 |
|
Diagnosis of Iron Deficiency Anemia in the Elderly by Transferrin Receptor–Ferritin Index
Ephraim Rimon, MD;
Shmuel Levy, MD;
Alexander Sapir, MD;
Gregorius Gelzer, MD;
Ronit Peled, MPH;
David Ergas, MD;
Zev M. Sthoeger, MD
Arch Intern Med. 2002;162:445-449.
Background The diagnosis of iron deficiency anemia (IDA) in the elderly is difficult
because of the prevalence of chronic diseases, which can cause anemia with
high ferritin levels, even in the presence of iron deficiency. Therefore,
we studied the sensitivity and specificity of a serum transferrin receptor
assay, which is not affected by chronic diseases, in the diagnosis of IDA
in elderly patients.
Methods We performed a prospective controlled study of 49 consecutive male and
female patients older than 80 years who were admitted to an acute geriatric
department. Bone marrow aspirate confirmed IDA in all 49 patients. Fourteen
additional patients, also older than 80 years, with anemia but without evidence
of iron deficiency on results of bone marrow examination, served as a control
group. All patients underwent evaluation by means of a detailed medical history
and results of complete physical examination, routine blood tests, and specific
tests for diagnosis and evaluation of anemia. Examination of bone marrow aspirate
was performed for all patients. Levels of transferrin receptor in serum were
determined by means of a specific enzyme-linked immunosorbent assay. The transferrin
receptor–ferritin index (TR-F index) was defined as the ratio of serum
transferrin receptor level to log ferritin level.
Results Only 8 patients could be diagnosed as having IDA by means of routine
blood test results (serum iron, ferritin, and transferrin saturation levels).
In contrast, the TR-F index disclosed IDA in 43 of the 49 patients, thus increasing
the sensitivity from 16% to 88%.
Conclusions The diagnosis of IDA in the elderly by means of routine blood tests
has a very low sensitivity. The TR-F index is much more sensitive, and when
results are positive, the TR-F index can eliminate the need for bone marrow
examination.
From the Departments of Geriatrics (Drs Rimon, Levy, Sapir, and Gelzer
and Ms Peled) and Internal Medicine B (Drs Ergas and Sthoeger), Kaplan Medical
Center, Rehovot, Israel, which is affiliated with the Hebrew University and
Hadassah Medical School, Jerusalem, Israel.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Iron Deficiency Anemia
Clark
Nutr Clin Pract 2008;23:128-141.
ABSTRACT
| FULL TEXT
Sensitivity, Specificity, and Predictive Value of Serum Soluble Transferrin Receptor at Different Stages of Iron Deficiency
Choi
Annals of Clinical & Laboratory Science 2005;35:435-439.
ABSTRACT
| FULL TEXT
Editorial: Hot Topics in Geriatrics
Morley
J. Gerontol. A Biol. Sci. Med. Sci. 2003;58:M30-36.
FULL TEXT
Serum Ferritin vs Transferrin Receptor-Ferritin Index
Dosh et al.
Arch Intern Med 2002;162:1782-1783.
FULL TEXT
Ferritin Is More Cost-effective Than Transferrin Receptor-Ferritin Index for the Diagnosis of Iron Deficiency
Ruivard et al.
Arch Intern Med 2002;162:1783-1783.
FULL TEXT
|
