Plasma soluble transferrin receptor assay when screening for iron-deficiency in an unselected population of elderly anaemic patients.

摘要

Iron-deficiency anaemia (IDA) in men and postmeno-pausal women is commonly caused by blood loss via the gastrointestinal tract. Biochemical assessment of iron status includes measurement of serum iron, total iron binding capacity (TIBC), transferrin saturation (TSAT) and serum ferritin [1]. In younger, otherwise healthy individuals, the diagnosis of IDA is evident when the concentrations of iron and ferritin are subnormal, TIBC is increased and TSAT is below normal. In elderly anaemic patients who may suffer from concurrent diseases, e.g. infections, inflammatory diseases or cancer, the biochemical iron status is often difficult to interpret as it is influenced by acute-phase responses [2]. Anaemia induced by infections, inflammatory diseases or cancer is commonly referred to as anaemia of chronic disease (ACD). The most reliable method for discriminating between IDA and ACD is to perform a bone marrow examination [3]. In contrast to ACD, there is no readily stainable bone marrow iron in IDA.