Role Of Serum Soluble Transferrin Receptors (STFR) To Differentiate Iron Deficiency Anaemia And Anaemia Of Chronic Disease

ABSTRACT

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.