L’exploration de l’érythropoïèse via le taux sérique des récepteurs solubles de la transferrine (Rs-Tf) chez les sujets anémiques

Abstract

The aim of the present study is to evaluate in a hospitalized population of anemic adults the efficiency of the serum transferrin receptor (sTfR). The objective is to distinguish iron deficiency anemia (IDA) from anemia of chronic disease (ACD) and the combined forms (COMBI anemia). Serum iron and serum ferritin are the most used tests for the detection of iron deficiency, however these values may not be reliable. Serum ransferrin receptor (sTfR) has been introduced as a new tool, and its values are not affected by an increase in cytokine production in ACD patient. 132 patients, hospitalized at the CHU-Setif, were enrolled in this study; 50 were affected with IDA and 82 were affected with ACD. The control group included 60 healthy adults. Iron status was evaluated in these patients including serum transferrin receptor. Results: showed that values of iron, MCV, and hemoglobin in IDA, ACD and COMBI groups were not significantly different. Serum ferritin values IDA from ACD reliably but the diagnostic usefulness of ferritin measurements in ACD and COMBI patients is limited for their wide range of variation. Serum TfR levels were > 4.39 mg/L in men and >3.69 mg/L in women in all IDA patient tested. This helped us to select 51% patients with COMBI anemia among the 82 patients with ACD. Serum TfR was the best test to differentiate IDA and COMBI anemia from ACD patients. Calculation of the ratio sTfR/log ferritin (sTfR-F Index), is a way of combining sTfR and ferritin results. This ratio provided an important parameter for the of patients with depleted iron pools. We conclude that sTfR measurement is a sensitive and a valuable-noninvasive tool for the diagnosis of iron depletion. It proves an attractive additional to the conventional laboratory tests in the prediction of depleted iron pools in anemic adult population.