Soluble transferrin receptor-ferritin index and estimated body iron in iron-deficiency anemia in “select” chronic diseases

Abstract

Dear Editor, This paper reports valuable parameters, soluble transferrin receptor-ferritin index (sTfR-F) and estimated body iron (EBI), to make the diagnosis of iron deficiency anemia (IDA) in chronic diseases. Based on the textbook definition [1], anemia of chronic diseases do not include anemia caused by bone marrow replacement, blood loss, renal failure, hepatic diseases, hemolysis, and endocrine deficiencies and so those diseases were excluded in this study. In addition, to obtain a high efficiency in detecting IDA from chronic diseases, the patients were limited to those with “select” chronic diseases excluding pernicious anemia, parvovirus B19, and hematologic malignancies. The “select” chronic diseases were arbitrary made for this study. Those patients were admitted to Chosun University Hospital. One hundred seventy-seven patients with select chronic diseases, including 27 patients with chronic infections, 71 patients with chronic diseases, and 79 patients with non-hematologic malignancies, were studied. The male– female ratio was variable and the ages ranged from 18– 81 years. All patients were divided into three disease groups according to the criteria for anemia and IDA (below described). Thus, there were 48 patients with non-anemic state in select chronic diseases (NAsCD group), 110 patients with anemia of select chronic diseases (AsCD group), and 19 patients with IDA in select chronic diseases (IDA-sCD group). The criterion for anemia was a hemoglobin 17%, and concurrent microcytic hypochromic RBC with anisocytosis on the peripheral blood smear. The patients were further divided into four iron status groups according to the grade of iron granules in bone marrow particles as follows: increased iron group showing many iron granules, adequate iron group showing some iron granules, decreased iron group showing a few iron granules, and deficient iron group showing no iron granules. The numbers of patients in the deficient iron group were three (6.25%) of 48 patients in NAsCD, 11 (10.0%) of 110 patients in AsCD, and 18 (94.74%) of 19 patients in IDA-AsCD (Table 1). Hematologic parameters (Hb and CHr), serum ferritin, and sTfR were determined on an ADVIA 120 automated hematology analyzer (Siemens, Tarrytown, NY, USA), an Axsym analyzer (Abbott Laboratories, Abbott Park, IL, USA), and a BNII nephelometer (Dade Behring, Marburg, Germany), Ann Hematol (2009) 88:913–915 DOI 10.1007/s00277-008-0668-4