Low ferritin without anemia in blood donors at Amazon Blood Center

O ferro e nutriente essencial para todas as celulas humanas. Doadores de sangue perdem em cada doacao uma media de 242 t 17 mg de ferro e, em geral, os estoques de ferro sao pressionados pelas doacoes de repeticao a partir da 2a doacao de sangue por ano. Sabendo da importancia do ferro nas diversas celulas do nosso organismo, tivemos por objetivo avaliar se doadores de sangue do Hemocentro de Manaus (HEMOAM) desenvolvem sideropenia sem anemia apos doacoes consecutivas. Para isso, a ferritina serica foi medida em 528 doadores de sangue, do sexo masculino, com idade entre 18 a 61 anos, divididos em 313 doadores de repeticao, com 4 ou mais doacoes anuais, com intervalo entre elas de 8 a 10 semanas, e 215 primodoadores que compareceram ao hemocentro do Amazonas no periodo de setembro de 2001 a junho de 2002. Esses doadores foram classificados, conforme o numero de doacoes, em primodoadores (grupo 1), e doadores de repeticao, com 4 doacoes (grupo 2), com 5-9 doacoes (grupo 3), com 9-12 doacoes (grupo 4), e com mais de 12 doacoes (grupo 5). Utilizamos a determinacao da Ferritina serica pela tecnica de microparticula enzimaimunoensaio(MEIA), utilizando equipamento automatizado (Abott AXSYM system) e dos indices hermatimetricos em modelo ADVIATM 120. Deplecao do deposito de ferro, definida por niveis de ferritina menores de 20ng/l, foi encontrada em 7,4 por cento[16/215] dos primodoadores e em 48,6 por cento [152/313] dos doadores de repeticao. [p<0,001]a(au)Iron is an essential nutrient for all human cells. Each donation spoils 24717mg of iron from the donor. Iron store are pressed by repeated donations, usually starting from the second donation in one year. Serum levels of ferritin has been measured in 528 male blood donors, 18 to 61 years old, 313 of them with 4 or more donations in one year with intervals of 8 to 10 weeks, and 215 of them being first time donors. They attended the “Hemocentro do Amazonas”, from september 2001 to june 2002. These donors were stratified by the number of donations, as first time donors (group 1), donors with 4 donations (group 2), 5 to 9 donations (group 3), 10 to 12 donations (group 4) and more than 12 donations (group 5). Shortage of iron stores defined by serum ferritin values below 20ng/L was found in 7,4% (16/215) of first time donors, and in 48,6%(152/313) of multi-time donors. With more stringent criteria – ferritin values below 12ng/L - 3,7%(8/215) of first-time donors, as opposed to 24,9%(78/313) of multi-time donors, showed severe depletions. It was clearly demonstrated that, within multi-time donors, depletions of iron stores were already present at the fourth donation, but with the greatest impact between the fifth and the nineth donation. The influence of demographic, physiologic, social and economic factors was assessed. Family income, having a job, and the use of non-steroidal-anti-inflamatory drugs appeared as the most important co-variables for iron shortage in the population under study. Notwithstanding, there was a poor correlation between early stages of iron depletion and hematimetric indexes. We concluded that multi-time donors, with more than 5 donations per year, should be monitored for iron depletion with the measurement of ferritin levels. It is important to create protocols to supply these donors at risk with iron reposition, with the aim of avoiding damage to their health, and consequent loss in quality and quantity in the collected blood.BV UNIFESP: Teses e dissertaçõe

Paraparesia espástica tropical/mielopatia associada ao HTLV-1: relato de dois casos com manifestações dermatológicas em familiares de doador de sangue HTLV-1 positivo assintomático no Hemocentro do Amazonas - Hemoam Tropical spastic paraparesis/myelopathy associated with HTLV-1: report of two related cases with dermatological involvement

Dois casos de paraparesia espástica tropical / mielopatia associada ao HTLV-1 (HAM/TSP) foram diagnosticados no Hemocentro do Amazonas - Hemoam, em familiares de doador de sangue soropositivo para o HTLV-1 assintomático. Aqui descrevemos a investigação familiar, as características clínicas dos casos e as manifestações dermatológicas associadas.<br>Herein we report on two cases of tropical spastic paraparesis / myelopathy associated with HTLV-1 (HAM/TSP) diagnosed in relatives of a blood donor found positive for HTLV-1 at serologic screening. The donor himself was asymptomatic. Family studies, the clinical characteristics of the cases and the associated dermatologic manifestations are reported

