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Erschienen in: Annals of Hematology 2/2004

01.02.2004 | Original Article

Evaluation of serum ferritin in screening for iron deficiency in tuberculosis

verfasst von: M. Kotru, U. Rusia, M. Sikka, S. Chaturvedi, A. K. Jain

Erschienen in: Annals of Hematology | Ausgabe 2/2004

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Abstract

Serum ferritin (SF) values ≤10 µg/l are diagnostic of absent Bone Marrow Iron (BMI) stores and therefore of iron deficiency (ID). However, SF, which may be elevated as a part of acute phase reaction, is an unreliable indicator of BMI stores in the setting of chronic disorders, making it difficult to diagnose ID in these patients. Thus, in chronic disorders (CD) such as tuberculosis, bone marrow examination is the only reliable way to establish ID. This study was done in order to identify levels of SF that would be indicative of absent BMI stores and also to study a combination of hematological and biochemical parameters that would be helpful in raising the predictive power of SF in patients of tuberculosis. Fifty-five tuberculosis patients were studied and classified into Iron Deplete (ID) and Iron Replete (IR) based on BMI. Raising the cut-off values of SF from ≤10 µg/l to ≤30 µg/l diagnosed 88% of ID cases correctly, as compared with 61% when cut-off levels of ≤10 µg/l were used. At cut-off values higher than 30 µg/l, the sensitivity was markedly reduced. Therefore, raising cut-off levels of SF to ≤30 µg/l was most effective in predicting absent BMI, especially in a population where ID is highly prevalent. Combination of SF ≤30 µg/l with mean corpuscular volume (MCV), erythrocyte sedimentation rate (ESR) and total iron binding capacity (TIBC) did not improve the predictive power of SF further. Also, 89.5% cases could be correctly classified by logistic regression equations using SF with ESR and C- reactive protein (CRP).
Literatur
1.
Zurück zum Zitat Ahluwalia N, Lammi-Keefe CJ, Bendel RB, Morse EE, Beard JL, Haley NR (1995) Iron deficiency and anemia of chronic disease in elderly women: a discriminant analysis approach for differentiation. Am J Clin Nut 61:590–596 Ahluwalia N, Lammi-Keefe CJ, Bendel RB, Morse EE, Beard JL, Haley NR (1995) Iron deficiency and anemia of chronic disease in elderly women: a discriminant analysis approach for differentiation. Am J Clin Nut 61:590–596
2.
Zurück zum Zitat Bain BJ (1994) Basic hematological techniques. In: Dacie JV, Lewis SM (eds) Practical hematology, 8th edn. Churchill Livingstone, Edinburgh, pp 49–82 Bain BJ (1994) Basic hematological techniques. In: Dacie JV, Lewis SM (eds) Practical hematology, 8th edn. Churchill Livingstone, Edinburgh, pp 49–82
3.
Zurück zum Zitat Balaban EP, Sheehan RG, Demian SE, Cox JV, Frenkel EP (1993) Evaluation of bone marrow iron stores in anemia associated with chronic disease: a comparative study of serum and red cell ferritin. Am J Hematol 42:177–181PubMed Balaban EP, Sheehan RG, Demian SE, Cox JV, Frenkel EP (1993) Evaluation of bone marrow iron stores in anemia associated with chronic disease: a comparative study of serum and red cell ferritin. Am J Hematol 42:177–181PubMed
4.
Zurück zum Zitat Beck JR, Cornwell GG III, French EE, Meier FA, Brink-Johnsen T, Rawnsley HM (1981) The ‘Iron Screen’: modification of standard laboratory practice with data analysis. Human Pathol 12:118–126 Beck JR, Cornwell GG III, French EE, Meier FA, Brink-Johnsen T, Rawnsley HM (1981) The ‘Iron Screen’: modification of standard laboratory practice with data analysis. Human Pathol 12:118–126
5.
Zurück zum Zitat Blake DR, Waterworth RF, Bacon PA (1981) Assessment of iron stores in inflammation by assay of serum ferritin concentration. Br Med J 283:147–148 Blake DR, Waterworth RF, Bacon PA (1981) Assessment of iron stores in inflammation by assay of serum ferritin concentration. Br Med J 283:147–148
6.
Zurück zum Zitat Coenen JLLM, van-Dieijen-Visser, van-Pelt J, van-Deursen CTBM, Fickers MMF, van-Werch JWJ, Brambacher PJ (1991) Measurements of Serum ferritin used to predict concentrations of iron in bone marrow in anemia of chronic disease. Clin Chem 37:560–563PubMed Coenen JLLM, van-Dieijen-Visser, van-Pelt J, van-Deursen CTBM, Fickers MMF, van-Werch JWJ, Brambacher PJ (1991) Measurements of Serum ferritin used to predict concentrations of iron in bone marrow in anemia of chronic disease. Clin Chem 37:560–563PubMed
7.
Zurück zum Zitat Cook JD, Lynch SR (1986) The liabilities of iron deficiency. Blood 68:803–809.PubMed Cook JD, Lynch SR (1986) The liabilities of iron deficiency. Blood 68:803–809.PubMed
