Možnosti diagnostiky a diferenciální diagnostiky anémie z nedostatku železa

Possibilitiesof Diagnosis and Differential Diagnosis of iron deficiency anaemia

Iron deficiency is one of the most frequent pathological conditions worldwide. Its diagnosis is as a rnle easy, difficulties arise in tase of coincidence of iron deficiency and the acute phase reaction or anaemia associated with chronic disease. In addition to common laboratory examinations such as assessment of serum iron, total or free binding capacity of transferrin and ferritin nowadays new methods are introduced finto practice such as concentration of soluble transferrin receptorn and an index associating the advantages of the ferritin examination and the mentioned soluble transferrin receptor. Our work analyzes the results in a group of 313 subjects. 211 women and 102 men aged 2 to 91 years (medián 55 years) referred to our out-patient department on account of anaemia not responding adequately to oral iron therapy. The results esere compared with those obtained in 20 healthy blond donors. For the diagnosis of iron deficiency anaemia analysis of parameers of the haemogram and a combination of serum iron and free or total binding capacity is sufficient. In cases where iron deficiency is combined with anaemia of chronic diseases or in tase of acute phase reaction examination of soluble transferrin receptorn and analysis of the TfR/log ferritin index proves useful. For the diagnosis of latent iron deficiency in cases without the acute phase reaction assessment of ferritin is reliable, in patients with the acute phase reaction we cannot do without assessment of the concentration of soluble transferrin receptorn and without analysis of the sTfR/log ferritin index. The mentioned methods are quite sufficient for the diagnosis of iron deficiency in the majority of cases and invasive bone marrow examination is not necessary as a rnle.

Key words:
iron deficiency, iron, ferritin, soluble transferrin receptor, anaemia