Serum transferrin receptor levels in anaemic patients with rheumatoid arthritis

Abstract

The value of s-Transferrin Receptor (s-TfR) measurements in recognizing simultaneous iron deficiency in anaemia of chronic disease was examined in 35 anaemic patients with active rheumatoid arthritis. Based on a quantification of stainable bone marrow (marrow iron grade 0-4) and serum ferritin concentrations (levels < 60 micrograms l-1) compatible with iron deficiency) the anaemia was found to be aggravated by iron deficiency in 19/35 or 54% of the patients. There was no significant difference between the mean s-TfR concentrations in patients with adequate iron in comparison to patients with iron depletion [2.9 (1.6) mg l-1 v. 2.7 (1.4) mg l-1; t = 0.273; p = 0.786; Student's t-test]. Mean s-TfR levels in both patients with adequate iron and depleted iron stores were within the normal range, but tended to be higher than in normal individuals [mean (SD): 1.54 (0.43) mg l-1]. In patients with no stainable marrow iron (MIG 0; N = 15) a significant inverse correlation was found between s-TfR concentrations and s-ferritin levels (r = 0.57; p< 0.05). 5/15 patients with MIG = 0 exhibited significantly raised concentrations of s-TfR values > 3.05 mg l-1 (the highest normal value of the normal range). Increases of s-TfR levels were consistently moderate, and never exceeded a level of 7 mg l-1, which is markedly lower than concentrations measured in patients with iron deficiency anaemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Assessment of iron status using plasma transferrin receptor in pregnant women with and without human immunodeficiency virus infection in Malawi

“…These ®ndings are contrary to earlier studies which suggested that plasma transferrin receptor was not affected by the anemia of chronic disease (Ferguson et al, 1992;Nielson et al, 1994;Kuvibidila et al, 1996). Further studies are needed to identify additional laboratory indicators of iron de®-ciency anemia in groups of individuals who have a heavy burden of concurrent infection.…”

“…Serum or plasma transferrin receptor concentrations are considered a sensitive indicator of tissue iron availability, (Ahluwalia, 1998) and studies have suggested that serum or plasma transferrin receptor is not affected by chronic disease, liver disease, infection, malnutrition or in¯amma-tion (Ferguson et al, 1992;Nielson et al, 1994;Kuvibidila et al, 1996). Serum or plasma transferrin receptor concentrations have been reported to be a sensitive and speci®c marker of iron de®ciency during pregnancy, (Carriaga et al, 1991;A Ê kesson et al, 1998) although this indicator has not been examined widely in populations at high risk for iron de®ciency.…”

Soluble transferrin receptor for the evaluation of erythropoiesis and iron status

“…Contrarily to serum ferritin, sTfR may thus prove to be a diagnostic test of iron deficiency in patients with inflammation. However, in some studies, sTfR levels could not distinguish accurately among patients with rheumatoid arthritis [92,93], inflammatory bowel disease [94] or other inflammatory disorders [95], those with or without iron deficiency. In addition, several studies have observed higher sTfR levels in iron-replete rheumatoid arthritis patients compared to normal subjects, even if they remain lower than in iron deficiency anemia [92,96 -98].…”

“…In patients with rheumatoid arthritis or other forms of anemia of chronic disorders, sTfR levels may well remain within the normal range even when iron stores are depleted [93] because cytokines or other factors also suppress erythropoiesis directly or through inhibition of Epo production. On the other hand, levels may be elevated even when iron stores are adequate [96] because marrow erythropoietic activity may be increased.…”

Mangelnde Eisenverfügbarkeit: Welche Laboruntersuchungen anfordern und wie klinisch interpretieren? https://degruyter.instruct.eu

“…Die Bedeutung des sTfR zur Diagnostik leerer Eisenspeicher wird kontrovers diskutiert. Einige Studien fanden keinen signifikanten sTfR-Unterschied bei nachweisbarem und nicht nachweisbarem Speichereisen im Knochenmark [38,39], andere fanden dass der sTfR den Eisenmangel bei Frauen anzeigt, wenn dieser als positive Antwort einen Hb-Anstieg nach 3-monatiger Eisentherapie aufzeigt [22]. Der sTfR und Zinkprotoporphyrin zeigten eine gute Vergleichbarkeit und hatten bei Eisenmangel keine erhöhten Werte, aber bei Eisenmangelanämie [40].…”