Sideropenia sem anemia em doadores de sangue do Hemocentro do Amazonas - Hemoam Sideropenia without anemia in blood donors of the Amazon Blood Bank - Hemoam

Uma doaç��o de aproximadamente 475mL de sangue depleta em média 242 &plusmn; 17 mg de ferro do doador, o que pode ter conseqüências variáveis em suas reservas e na sua saúde. Tivemos por objetivo avaliar se doadores de sangue do Hemocentro do Amazonas - Hemoam desenvolvem sideropenia sem anemia após doações consecutivas. A ferritina sérica foi medida em 528 doadores de sangue, do sexo masculino, com idade entre 18 a 61 anos, divididos em 313 doadores de repetição, com 4 ou mais doações regulares, e 215 primodoadores, que compareceram ao Hemocentro do Amazonas no período de setembro de 2001 a junho de 2002. Depleção do depósito de ferro, definida por níveis de ferritina menores de 20 ng/L, foi encontrada em 7,4% [16/215] dos primodoadores e em 48,6% [152/313] dos doadores de repetição. Utilizando-se de um critério mais rigoroso, como valores de ferritina < 12 ng/L, observou-se que 3,7% [8/215] dos primodoadores e 24,9% [78/313] dos doadores de repetição apresentavam depleção marcial severa. Concluímos que doadores de repetição, a partir da 5ª doação consecutiva, estão sob risco de depleção de reservas de ferro. Esses doadores devem ser monitorados, através da dosagem da ferritina sérica, sendo fundamental discutir um protocolo de reposição de ferro para esses doadores, evitando-se danos à saúde deles e a perda de qualidade do sangue doado.<br>A blood donation of 475 mL could deplete 242 &plusmn; 17 mg of iron from blood donors. The objective of this report is to evaluate if blood donors could develop sideropenia without anemia after several donations. Serum levels of ferritin were measured in 528 male blood donors, with ages ranging from 18 to 61 years old. A total of 313 of them had made 4 or more donations and 215 of them were first time donors. They donated blood in the Hemocentro do Amazonas - Hemoam, from September 2001 to June 2002. Deletion of iron stores characterized by serum ferritin levels of less than 20 ng/L was found in 7.4% (16/215) of first time donors, and in 48.6% (152/313) of multiple donors. With more stringent criteria of ferritin values less than 12 ng/L, 3.7% (8/215) of first-time donors as opposed to 24.9% (78/313) of multiple donors showed severe depletions. We concluded that multiple donors, after more than 5 repeated donations, are at risk of depleted iron and ferritin levels. It is important to implant protocols of iron supplementation for these donors to avoid damage to their health and consequent loss in quality and quantity in the collected blood

Absence of HTLV-1/2 infection and dermatological diseases in Manaus, State of Amazonas, Brazil

Introduction The prevalence of human T-cell lymphotropic virus types 1 and 2 (HTLV-1/2) infection is heterogeneous across different populations. We tested the hypothesis that HTLV-1/2 infection occurs more often in dermatological patients. Methods A total of 1,091 patients from a tropical dermatology clinic were tested for HTLV-1/2. In parallel, 6865 first-time blood donors from the same geographic area were screened for HTLV-1/2; HTLV-1/2 positive blood donors underwent dermatological examinations. Results The prevalence of HTLV-1/2 in first-time blood donors was 0.14%. No co-occurrence of HTLV-1/2 infection and dermatological conditions was observed. Conclusions Our results challenge the hypothesis that HTLV-1/2 infection occurs more often in dermatological patients

Incidence and risk factors for agranulocytosis in Latin American countries - the Latin study

Purpose LATIN is a multinational case-control study designed to identify risk factors for agranulocytosis and to estimate the incidence rate of the disease in some Latin American countries. Methods Each study site in Brazil, Argentina and Mexico conducted an active search of agranulocytosis patients in hematology clinics and looked for possible associations with drug use. Results The overall incidence rate was 0.38 cases per 1 million inhabitant-years. Agranulocytosis patients more often took medications already associated with agranulocytosis than controls (p=0.01), mainly methimazole (OR 44.2, 95% CI 6.8 to infinity). The population attributable risk percentage (etiologic fraction) was 56%. The use of nutrient supplements was more frequent among patients than controls (p=0.03). Conclusions Agranulocytosis seems to be very rare in Latin America. The lower than expected number of cases identified during the study period precluded estimation of the risk associated to individual drugs, with the exception of methimazol. However, this is the longest series of agranulocytosis cases ever gathered in Latin America, and information on drug exposures was collected prospectively. The conclusion is that drug-induced agranulocytosis does not seem to be a major public health problem in the study regions