Résumé
Background:Iron deficiency is a common condition that is usually diagnosed using conventional laboratory tests of iron status, such as serum ferritin and transferrin saturation. However, both ferritin and transferrin proteins are markedly influenced by inflammation, behaving as acute-phase reactants and making it difficult to differentiate between iron-deficiency anemia (IDA) and anemia of chronic disease (ACD). Objectives: To evaluate the roleof serum soluble transferrin receptors (STFR) to differentiate iron deficiency anaemia and anaemia of chronic disease.Material And Methods:A cross-sectional study was conducted in the Department of Medicine, Victoria hospital and Bowring and Lady Curzonhospital, Bangalore Medical College and Research institute, Bangalore. A total of 150 blood samples were evaluated, i.e., 50 samples from iron deficiency anaemia group and 50 samples from patients with anaemia of chronic disorders & 50 samples from healthy normal individual.Result:In present study, samples are age matched with mean age of control 45.66±10.23, ACD 50.68±18.03, IDA 48.14±18.47. Hb, MCV, MCHC & MCH were decreased in both the groups. However, the decrease in Hb & MCV was much more in IDA as compared to ACD. Microcytosis was seen in 92% cases of IDA while it was observed in only 11% cases of ACD. Serum soluble transferrin receptor levels is <3 ?gm/ml in 90% of ACD group whereas >3 ?gm/ml in 78% of IDA Group.STFR/ log ferritin index was >1.5 in 80% of IDA. 90% of ACD and control subjects had STFR/log ferritin index <1.5. STFRlevels were significantly higher in IDA (7.7± 5.8) as compared to the ACD cases (1.6 ±0.89) (p<0.001). STFR/Log ferritin index is significantly higher in patients with Iron deficiency anemia (9.34±10.25) as compared to ACD (0.76±0.52) (p<0.001).Conclusion:The STFRlevels along with the STFR/Log ferritin index indices is very useful in differentiating pure IDA, ACD and ACD with coexisting iron deficiency, thus pr oviding anon invasive alternative to bone marrow iron.
Résumé
Background:Tuberculosis of the central nervous system accounts for ~5% of extrapulmonary cases in the United States. It is seen most often in young children but also develops in adults, especially those infected with HIV. If unrecognized, tuberculous meningitis is uniformly fatal. This disease responds to chemotherapy.Cerebrospinal fluid (CSF) evaluation is the single most important aspect of laboratory diagnosis of meningitis. Basic studies of CSF that should be performed in meningitis include measurement of pressure, cell count and differential count, estimation of glucose and protein levels, Gram's stain and culture.Objectives:To evaluate the diagnostic significance of CSF adenosine deaminase (ADA) activity in tuberculous meningitis.Material & Methods:70 Tubercular Meningitis patients who were admitted in Department of Medicine, Victoria hospital were included. The study was approved by the Ethical Committee of Bangalore Medical College and Research Institute, Bangalore. Patients were selected after fulfilling the following inclusion and exclusion criteria.Results:The mean age of the 70 patients studied was 39.82+16.48 years. The youngest patient was 18 years old and oldestpatient was 70 years.The mean value of ADA activity in tubercular meningitis was 18.07±8.03IU/L. Cut-off value of ADA in our study was 10 IU/. The result was statistically significant with a p value<0.001. Conclusion: The test for ADA in CSF is simple and can be carried out in a central laboratory with a rapid diagnosis, thus reducing unwarranted or harmful therapy for patients.Elevated CSF-ADA level helpsin differentiating tubercular from non-tubercular meningitis.