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

Karlsson, Torbjörn

doi:10.1186/s12950-017-0166-3

Cited by 14 publications

(11 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While these methods have good specificity, their sensitivity is poor. 13 To overcome this, the development and introduction of an Enzymelinked Immunosorbent Assay (ELISA)-based method has been widely researched, [14][15][16][17][18][19] and although very few commercial assays are currently available, the Hepcidin-25 (bioactive) ELISA immunoassay does have future potential in a routine clinical laboratory due to the high sensitivity, high specificity and relative cost efficiency.…”

Section: Introductionmentioning

confidence: 99%

A simplified diagnostic pathway for the differential diagnosis of iron deficiency anaemia and anaemia of chronic disease

Svenson

Bailey

Durairaj

et al. 2021

Int J Lab Hematology

View full text Add to dashboard Cite

Introduction: Iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD) are common causes of anaemia with similar clinical and laboratory features. IDA is caused by low iron stores while ACD is due to iron-restricted erythropoiesis occurring in inflammatory states. Differential diagnosis requires analysis of multiple biochemical and haematological parameters. IDA can occur simultaneously to ACD (mixed aetiology). It is essential that true iron deficiency is identified, as these patients will require iron therapy. This preliminary study investigated whether hepcidin, the master regulator of iron homeostasis, in conjunction with reticulocyte haemoglobin equivalent (RetHe) has the potential to differentiate IDA from ACD, and to exclude IDA in patients with mixed aetiology.Methods: Hepcidin concentration (measured using a commercially available ELISA method), RetHe, and iron parameters along with C-reactive protein (CRP) were analysed in 77 Gastroenterology patients with anaemia in a secondary care setting.Results: Receiver operator characteristic (ROC) analysis showed that hepcidin at an optimal cut-off concentration of <6ng/ml could identify IDA with a sensitivity and specificity of 88.9% and 90.6% respectively and could distinguish ACD from IDA with both a sensitivity and specificity of 100% at a cut-off of >46ng/ml. Identifying true IDA in mixed aetiology patients could be achieved by RetHe analysis and applying an optimal cut-off of <30pg. Conclusion:Hepcidin, in conjunction with RetHe, offers a new simplified diagnostic pathway for differential diagnosis of IDA and ACD, thereby reducing the diagnostic turnaround time and allowing appropriate treatment of patients with a true iron deficiency.

show abstract

Section: Introductionmentioning

confidence: 99%

A simplified diagnostic pathway for the differential diagnosis of iron deficiency anaemia and anaemia of chronic disease

Svenson

Bailey

Durairaj

et al. 2021

Int J Lab Hematology

View full text Add to dashboard Cite

show abstract

“…Initially, hepcidin detection was conducted using mass spectrometry, however, immunoassays have become available in recent years [86][87][88][89]. Isoform specificity [87], adhesion to laboratory plastics [85], and difficulties in antibody generation [87,90], have been barriers for hepcidin immunoassay development.…”

Section: Hepcidinmentioning

confidence: 99%

Re-examining ferritin-bound iron: current and developing clinical tools

Grant

Clucas

McColl

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

Iron is a highly important metal ion cofactor within the human body, necessary for haemoglobin synthesis, and required by a wide range of enzymes for essential metabolic processes. Iron deficiency and overload both pose significant health concerns and are relatively common world-wide health hazards. Effective measurement of total iron stores is a primary tool for both identifying abnormal iron levels and tracking changes in clinical settings. Population based data is also essential for tracking nutritional trends. This review article provides an overview of the strengths and limitations associated with current techniques for diagnosing iron status, which sets a basis to discuss the potential of a new serum marker – ferritin-bound iron – and the improvement it could offer to iron assessment.

show abstract

“…The typical detection range for se-rum/plasma ferritin by ELISA was around 0.01–0.1 ng, but its sensitivity depends on the particular characteristics of the antibody–antigen interaction. At the same time, some substrates have yielded enhanced chemiluminescent or fluorescent signals to improve ferritin results, where sensitivity and specificity of this technique were 91%, and 83%, respectively [ 17 ]. Moreover, immunoturbidimetric and immunochemiluminescence methods were widely used for serum ferritin detection [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…At the same time, some substrates have yielded enhanced chemiluminescent or fluorescent signals to improve ferritin results, where sensitivity and specificity of this technique were 91%, and 83%, respectively [ 17 ]. Moreover, immunoturbidimetric and immunochemiluminescence methods were widely used for serum ferritin detection [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study for Measuring Serum Ferritin Levels with Three Different Laboratory Methods: Enzyme-Linked Immunosorbent Assay versus Cobas e411 and Cobas Integra 400 Methods

et al. 2022

View full text Add to dashboard Cite

Different laboratory methods are used to measure serum ferritin levels as a marker of iron status in the general population. This study aimed to compare serum ferritin levels using enzyme-linked immunosorbent assay (ELISA) versus immunochemiluminescence (Cobas e411) and immunoturbidimetric (Cobas Integra 400) methods in terms of sensitivity, specificity and accuracy, and whether they can be used interchangeably. A comparative cross-sectional study enrolled one hundred and six adult Yemeni patients (33 males and 73 females) aged 18–55 years, recruited from the dermatology and cosmetic center of Hadhramout Modern Hospital, Mukalla, Yemen. Serum ferritin levels were measured using ELISA, Cobas e411, and Cobas Integra 400 methods. For method comparison, a paired-sample t-test was used. For the consistency between the three methods, they were analyzed with regression and Pearson correlation coefficient. For determining accuracy, a receiver operating curve (ROC) was used. Bias error between the methods was determined through a Bland–Altman plot analysis. Our results did not show any significant statistical difference between ELISA and Cobas e411 (52.55 ± 7.4 µg/L vs. 52.58 ± 7.5 µg/L, p = 0.967), while there were significantly higher values from Cobas Integra 400 results than Cobas e411 (56.31 ± 7.8 µg/L vs. 52.58 ± 7.5 µg/L, p < 0.001) and ELISA (52.55 ± 7.4 µg/L vs. 56.31 ± 7.8 µg/L, p < 0.001). According to the correlation coefficient and linear regression analysis, a strong association between ELISA with Cobas e411 (r = 0.993, p < 0.001) and Cobas Integra 400 results (r = 0.994, p < 0.001) were revealed. For determining accuracy, Cobas e411 and Cobas Integra 400 results showed higher sensitivity (92.0%; 90.0%) and specificity (97.7%; 99.9%) respectively. Additionally, the Bland–Altman plot analysis showed a high agreement between the ELISA and Cobas e411 methods (bias: −0.035). In contrast, there was a low agreement between the ELISA and Cobas Integra 400 methods (bias: −3.75). Similarly, the agreement between Cobas e411 and Cobas Integra 400 methods was low (bias: −3.72). Serum ferritin levels were measured by Cobas e411, and Cobas Integra 400 methods were strongly correlated with the ELISA results, with higher sensitivity, specificity, and accuracy. However, further investigations with larger samples are required for improved accuracy and more precise results, and to determine whether they can be used interchangeably.

show abstract

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

Cited by 14 publications

References 35 publications

A simplified diagnostic pathway for the differential diagnosis of iron deficiency anaemia and anaemia of chronic disease

A simplified diagnostic pathway for the differential diagnosis of iron deficiency anaemia and anaemia of chronic disease

Re-examining ferritin-bound iron: current and developing clinical tools

A Comparative Study for Measuring Serum Ferritin Levels with Three Different Laboratory Methods: Enzyme-Linked Immunosorbent Assay versus Cobas e411 and Cobas Integra 400 Methods

Contact Info

Product

Resources

About