Reticulocyte hemoglobin content (CHr) predicted iron deficiency in children better than traditional biochemical indicators of iron metabolism, according to Massachusetts researchers who compared several screening methods. It is imnportant to detect iron deficiency before anemia develops and leads to impairment in cognitive performance, asserted the authors, who have shown CHr is an early indicator of iron deficiency in patients treated with recombinant human erythropoietin.
Frank Aram Oski, M.D., FAAP, of Baltimore, died at his home Dec. 7 of prostate cancer. He was 64. At the AAP Annual Meeting in October in Boston, Dr. Oski received the 1996 Lifetime Achievement Award for Medical Education, for his editing, writing, teaching and investigating. "He has influenced many pediatric students and residents with his sound academic knowledge and a sense of social conscience," the award notes. Dr. Oski was internationally regarded as an expert in pediatric hematology and clinical care. His contributions led to better understanding of: iron deficiency and its effects on behavior and learning; the reasons premature infants become anemic; and why children with sickle cell anemia have strokes.
There is a link between iron deficiency in infancy and later developmental problems, according to findings of a study conducted by the National Institute of Child Health and Human Development. Although iron-deficiency anemia has been associated with lower levels of mental and motor development in infancy, the long-term effects of the deficiency are less clear, according to researchers at Case Western Reserve University School of Medicine in Cleveland.
In response to Dr. Needleman's letter advising physicians to delay investing in a fluorometer to measure zinc protoporphyrin until the national Centers for Disease Control Task Force and AAP Committee on Environmental Hazards issues a new statement regarding the acceptable lead level in children, I would like to comment. First, I emphasize that lead screening is only one use of our hematofluorometer (or zinc protoporphyrin assays in general). Zinc Protoporphyrin (ZPP) is also elevated in iron deficiency and is the most sensitive and earliest detector of iron deficient erythropoiesis. ZPP values become abnormal long before low hemoglobin and hematocrit signal blatant anemia. Iron deficiency, even in the absense of anemia jeopardizes a child's ability to thrive. Irritability, decreased attention span and impaired learning occur independent of anemia.