Serum transferrin receptor in children and adolescents with inflammatory bowel disease

Abstract

The results suggest that serum transferrin receptor is a useful parameter for the diagnosis of iron deficiency in inflammatory bowel disease, in particular, the transferrin receptor/ferritin ratio with a cut-off level > or = 350.

Is Iron Deficiency in the Absence of Anemia Associated With Fatigue in Inflammatory Bowel Disease?

“…Measuring sTfR concentration can improve the diagnostic accuracy of iron deficiency, particularly in the setting of inflammation or chronic disease. sTfR is inversely related to intracellular iron stores, but is relatively insensitive to inflammation (22). Individuals were classified as either iron deficient (ferritin < 20 ug/L or sTfR> 28 mg/L) or iron nondeficient (ferritin >20 ug/L and sTfR< 28 mg/L).…”

“…Previously, IBD research that assessed iron deficiency either didn't define it (21), used serum ferritin and mean corpuscular volume <66 (22), or used both serum ferritin and transferrin saturation (23) to estimate iron stores. Expert reviews have suggested the use primarily of serum ferritin (with or without transferrin saturation) (18)(19)(20), with some indicating that the addition of sTfR could enhance the ascertainment of iron deficiency in IBD, considering that serum ferritin is an acute phase reactant and thus can be difficult to interpret in the presence of inflammation (19,20).…”

Pathogenesis and treatment of anemia in inflammatory bowel disease

“…1,17 The concentration of soluble transferrin receptor and the ratio of log ferritin/soluble transferrin receptor have been found to be helpful in the differential diagnosis between ACD and ACD/IDA 15,17 but published data exist only for pediatric IBD. 18 While ACD is mostly normochromic and normocytic, ACD/IDA more frequently presents as microcytic and hypochromic anemia. 6,15 Other aids to the differentiation between the two conditions include quantification of reticulocyte hemoglobin and the percentage of hypochromic red cells, which indicate the availability of iron for erythroid progenitors, as well as determination of hepcidin in serum.…”

Soluble transferrin receptor for the evaluation of erythropoiesis and iron status

“…Contrarily to serum ferritin, sTfR may thus prove to be a diagnostic test of iron deficiency in patients with inflammation. However, in some studies, sTfR levels could not distinguish accurately among patients with rheumatoid arthritis [92,93], inflammatory bowel disease [94] or other inflammatory disorders [95], those with or without iron deficiency. In addition, several studies have observed higher sTfR levels in iron-replete rheumatoid arthritis patients compared to normal subjects, even if they remain lower than in iron deficiency anemia [92,96 -98].…”

“…However, the combined use of sTfR and ferritin or the use of TfR/ferritin or TfR/log ferritin ratios may increase the efficacy of sTfR in identifying iron deficiency in patients with chronic inflammation [61,87,88,94,103]. In particular, the log (sTfR/ferritin) ratio may prove superior to the sTfR/log ferritin index [68].…”