Q J Med 2000; 93: 198
© 2000 Association of Physicians
Correspondence |
Serum transferrin receptor assay in iron deficiency anaemia and anaemia of chronic disease in the elderly
Department of Medicine for the Elderly, Tameside General Hospital, Ashton under Lyne
Sir,
More important than the differentiation between iron deficiency anaemia (IDA) and the anaemia of chronic disorders (ACD) is the distinction which often needs to be made between the coexistence of IDA and ACD vs. the sole diagnosis of ACD. Therefore, the issues raised by Chua et al.1 need to be ‘fine tuned’ through the use of the ratio serum TfR/log ferritin, the so-called ‘TfR-F’ index.2 In one study, the ratio achieved statistically significant separation between iron-deficient patients with coexisting ACD vs. patients with the sole diagnosis of ACD. In that study the ‘gold standard’ for the diagnosis of iron deficiency was the absence of stainable iron from a bone-marrow aspirate.2 Although the study comprised 129 patients, including 64 with ACD and 17 with combined ACD and iron deficiency, no mention was made of the age range, and it is this omission which would justify embarking on a comparable study in the elderly age group.
References
1.
Chua E, Clague JE, Sharma AK, Horan MA, Lombard M. Serum transferrin receptor assay in iron deficiency anaemia and anaemia of chronic disease in the elderly. Q J Med 1999; 92:587–94.
2.
Punnonen K, Irjala K, Rajamaki A. Serum transferrin receptor and its ratio to serum ferritin in the diagnosis of iron deficiency. Blood 1997; 89:1052–7.
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