Abstract
Background: People suffering from iron deficiency anaemia often complain of tingling and weakness in their limbs. In this study, we tried to explore whether there is any impairment of neuronal transmission in peripheral nerves in iron deficiency anaemia.
Materials & Methods: About 30 iron deficiency anaemia cases and 30 age sex matched non-anaemic controls were examined. All the subjects underwent nerve conduction studies. Distal latency, amplitude of compound motor action potential (cmap) and conduction velocity of bilateral median and ulnar nerves were measured. Haematological estimations were done for haemoglobin percentage, MCV, MCH and MCHC. Findings were compared between groups by unpaired students’t-test. Association among blood parameters and NCS findings were tested by Pearson's correlation coefficient (r value). Each time p< 0.05 was considered significant.
Results: Anaemic patients showed significantly higher distal latencies but lower conduction velocity and amplitude of both median and ulnar nerves than non-anaemic controls (p<0.05 in each case). Haemoglobin percentage, MCV, MCH, MCHC showed negative correlation with latencies of median and ulnar nerves and a positive correlation with amplitude and conduction velocity (p<0.05 in each case).
Conclusion: Iron deficiency anaemia may cause impairment of peripheral nerve conduction and severity is directly proportional to haemoglobin percentage.
Keywords: Iron deficiency anaemia, Nerve Conduction studies, Distal latencies.
References
- Youdim MBH. Neuropharmacological and neurochemical aspects of iron deficiency. In: Dobbing J, ed. Brain, Behaviour and Iron in the infant diet, London: Springer-Verlag 1990:83-106.
- Jacobson S. Sequence of myelination in the brain of the albino rat in cerebral cortex, thalamus and related structures. J Camp Neural 1963; 121:5-29.
- Morris CM, Candy JM, Bloxham CA, Edwardson JA. Distribution of transferring receptors in relation to cytochrome oxidase activity in the human spinal cord, lower brainstem and cerebellum. J Neural Sci 1992; 111:158-172.
- WHO Global Database on Child Growth and Malnutrition. Available at who.int/nutgrowthdb/en, Acessed on 14th March, 2018.
- Erslev AJ. Clinical manifestations and classification of erythrocyte disorders. In: Beutler E, Lichtman MA, Coller BS, Kipps TJ, eds. Williams Haematology, 5th edition, New York: McGraw-Hill,1995, 441-7.
- Erlanger J. The interpretation of the action potential in cutaneous and muscle nerves. Am J Physiol 1927; 82:644-655.
- Erlanger J, Gasser HS. Electrical signs of nervous activity. Philadelphia: University of Pennsylvania Press; 1937.
- Simpson JA. Fact and fallacy in measurement of conduction velocity in motor nerves. Journal of Neurology, Neurosurgery, and Psychiatry 1964; 27(5):381-385.
- Kimura J. Electrodiagnosis in diseases of nerve and muscles: principles and practice. Philadelphia: FA Davis; 1986. P.109
- Misra UK, Kalita J. Variables affecting nerve conduction study: Clinical neurophysiology 2014; 21:28.
- Ania BJ, Suman VJ, Fairbanks VF, Rademacher DM, Melton LJ 3rd. Incidence of anaemia in older people: an epidemiologic study in a well defined population. J Am Geriatr Soc 1997; 45: 825-31.
- Beard JL, Connor JR. Iron status and neural functioning. Ann Rev Nutr 2003; 23: 41-58.
- Carley A. Anaemia: when is it not iron deficiency? Pediatr Nurs 2003; 29: 205-11.
- Glazer Y, Bilenko N. Effect of iron deficiency and iron deficiency anaemia in the first two years of life on cognitive and mental development during childhood. Harefuah 2010; 149: 309-14.
- Connor JR, Menzies SL. Relationship of iron to oligodendrocytes and myelination. Glia 1996; 17: 83-93.
- Mwanjewe J, Hui BK, Coughlin MD, Grover AK. Treatment of Pheochromocytoma 12 cells with nerve growth factor increases iron uptake. Biochem J 2001 August; 357(pt3): 881-6.
- Todorich B, Pasquini JM, Garcia CT, Paez PM, Connor JR. Oligodendrocytes and myelination: The role of iron. Glia 2009 April; 57(9): 467-478.
- Rosato-Siri MV, Badaracio ME, Ortiz EH, Belforte N, Guardia-Clausi M, Soto EF, et al. Oligodendrocytes in iron deficient rats: Effect of apotransferrin. Journal of Neuroscience Research 2010 June; 88(8):1695-1707.
- Kabakus N, Ayar A, Yoldas TK. Reversal of iron deficiency anaemia induced peripheral neuropathy by iron treatment in children with iron deficiency anaemia. J Trop Pediatr 2002; 48: 204-9.
- Degirmenci Y, Kececi H. Electrophysiological changes in iron deficiency anaemia. Neurol. Croat. 2011; 60(1):1-10.
Corresponding Author
Dr Writtika Chattaraj
Assistant Professor, Dept of Physiology, Diamond Harbour Govt. Medical College, Bankura - Beliator - Sonamukhi - Khandaghosh - Nischintapur Road, Harindanga, Diamond Harbour, West Bengal 743331
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v6i9.182