8.
Zurück zum Zitat Hansen TM, Hansen NE (1986) Serum ferritin as indicator of iron responsive anemia in patients with rheumatoid arthritis. Ann Rheum Dis 45:596–603PubMed Hansen TM, Hansen NE (1986) Serum ferritin as indicator of iron responsive anemia in patients with rheumatoid arthritis. Ann Rheum Dis 45:596–603PubMed
9.
Zurück zum Zitat International committee for standardization in hematology (1978) Recommendation for the measurements of serum iron in human blood. 38:291–294 International committee for standardization in hematology (1978) Recommendation for the measurements of serum iron in human blood. 38:291–294
10.
Zurück zum Zitat Konijn AM, Hershko C (1977) Ferritin synthesis in inflammation. I. Pathogenesis of impaired iron release. Br J Hematol 37:7–16 Konijn AM, Hershko C (1977) Ferritin synthesis in inflammation. I. Pathogenesis of impaired iron release. Br J Hematol 37:7–16
11.
Zurück zum Zitat Krause JR, Stole V (1980) Serum Ferritin and bone marrow iron stores Am J Clin Pathol 74:461–464 Krause JR, Stole V (1980) Serum Ferritin and bone marrow iron stores Am J Clin Pathol 74:461–464
12.
Zurück zum Zitat Kurer SB, Seifert B, Michel B, et al (1995) Prediction of iron deficiency in chronic inflammatory rheumatic disease anemia. Br J Hematol 91:820–826 Kurer SB, Seifert B, Michel B, et al (1995) Prediction of iron deficiency in chronic inflammatory rheumatic disease anemia. Br J Hematol 91:820–826
13.
Zurück zum Zitat Lee GR (1999) Anemia: a diagnostic strategy. In: Lee GR, Foerster J, Lukens J, Paraskevas F, Greer JP, Rodgers GM (eds) Wintrobe’s clinical hematology, 10th edn. Williams and Wilkins, Baltimore, MD, pp 920–933 Lee GR (1999) Anemia: a diagnostic strategy. In: Lee GR, Foerster J, Lukens J, Paraskevas F, Greer JP, Rodgers GM (eds) Wintrobe’s clinical hematology, 10th edn. Williams and Wilkins, Baltimore, MD, pp 920–933
14.
Zurück zum Zitat Means RT (1999) The anemia of chronic disorders. In: Lee GR, Foerster J, Lukens J, Paraskevas F, Greer JP, Rodgers GM (eds) Wintrobe’s clinical hematology, 10th edn. Williams and Wilkins, Baltimore, MD, pp 1012–1014 Means RT (1999) The anemia of chronic disorders. In: Lee GR, Foerster J, Lukens J, Paraskevas F, Greer JP, Rodgers GM (eds) Wintrobe’s clinical hematology, 10th edn. Williams and Wilkins, Baltimore, MD, pp 1012–1014
15.
Zurück zum Zitat Mulherin K, Shelly M, Saunders A, et al (1996) The diagnosis of iron deficiency in patients with rheumatoid arthritis and anemia: an algorithm using simple laboratory measures. J Rheumatol 23:237–240PubMed Mulherin K, Shelly M, Saunders A, et al (1996) The diagnosis of iron deficiency in patients with rheumatoid arthritis and anemia: an algorithm using simple laboratory measures. J Rheumatol 23:237–240PubMed
16.
Zurück zum Zitat Park K (1997) Park’s textbook of preventive and social medicine, 15th edn. Banarsidas Bhanot, Jabalpur, India, pp 139–140 Park K (1997) Park’s textbook of preventive and social medicine, 15th edn. Banarsidas Bhanot, Jabalpur, India, pp 139–140
17.
Zurück zum Zitat Ressler M, Zak B (1958) Serum unsaturated binding capacity. Am J Clin Pathol 30:87–90 Ressler M, Zak B (1958) Serum unsaturated binding capacity. Am J Clin Pathol 30:87–90
19.
Zurück zum Zitat Vreugdenhil G, Daltus CAM, Van-Ejik HG (1990) Anemia of chronic disorders: diagnostic significance of erythrocytes and serological parameters in iron deficient rheumatoid arthritis patients. Br J Rheumatol 29:105–110PubMed Vreugdenhil G, Daltus CAM, Van-Ejik HG (1990) Anemia of chronic disorders: diagnostic significance of erythrocytes and serological parameters in iron deficient rheumatoid arthritis patients. Br J Rheumatol 29:105–110PubMed
20.
Zurück zum Zitat Witte DL Angstadt DS, Davis SH, Schrantz RD (1988) Predicting bone marrow iron stores in anemic patients in a community hospital using serum ferritin and Erythrocyte sedimentation rate. Am J Clin Path 90:85–87PubMed Witte DL Angstadt DS, Davis SH, Schrantz RD (1988) Predicting bone marrow iron stores in anemic patients in a community hospital using serum ferritin and Erythrocyte sedimentation rate. Am J Clin Path 90:85–87PubMed
Metadaten
Titel
Evaluation of serum ferritin in screening for iron deficiency in tuberculosis
verfasst von
M. Kotru
U. Rusia
M. Sikka
S. Chaturvedi
A. K. Jain
Publikationsdatum
01.02.2004
Verlag
Springer-Verlag
Erschienen in
Annals of Hematology / Ausgabe 2/2004
Print ISSN: 0939-5555
Elektronische ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-003-0788-9

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