0000000000268558
AUTHOR
Lothar Thomas
The diagnostic plot: a concept for identifying different states of iron deficiency and monitoring the response to epoetin therapy.
Iron balance is regulated by the rate of erythropoiesis and the size of the iron stores. Anemia that accompanies infection, inflammation, and cancer (anemia of chronic disease) features normal or increased iron stores, although patients may have functional iron deficiency, namely, an imbalance between iron requirements of the erythroid marrow and the actual supply. The proportion of hypochromic red cells and the hemoglobin content of reticulocytes are direct indicators of functional iron deficiency. Biochemical markers, especially the soluble transferrin receptor/log ferritin ratio (ferritin index), are useful indicators of the iron supply to erythropoiesis. The relationship between functio…
Anemia of Chronic Disease: Pathophysiology and Laboratory Diagnosis
Classic iron deficiency (ID) does not represent a challenge for the laboratory and physicians. The anemia that accompanies infection, inflammation, and cancer, commonly termed anemia of chronic disease (ACD), features apparently normal or increased iron stores. However, 20% of these patients have iron-restricted erythropoiesis (functional ID), an imbalance between the iron requirements of the erythroid marrow and the actual iron supply. Functional ID leads to a reduction in red cell hemoglobiniza-tion, causing hypochromic microcytic anemia. The diagnosis of functional ID in real time is based on measuring the hemoglobin content of reticulocytes. An examination of the biochemical markers of …
Detection of iron restriction in anaemic and non-anaemic patients: New diagnostic approaches.
Objective The aim of this study was to detect iron restriction in non-anaemic patients and iron-restricted erythropoiesis (IRE) in patients with anaemia. Method Haematologic indices and biochemical markers of iron deficiency (ID) were determined using the clinically accepted cut-off level for serum ferritin of ≤30 μg/l as reference of ID. To evaluate the prevalence of iron restriction and IRE in patients with higher ferritin levels we used the thresholds of the markers of ID as reference. Results In the anaemic group 17.1% of patients with ferritin levels >30 μg/l had IRE. The number of patients with IRE declined with increasing ferritin concentration. Approximately 14% of patients without …