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Prediction of iron deficiency in chronic inflammatory rheumatic disease anaemia
Author(s) -
Kurer Sylvia Baumann,
Seifert Burkhardt,
Michel Beat,
Ruegg Regula,
Fehr Jörg
Publication year - 1995
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1995.tb05395.x
Subject(s) - ferritin , bone marrow , transferrin saturation , iron deficiency , soluble transferrin receptor , medicine , transferrin , serum iron , gastroenterology , anemia , immunology , endocrinology , iron status
Summary. We prospectively studied 45 anaemic patients (3 7 women, 8 men) with chronic inflammatory rheumatic diseases. The combination of serum ferritin and CRP (as well as ESR) in its predictive capacity for bone marrow iron stores was examined. The relationship between other iron‐related measurements (transferrin, transferrin saturation, soluble transferrin receptor, erythrocyte porphyrins and percentage of hypochromic/microcytic erythrocytes) and bone marrow iron stores was also investigated. Stainable bone marrow iron was taken as the most suitable standard to separate iron‐deficient from iron‐replete patients. 14 patients (31%) were lacking bone marrow iron. Regression analysis showed a good correlation between ferritin and bone marrow iron (adjusted R 2 =0.721, P<00001). The combination of ferritin and CRP (ESR) did not improve the predictive power for bone marrow iron (adjusted R 2 =0.715) in this cohort of patients with low systemic inflammatory activity. With respect to the bone marrow iron content the best predictive cut‐off value of ferritin was 30μg/l (86% sensitivity, 90% specificity). The other iron‐related parameters both individually and when combined were less powerful in predicting bone marrow iron than ferritin alone. Only zinc bound erythrocyte protoporphyrin in combination with ferritin slightly improved prediction (adjusted R 2 =0.731). A cut‐off point of 11% hypochromic erythrocytes reached a high specificity (90%), but was less sensitive (77%).