some pregnancy tests. 

Transferrin saturation (serum iron/TIBC)—indicates the amount of transferrin that is bound with iron it is lower in iron-deficiency anemia. 

Mean cell hemoglobin concentration (MCHC) Iron Studies Serum iron 33.4-35.5 g/dL (334-355 g/L) Hemoglobin divided by the hematocrit also low in iron-deficiency anemia. 

Transferrin saturation (TSAT) Other Tests 30-50% (0.30-0.50) Transferrin saturation = (serum iron/TIBC) x 100 a saturation of less than 15% is common in iron-deficiency anemia. 

Lilis R, Eisinger J, Blumberg W, et al. 1978. Hemoglobin, serum iron, and zinc protoporphyrin in lead-exposed workers. Environ Health Perspect 25 97-102. 

Ceruloplasmin Ferroxidase activity Cp-/- mice (Harris et al, 1999) Aceruloplasminaemia (Logan et al, 1994 Takahashi et al, 1996) deficient iron mobilization low serum iron tissue iron overload... 

Diagnosis of anemia of chronic disease is usually one of exclusion, with consideration of coexisting iron and folate deficiencies. Serum iron is usually decreased but, unlike iron-deficiency anemia, serum ferritin is normal or increased and TIBC is decreased. The bone marrow reveals an abundance of iron the peripheral smear reveals normocytic anemia. 

Early determinations of iron and hemoglobin in blood were described by Herrmann et al53) and Bohmer et al 54). Zettner and co-workers ss) determinent serum iron by extracting the bathophenanthroline complex into MIBK. The serum could be diluted with water and aspirated only if the iron level was above 2 ppm. Rodgerson and Heifer S6) tried aspirating undiluted serum but obtained irreproduc-... 

More recent determinations of serum iron have been reported by Schmidt 57), who simply diluted with lanthanum chloride solution, and by Tavenier and Hellen-doorn58), who deproteinized samples in the latter study, iron in the protein precipitate is analyzed to correct the serum iron level. Uny etal. 59) determined serum iron, using ultrasonic nebulization of the sample to increase the sensitivity. Olson and Hamlin 6°) have determined serum iron and total iron-binding capacity. Proteins are precipitated and iron (III) is released by heating with trichloroacetic acid. 

Hepatic Effects. An increase in serum iron, which may reflect an adverse liver effect, was observed in workers exposed for 6 months to phenol in a wood treatment liquid (Baj et al. 1994). Elevated concentrations of hepatic enzymes in serum, and an enlarged and tender liver suggestive of liver injury, were reported in an individual who had been exposed repeatedly to phenol vapor for 13.5 years (Merliss 1972). Since phenol was also spilled on his clothes resulting in skin irritation, dermal and inhalation exposures were involved. A 2-fold increase in serum bilirubin was observed in a man who was accidentally splashed with a phenol solution over his face, chest wall, hand, and both arms (Horch et al. 1994). Changes in liver enzymes were not observed in persons exposed to phenol in drinking water for several weeks after an accidental spill (Baker et al. 1978). This study is not conclusive because the measurements were completed 7 months after the exposure. 

Serum iron t Serum iron 4- Serum iron T... 

Monitoring Serum iron determinations (especially by colorimetric assays) may not be meaningful for 3 weeks serum ferritin peaks after about 7 to 9 days and slowly returns to baseline after about 3 weeks. 

Chloramphenicol Serum iron levels may be increased because of decreased iron clearance and erythropoiesis due to direct bone marrow toxicity from chloramphenicol. 

Monitoring Exercise caution to withhold iron administration in the presence of evidence of tissue iron overload. Periodically monitor hematologic and hematinic parameters (hemoglobin, hematocrit, serum ferritin, and transferrin saturation). Withhold iron therapy in patients with evidence of iron overload. Transferrin saturation values increase rapidly after IV administration of iron sucrose thus, serum iron values may be reliably obtained 48 hours after IV dosing. 

Lab test abnormalities Low serum iron (9.2%) usually does not persist in the majority of cases and is not associated with reductions in hemoglobin or changes in other hematologic indices. 

Biliary excretion As most entacapone excretion is via the bile, exercise caution when drugs known to interfere with biliary excretion, glucuronidation, and intestinal beta-glucuronidase are given concurrently with entacapone (see Drug Interactions). Lab test abnormalities Entacapone is an iron chelator. The impact of entacapone on the body s iron stores is unknown however, a tendency towards decreasing serum iron concentrations was noted in clinical trials. In a controlled clinical study, serum ferritin levels (as a marker of iron deficiency and subclinical anemia) were not P.764... 

Adverse reactions may include the following Fever porphyria dysuria gout hepatic reaction nausea vomiting anorexia thrombocytopenia and sideroblastic anemia with erythroid hyperplasia vacuolation of erythrocytes increased serum iron concentration adverse effects on blood clotting mechanisms mild arthralgia and myalgia hypersensitivity reactions including rashes, urticaria, pruritus fever acne photosensitivity porphyria dysuria interstitial nephritis. 

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