Assessment of peripheral nerve conduction in iron deficiency anemia patients in Indian rural adult population attending a tertiary care hospital

Abstract

Background: Iron deficiency anemia (IDA) is the most common nutritional deficiency anemia in India. Peripheral neuropathy can result due to iron deficiency as it disrupts myelination and neuronal energetics in neuronal functioning. Nerve conduction studies (NCS) can quantitatively detect peripheral nerve dysfunction. This study was conducted to observe effect of IDA on peripheral nerve conduction velocity in adults using neuroelectrophysiological techniques with the aim to recommend Complete Blood Count for serologic evaluation of patients with peripheral neuropathy in Indian population. Objectives: This study aims to compare motor and sensory nerve conduction study parameters between controls and IDA patients and evaluate the effect of various grades of IDA on motor and sensory nerves. Methodology: 30 newly diagnosed patients of IDA in age group of 20-45 yrs and 30 healthy controls in same age group were recruited in this study. NCS was conducted on bilateral motor and sensory median and ulnar nerves in Neurophysiology laboratory using Neurosoft machine. Neuroelectrophysiological data of both the groups was evaluated and analysed using Student’s unpaired t test. Also, patients were categorised as mild, moderate and severe anemia cases and one way ANOVA was used for comparison among patients with various grades of anemia. Results: CMAP (compound muscle action potential), SNAP (sensory nerve action potential) and nerve conduction velocity (NCV) of bilateral median and ulnar nerves was reduced and DL (distal latency) was increased in bilateral median and ulnar nerves in patients with IDA compared to controls. The results were statistically significant ( p =0.001). A highly significant difference between motor and sensory nerve conduction values between mild, moderate and severe IDA patients was also observed ( p =0.001). Conclusion: The results of the study confirmed peripheral nerves involvement in IDA patients. As severity of anemia increases, peripheral neuropathy worsens. These results can be extrapolated for screening patients with peripheral neuropathy for iron deficiency as a routine part of diagnostic approach for peripheral neuropathy.