BackgroundThe most common types of anaemia in rheumatoid arthritis (RA) are iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD). The differentiation between both is very important and challenging.Objectivesis to select the most simple, cheap, accurate method differentiate IDA from ACD in RA patients.MethodsThis case control study was carried out on 80 RA patients. Group I 40 RA patients with anaemia Group II 40 RA patients without anaemia, complete blood count, assessment of disease activity using DAS 28 score, serum iron, total iron binding capacity (TIBC) “transferrin level”, transferrin saturation (TSAT), serum ferritin, log ferritin and transferrin/log ferritin were tested, then we divided the patients in group 1 into 2 subgroups according to TSAT : group Ia (RA patients with anaemia and low TSAT) and group Ib (RA patients with anaemia and normal TSAT) and we compared the parameters.ResultsThere was a statistically significant difference between anaemic and non anaemic RA patients as regard serum iron level and transferrin saturation and there was no significant difference as regard serum ferritin, log ferritin, transferrin and transferrin/log ferritin. Among the anaemic group (67.5%) had low TSAT (IDA) and only (32.5%) had normal TSAT (ACD). In these 2 subgroups there was no significant differences as regard DAS28 score, blood indices, serum ferritin and transferrin/log ferritin) except Log ferritin and there was positive correlation between TSAT and (ferritin and log ferritin) and significant negative correlation between TSAT and transferrin/log ferritin.Abstract FRI0081 – Table 1Clinical and laboratory parameters in both groupsCharacteristicGroup I40RA+anaemiaGroup II40RA without anaemiaP
DAS-282.99±1.072.35±0.770.002*Hb (g/dl)9.62±0.9612.95±0.64<0.0001*MCV (fl)79.71±7.2983.0±9.340.083MCH (pg/cell)26.06±4.0528.05±2.660.006*MCHC (g/dl)31.1±2.2131.23±2.38 0.8Serum iron (μg/ml)0.66±0.370.89±0.380.0076*Serum ferritin (ng/ml)83.02±93.0884.87±86.82 0.927TIBC (μg/ml)3.94±1.063.71±0.590.23TSAT (%)17.7±10.624.73±11.360.0054*Log ferritin1.61±0.751.7±0.460.52Transferrin/Log ferritin3.23±3.82.41±0.90.18Figure 1 Correlation between TSAT and (serum ferritin, log ferritin and Transferrin/Log ferritin)ConclusionsIron deficiency anaemia is prevalent in RA patients. A combination use of serum ferritin and TSAT is the most simple, accurate parameter now to differentiate both. log ferritin, transferrin/log ferritin may be promising new parameters in diagnosis of IDA in general population but their use in inflammatory diseases like RA still has a limitation so we suggest further large studies to be done in order to assess their accuracy.References[1] Song J-S, Park W, Bae S-K, Kim S-S, Lee Y-H, Choi J-W, et al. The usefulness of serum transferrin receptor and ferritin for assessing anemia in rheumatoid arthritis: comparison with bone marrow iron study. Rheumatology International2001;21(1):24–9.[2] Castel R, Tax MG, Droogendijk J, Leers MP, Beukers R, Levin M-D, et al. The transferrin/log (ferritin) ratio: a new t...