scholarly journals Studying anemia of chronic disease and iron deficiency in patients with rheumatoid arthritis by iron status and circulating hepcidin

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Warqaa Khalaf ◽  
Haithem Ahmed Al-Rubaie ◽  
Sami Shihab

Anemia of chronic disease (ACD) and iron deficiency anemia (IDA) are the two most important types of anemia in rheumatoid arthritis (RA). Functional iron deficiency in ACD can be attributed to overexpression of the main iron regulatory hormone hepcidin leading to diversion of iron from the circulation into storage sites resulting in iron-restricted erythropoiesis. The aim is to investigate the role of circulating hepcidin and to uncover the frequency of IDA in RA. The study included 51 patients with RA. Complete blood counts, serum iron, total iron binding capacity, ferritin, and hepcidin- 25 were assessed. ACD was found in 37.3% of patients, IDA in 11.8%, and combined (ACD/IDA) in 17.6%. Serum hepcidin was higher in ACD than in control and the other groups (P≤0.001). It was strongly and positively correlated with ferritin (P<0.001), while hemoglobin, serum iron, and total iron binding capacity were negatively correlated with hepcidin (P=0.016, 0.022 and <0.001, respectively). High serum hepcidin was significantly associated with ACD in RA. IDA alone or combined with ACD was encountered in about a third of patients.

1981 ◽  
Vol 27 (2) ◽  
pp. 276-279 ◽  
Author(s):  
F Peter ◽  
S Wang

Abstract Ferritin values for 250 selected sera were compared with values for iron, total iron-binding capacity (TIBC), and transferrin saturation, to assess the potential of the ferritin assay for the detection of latent iron deficiency. The specimens were grouped (50 in each group) according to their values for iron and TIBC. In Group 1 (low iron, high TIBC) the saturation and ferritin values both indicated iron deficiency in all but one. In the 100 specimens of Groups 2 (normal iron, high TIBC) and 4 (normal iron, high normal TIBC), the saturation values revealed 16 iron-deficient cases, the ferritin test 55. For Groups 3 (low iron, normal TIBC) and 5 (low iron, low TIBC), the ferritin test revealed fewer cases of iron deficiency than did the saturation values (37 cases vs 51 cases, in the 100 specimens). Evidently the ferritin test detects iron deficiency in many cases for whom the serum iron and TIBC tests are not positively indicative. The correlation of serum ferritin with iron, TIBC, and transferrin saturation in the five groups was good only in the case of specimens for which the TIBC was normal; if it was abnormal the correlation was very poor.


2014 ◽  
Vol 95 (5) ◽  
pp. 769-775 ◽  
Author(s):  
G R Hasanova ◽  
I G Mustafin

Aim. To provide clinical and laboratory characteristics of anemia of chronic disease in HIV infection in order to improve its diagnosis. Methods. The study included 63 HIV-infected patients with anemia of chronic disease. Assessed were the frequency of complaints and physical changes, erythrocyte indices, serum iron level, total iron-binding capacity of the blood, soluble transferrin receptor and erythropoietin markers of inflammation (ferritin, interleukin-1β, tumor necrosis factor-α, soluble receptor CD14, C-reactive protein). Comparison group consisted of a group of 35 patients with iron deficiency anemia. Results. The most frequent were complaints of weakness, fatigue and diarrhea. Hemoglobin level of the majority of patients corresponded to mild anemia. It often had a micro- or normocytic character (48.1±6.8 and 46.3±6.8% of patients, respectively), was normochromic (53.7±6.8% of patients) and hyporegenerative; in 94% of patients relative level of reticulocytes in the blood level was 0.2-1.2%; 87.3% had a reduced number of red blood cells. A negative relationship between levels of hemoglobin with erythropoietin (r=-0.5, p=0.0003) was established. Low levels of serum iron was typical for anemia of a chronic disease, as well as for iron-deficiency anemia. In patients with anemia of chronic disease revealed were significantly higher levels of soluble receptor CD14, C-reactive protein and ferritin and the relatively low level of total iron binding capacity of serum. Conclusion. Anemia of chronic disease in HIV infection is characterized by a predominance of light forms, the frequent lack of «typical for anemia» complaints; mainly micro or normocytic, normochromic types of process with low serum iron; hyporegeneration character against the backdrop of an adequate response to erythropoietin-synthesizing cells decrease in hemoglobin concentration; high levels of markers of inflammation (sCD14, C-reactive protein and ferritin) and relatively low total iron binding capacity of serum.


1975 ◽  
Vol 21 (8) ◽  
pp. 1063-1066 ◽  
Author(s):  
Swei H Tsung ◽  
Waldemar A Rosenthal ◽  
Karen A Milewski

Abstract Because of uncertainty as to the molecular weight of transferrin, a previous comparison [Von der Heul et al., Clin. Chim. Acta 38, 347 (1972)] between transferrin content of serum and total iron-binding capacity cannot be definitive. We found a conversion factor for expressing transferrin as iron-binding capacity by measuring the maximum amount of iron bound by 1 mg of transferrin. We compared the resulting calculated value with values obtained by three other methods for measuring total iron-binding capacity. We agree with the previous observation that the latter, as measured radioisotopically, give higher results than would be judged from the transferrin content but the same as those for two chemical methods. The diffusion rate of transferrin in agar was the same irrespective of the degree of iron saturation. Serum transferrin concentrations were low in patients with anemia resulting from malignancy, chronic disorders, and cirrhosis of the liver, and high or normal in patients with iron deficiency anemia and in pregnant women or women who were taking birth-control pills. Measurement of transferrin concentration can be used to distinguish iron deficiency anemia from anemia resulting from chronic disorders, but offers no advantages over existing methods for estimating total ironbinding capacity.


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