Abstract

Research Article

Role of RBC Parameters to Differentiate between Iron Deficiency Anemia and Anemia of Chronic Diseases

Reena Bhaisare*, Ravindranath M and Gurmeet Singh

Published: 27 July, 2023 | Volume 7 - Issue 1 | Pages: 021-024

Introduction: In the present study we evaluated and compared RBC parameters, iron status, and ferritin for discriminating between patients with iron deficiency anemia and anemia of chronic disease. Anemia that accompanies infection, inflammation, and cancer, is commonly termed anemia of chronic disease (ACD). 
Methods: We compared the ability of serum ferritin concentration, using the microplate immunoenzymometric assay method with other, more traditional indicators of iron status like total iron binding capacity [TIBC], mean corpuscular volume [MCV], percent transferrin saturation [%TS], RBC distribution width [RDW], and serum iron concentration [SIC]. The ferritin concentration was determined in 80 serum samples selected from men and women above the age of 18 years. The patients were assigned to IDA and ACD groups based on serum ferritin concentration.
Observation: By studying the ROC Curve for various red cell parameters for the diagnosis of IDA and ACD, we found that diagnostic accuracy of various indicators was as follows TIBC>TS%>MCV>MCH>SI>MCHC for anemia of chronic diseases, and TIBC>MCH>MCV>MCHC>TS%>SI for iron deficiency anemia. When both the value of AUCs (Area under Curve) of ROC were compared it is apparent that TIBC, TS%, MCV, and MCH are important discriminating factors between IDA and ACD. Conclusion: Conventional laboratory parameters play an important role in distinguishing overt causes of IDA and ACD. MCV, MCH, and TIBC were found to be (p -value < .05) significantly discriminated against IDA and ACD. Serum ferritin is an important diagnostic tool with reasonable accuracy for the detection and differentiation of iron deficiency anemia and anemia of chronic disease.

Read Full Article HTML DOI: 10.29328/journal.jhcr.1001024 Cite this Article Read Full Article PDF

References

  1. Agarwal N, Prchal JT. Anemia of chronic disease (anemia of inflammation). Acta Haematol. 2009;122(2-3):103-8. doi: 10.1159/000243794. Epub 2009 Nov 10. PMID: 19907147.
  2. World Health Organization. Nutritional Anemias. Technical Report Series No. 405. Geneva, Switzerland: WHO, 1968.
  3. Wians FH Jr, Urban JE, Keffer JH, Kroft SH. Discriminating between iron deficiency anemia and anemia of chronic disease using traditional indices of iron status vs transferrin receptor concentration. Am J Clin Pathol. 2001 Jan;115(1):112-8. doi: 10.1309/6L34-V3AR-DW39-DH30. PMID: 11190796.
  4. Goyal R, Das R, Bambery P, Garewal G. Serum transferrin receptor-ferritin index shows concomitant iron deficiency anemia and anemia of chronic disease is common in patients with rheumatoid arthritis in north India. Indian J Pathol Microbiol. 2008 Jan-Mar;51(1):102-4. doi: 10.4103/0377-4929.40417. PMID: 18417876.
  5. Fleming MD, Trenor CC 3rd, Su MA, Foernzler D, Beier DR, Dietrich WF, Andrews NC. Microcytic anaemia mice have a mutation in Nramp2, a candidate iron transporter gene. Nat Genet. 1997 Aug;16(4):383-6. doi: 10.1038/ng0897-383. PMID: 9241278.
  6. Wians FH Jr, Urban JE, Keffer JH, Kroft SH. Discriminating between iron deficiency anemia and anemia of chronic disease using traditional indices of iron status vs transferrin receptor concentration. Am J Clin Pathol. 2001 Jan;115(1):112-8. doi: 10.1309/6L34-V3AR-DW39-DH30. PMID: 11190796.
  7. Mast AE, Blinder MA, Gronowski AM, Chumley C, Scott MG. Clinical utility of the soluble transferrin receptor and comparison with serum ferritin in several populations. Clin Chem. 1998 Jan;44(1):45-51. PMID: 9550557.
  8. Ahluwalia N. Diagnostic utility of serum transferrin receptors measurement in assessing iron status. Nutr Rev. 1998 May;56(5 Pt 1):133-41. doi: 10.1111/j.1753-4887.1998.tb01738.x. PMID: 9624883.
  9. Oustamanolakis P, Koutroubakis IE, Kouroumalis EA. Diagnosing anemia in inflammatory bowel disease: beyond the established markers. J Crohns Colitis. 2011 Oct;5(5):381-91. doi: 10.1016/j.crohns.2011.03.010. Epub 2011 Apr 27. PMID: 21939910.
  10. Macdougall IC, Hutton RD, Cavill I, Coles GA, Williams JD. Poor response to treatment of renal anaemia with erythropoietin corrected by iron given intravenously. BMJ. 1989 Jul 15;299(6692):157-8. doi: 10.1136/bmj.299.6692.157. PMID: 2504356; PMCID: PMC1837074.
  11. Wians FH Jr, Urban JE, Keffer JH, Kroft SH. Discriminating between iron deficiency anemia and anemia of chronic disease using traditional indices of iron status vs transferrin receptor concentration. Am J Clin Pathol. 2001 Jan;115(1):112-8. doi: 10.1309/6L34-V3AR-DW39-DH30. PMID: 11190796.

Figures:

Figure 1

Figure 1

Figure 1

Figure 2

Figure 1

Figure 3

Figure 1

Figure 4

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?