Abstract

KHOSRAVI SHAHI, P.; CANO HORTONEDA, M.; CASTILLO RUEDA, A. del  and  PORTUGAL ALVAREZ, J. de. Case finding of iron overload in a university hospital. An. Med. Interna (Madrid) [online]. 2003, vol.20, n.2, pp.19-21. ISSN 0212-7199.

Background: The epidemiologic importance of iron overload disorders and the clinical lack of its diagnosis led us to an active search of cases among the hospitalized patients in a general university hospital. This situation will make it possible to have a larger and earlier number of diagnosis together with a preventive intervention and an effective treatment. Patients and methods: A transverse study was performed on patients admitted to a fifteen bedsward in the internal medicine department. They have all been applied, without exclusion criteria, the iron metabolism parameters survey. The transferrin saturation (TS), due to its sensitivity, specificity and positive predictive value, has been considered appropriate for the phenotypic screening of the iron overload disorders. Subjects with fasting TS of 45% or more were considered as risk population. Results: The study comprised 117 patients with an average age of 69.9±15.04. The high-risk population rate was 13.8% with an average age of 60.8±20.17, as compared to the low-risk population with an average age of 71.3±13.7 (p<0.05). The most outstanding illnesses associated to the high-risk population are chronic hepatitis and diabetes mellitus (31.25%). An 18.7% of the cases show undernourishment.  Conclusions: The iron overload is a prevalent illness whose early diagnosis requires a high clinical suspicion. The active search among the hospitalized patients, who have been made a TS, benefits the new cases detection. The TS is a screening technique with a high diagnostic profitability if you evaluate correctly the false positives. For that reason, we think the TS has to be included within the analytic requests which patients are made when admitted to hospital.

Keywords : Iron overload; Hemochromatosis; Transferrin saturation; Screening.

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