Serum transferrin receptor (sTfR) concentrations were measured in anaemic patients with rheumatoid arthritis (RA). Serum transferrin receptor concentrations were positively correlated with the percentage of hypochromic cells and negatively correlated with MCH. There was a weak correlation with serum ferritin (sFn) concentration but not with reticulocyte count. Thus, high concentrations of sTfR indicate iron-deficient erythropoiesis rather than levels of storage iron in the tissues. Patients were divided into three groups on the basis of sFn concentration: those with probable tissue iron deficiency, those with adequate iron stores and those with intermediate values of sFn which did not allow classification. The median sTfR concentration was significantly higher in the iron-deficient group than in the other two groups but because of overlap between the three groups, a single sTfR value was of limited value in determining the level of storage iron in an individual with RA.
Between 1982 and 1989 we identified 47 subjects with spuriously increased concentrations of free thyroxin (FT4) or free triiodothyronine (FT3) related to autoantibody interference in analog FT4 and (or) FT3 methods. The incidence of autoantibody interference observed during one year (1988) was 1 in 2460. In the subjects identified, 51% and 11%, respectively, showed an increased binding of radiolabeled T4 or T3 analog alone; 38% had an increased binding of both. Of 36 patients tested, 71% had autoantibodies to thyroglobulin and microsomal fraction of the thyroid, 19% to microsomal fraction alone, and 9.5% to thyroglobulin alone. In eight subjects, spuriously increased FT4 concentrations were reported with the following FT4 methods (in decreasing order of interference): Coat-A-Count, Amerlex-M, Amerlite, Seria, Magic Lite, Amerlex-MAB. In the same eight subjects, Amerlex-M and Seria reported spuriously increased concentrations of FT3.
Free beta-HCG is a new analyte that has been suggested to be superior to total HCG when used in combination with alpha-fetoprotein (AFP) for Down syndrome risk screening in early pregnancy. We have evaluated this claim on 21 samples collected from Down syndrome pregnancies and 180 samples from unaffected pregnancies. The detection rates for the combination of AFP with free beta-HCG or the combination of AFP with total HCG were identical (71 per cent) but the initial screen positive rate (equivalent to the false-positive rate) was 7.5 per cent for AFP + free beta-HCG screening compared with 3.5 per cent for AFP + total HCG screening. We conclude that the case for free beta-HCG is unproven and suggest that further data be collected before free beta-HCG becomes acceptable.
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