Serum transferrin receptor in children: usefulness for determinating the nature of anemia in infection
| Autor: | Francisco Lendinez Molinos, Amparo Carracedo Morales, Francisco J. Vico, M Angeles Vázquez López, Juan López Muñoz, Antonio Muñoz Hoyos, Moisés Leyva Carmona |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Anemia Mean corpuscular hemoglobin Protoporphyrins Infections Gastroenterology Hemoglobins Reticulocyte Count hemic and lymphatic diseases Internal medicine Receptors Transferrin medicine Humans Erythropoiesis Child Erythropoietin biology medicine.diagnostic_test Anemia Iron-Deficiency RED-CELL INDICES Transferrin saturation business.industry Area under the curve Transferrin Infant Hematology medicine.disease Ferritin Oncology Child Preschool Pediatrics Perinatology and Child Health Ferritins biology.protein Female Hemoglobin business Biomarkers medicine.drug |
| Zdroj: | Journal of pediatric hematology/oncology. 28(12) |
| ISSN: | 1077-4114 |
| Popis: | Objectives To know the variations of serum transferrin receptor (sTfR) and its indices depending on the status of body iron and the presence of infection in children, to evaluate their usefulness for recognizing the nature of anemia in infection, and to know the role of erythropoietic activity in these conditions. Design and methods Three hundred and sixty-eight children between 1 and 10 years were included: 206 healthy children; 60 iron deficient anemic children (IDA); 102 with anemia and infectious disease, 58 of them meeting criteria for IDA. We measured hemoglobin, red cell indices, reticulocytes, transferrin saturation, serum ferritin, erythrocyte protoporphyrin, serum erythropoietin, and sTfR. Statistic method: ANOVA test, multiple linear regression, and ROC curve. Results sTfR, sTfR/ferritin ratio, and sTfR-logferritin index values were found to increase significantly in IDA children. These values were significantly lower in infectious anemia than iron deficiency states. Serum erythropoietin only was elevated significantly in iron deficiency states. In children without infection, mean corpuscular hemoglobin, erythrocyte protoporphirin, erythropoietin logarithm, and total-iron-binding-capacity logarithm predicted 81% of sTfR variability. sTfR and its indices showed a very high sensitivity and specificity for recognizing iron deficiency states. In children with IDA and infection sensitivity for sTfR/ferritin ratio was low (area under the curve: 0.71; 95% confidence interval: 0.64-0.88). For discriminating the nature of anemia in infection the cut-off point obtained for sTfR, sTfR/ferritin ratio, and sTfR-F index were 3, 70, and 1.8, respectively, and their sensitivity and specificity were also very high. Conclusions sTfR, sTfR/ferritin ratio, and sTfR-F index are useful parameters for recognizing iron deficiency and the nature of anemia in infection. In IDA+infection, sTfR/ferritin ratio should not be recommended in the diagnosis of iron deficiency. In iron deficiency, erythropoietic activity has a secondary role as predictor factor of sTfR levels. |
| Databáze: | OpenAIRE |
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