Evaluation of a competitive hepcidin ELISA assay in the differential diagnosis of iron deficiency anaemia with concurrent inflammation and anaemia of inflammation in elderly patients

Torbjörn Karlsson

doi:10.1186/s12950-017-0166-3

Abstract

In this study, a competitive hepcidin ELISA assay was evaluated for its ability to differentiate between iron deficiency anaemia with concurrent inflammation and anaemia of inflammation in elderly patients, using the absence of stainable bone marrow iron as the diagnostic criterion for iron deficiency. In addition, correlation coefficients for hepcidin versus C-reactive protein, ferritin and interleukin-6 were determined. The optimal cut-off for hepcidin was 21 μg/L, corresponding to sensitivity and specificity of 100% and 67%, respectively, for iron deficiency. For ferritin, a sensitivity and specificity of 91% and 83%, respectively, correspond to an optimal cut-off of 87 μg/L. Receiver operating characteristics curve analysis revealed that ELISA analysis of hepcidin is not superior to ferritin in the diagnosis of iron deficiency in elderly anaemic patients with concurrent inflammation. Hepcidin shows a strong positive correlation with ferritin, and also correlates positively with C-reactive protein in this patient population.

Highlights

Anaemia in elderly patients is commonly caused by iron deficiency or inflammation [1]
This is, to our knowledge, the first study reported that use the lack of stainable bone marrow iron as the diagnostic criterion for iron deficiency (ID) in combination with a hepcidin ELISA assay in this patient category
Mean mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), Transferrin saturation (TSAT) and ferritin levels were significantly lower in the ID-anaemia of inflammation (AI) group (p < 0.01, < 0.05, < 0.01 and

Summary

Introduction

Anaemia in elderly patients is commonly caused by iron deficiency or inflammation [1]. A competitive hepcidin ELISA assay was evaluated for its ability to differentiate between IDA with concurrent inflammation and AI in elderly patients It would be a great advantage if an ELISA assay could be used for this purpose, since mass spectrometry analysis is considerably more labour intensive and expensive than ELISA analysis. This is, to our knowledge, the first study reported that use the lack of stainable bone marrow iron as the diagnostic criterion for iron deficiency (ID) in combination with a hepcidin ELISA assay in this patient category

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Conclusion