Indicadores do estado do ferro, proteínas de fase aguda e indicadores da inflamação na doença de Crohn e colite ulcerativa em crianças e adolescentes, no diagnóstico, na remissão e durante o tratamento da doença
Data
2013
Autores
Correa, Fernanda Ferreira 
Orientadores
Sdepanian, Vera Lucia
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: Avaliar os indicadores do estado corporal do ferro, as proteinas de fase aguda e os indicadores da inflamacao, em criancas e adolescentes com doenca inflamatoria intestinal, no diagnostico e na remissao da doenca. Metodos: Estudaram-se pacientes com doenca de Crohn ou colite ulcerativa, com idade media de 12,1 anos; 38 deles no diagnostico, 43 em fase de remissao da doenca e 35 controles saudaveis. Investigaram-se os indicadores do estado do ferro, as proteinas de fase aguda e os indicadores da inflamacao. Resultados: A proporcao de anemicos no grupo diagnostico (57,9%) foi maior do que no grupo remissao (18,6%). RDW, receptor de transferrina, capacidade total de ligacao do ferro, razao entre receptor de transferrina/ferritina (indicadores do estado corporal do ferro), ferritina (proteina de fase aguda), velocidade de hemossedimentacao, interleucina-6 e plaquetas (indicadores da inflamacao) apresentaram concentracoes estatisticamente maiores no grupo diagnostico comparados com o grupo remissao. Consideraram-se fatores independentes correlacionados com a hemoglobina: receptor de transferrina, velocidade de hemossedimentacao, plaquetas, razao entre o receptor de transferrina/ferritina e transferrina. Conclusoes: Foi possivel diferenciar o grupo diagnostico do grupo remissao por meio dos indicadores do estado corporal do ferro u RDW, receptor de transferrina, ferro serico, capacidade total de ligacao do ferro e razao entre o receptor de transferrina/ferritina u, das proteinas de fase aguda u ferritina e albumina u, e dos indicadores da inflamacao u velocidade de hemossedimentacao, interleucina-6 e plaquetas. Os fatores associados a hemoglobina foram receptor de transferrina, velocidade de hemossedimentacao, plaquetas, razao entre o receptor de transferrina/ferritina e transferrina.
Abstract Objective: Assess indicators of body iron status, acute phase proteins and indicators of inflammation in children and adolescents with inflammatory bowel disease, at diagnosis and at disease remission. Methods: We studied patients with Crohn's disease or ulcerative colitis, mean age 12.1 years, including 38 at diagnosis, 43 in disease remission phase, and 35 healthy controls. We investigated status indicators of iron, acute phase proteins, and indicators of inflammation. Results: The proportion of anemic subjects in the diagnosis group (57.9%) was greater than in the remission group (18.6%). RDW, transferrin receptor, total iron-binding capacity, transferrin receptor/ferritin ratio (indicators of body iron status), ferritin (acute phase protein), erythrocyte sedimentation rate, interleukin-6 and platelet count (indicators of inflammation) presented statistically greater concentrations in the diagnosis group compared to remission group. Independent factors correlated with hemoglobin were as follows: transferrin receptor, erythrocyte sedimentation rate, platelet count, transferrin receptor/ferritin ratio, and transferrin. Conclusions: It was possible to differentiate the diagnosis group from the remission group through the indicators of body iron status – RDW, transferrin receptor, serum iron, total ironbinding capacity and transferrin receptor/ferritin ratio of acute phase proteins ferritin and albumin and indicators of inflammation erythrocyte sedimentation rate, interleukin-6 and platelet counts. Hemoglobin-associated factors were transferrin receptor, erythrocyte sedimentation rate, platelet counts, transferrin receptor/ferritin ratio, and transferrin.
Abstract Objective: Assess indicators of body iron status, acute phase proteins and indicators of inflammation in children and adolescents with inflammatory bowel disease, at diagnosis and at disease remission. Methods: We studied patients with Crohn's disease or ulcerative colitis, mean age 12.1 years, including 38 at diagnosis, 43 in disease remission phase, and 35 healthy controls. We investigated status indicators of iron, acute phase proteins, and indicators of inflammation. Results: The proportion of anemic subjects in the diagnosis group (57.9%) was greater than in the remission group (18.6%). RDW, transferrin receptor, total iron-binding capacity, transferrin receptor/ferritin ratio (indicators of body iron status), ferritin (acute phase protein), erythrocyte sedimentation rate, interleukin-6 and platelet count (indicators of inflammation) presented statistically greater concentrations in the diagnosis group compared to remission group. Independent factors correlated with hemoglobin were as follows: transferrin receptor, erythrocyte sedimentation rate, platelet count, transferrin receptor/ferritin ratio, and transferrin. Conclusions: It was possible to differentiate the diagnosis group from the remission group through the indicators of body iron status – RDW, transferrin receptor, serum iron, total ironbinding capacity and transferrin receptor/ferritin ratio of acute phase proteins ferritin and albumin and indicators of inflammation erythrocyte sedimentation rate, interleukin-6 and platelet counts. Hemoglobin-associated factors were transferrin receptor, erythrocyte sedimentation rate, platelet counts, transferrin receptor/ferritin ratio, and transferrin.
Descrição
Citação
CORREA, Fernanda Ferreira. Indicadores do estado do ferro, proteínas de fase aguda e indicadores da inflamação na doença de Crohn e colite ulcerativa em crianças e adolescentes, no diagnóstico, na remissão e durante o tratamento da doença/. 2013. 80f. Tese (Doutorado em Pediatria) – Escola Paulista de Medicina, Universidade Federal de São Paulo. São Paulo, 2013.