RRML - Diagnostic relevance and correlations of soluble transferrin receptor in anaemia associated with chronic inflammatory diseases

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Nr. 14(1)/2009

Diagnostic relevance and correlations of soluble transferrin receptor in anaemia associated with chronic inflammatory diseases

Előd Nagy, Alexandrina Oşan, Amelia Tero-Vescan, Ibolya Kovács, Margit Mátyás

Abstract:

Hematopoietic progenitor cells, but also other rapidly dividing cell types express transferrin receptor, a molecule responsible for the uptake of iron from the circulating transferrin-Fe3+ complex. Due to proteolytic cleavage followed by shedding, a soluble form of the receptor (sTfR) appears in the bloodstream. sTfR has been proposed as a surrogate marker for evaluating iron stores and a diagnostic tool to differentiate between iron deficiency and anaemia of chronic disease. We have studied the correlations of sTfR in 30 ferriprive anaemia patients with chronic inflammatory conditions (rheumatoid arthritis, spondylitis ankylopietica and osteoarthritis) with the main CBC parameters, CRP and serum iron levels. sTfR values have been compared with those of a gender- and age-matched healthy control group. It has been proposed that sTfR is not modulated by inflammatory signals and therefore could substitute for transferrin and ferritin, very useful markers for iron deficiency, but influenced by the acute phase response. sTfR values were significantly higher in our anaemia patients than in control persons. Besides strong negative correlations with the main haematology parameters (Hgb, MCH, MCHC, MCV) we observed no relationship between sTfR and CRP. However, the existence of a negative correlation between WBC and sTfR has been demonstrated. In our opinion, these findings indicate that sTfR levels, which increase characteristically in iron depletion and in a lesser extent in ferriprive anaemia complicated with inflammation, could sometimes be insufficient in differential diagnosis of these two conditions.

Keywords: soluble transferrin receptor,iron deficiency,anaemia of chronic inflammatory disease

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Nagy E, Oşan A, Tero-Vescan A, Kovács I, Mátyás M. Diagnostic relevance and correlations of soluble transferrin receptor in anaemia associated with chronic inflammatory diseases. Rev Romana Med Lab. 2009;14(1):55-62