Læknablaðið - 15.01.2010, Side 17

FRÆÐIGREINAR
RANNSÓKN
hvort þátttakendur fengu jámmeðferð, sem getur
skekkt þéttni ferritíns í sermi til hækkunar, eða
krabbameinsmeðferð sem getur haft áhrif á sTfR
og CHr. Það skal einnig haft í huga að ekki er enn til
alþjóðlegur staðall fyrir mælingu á sTfR þannig að
niðurstöður úr mælingum á sTfR með mismunandi
aðferðum eru ekki alltaf sambærilegar. Þar að auki
eru notaðar mismunandi einingar við mælingar á
sTfR sem eykur enn á ósamræmið.
Samantekt
Hjá sjúklingum með bólgusvörun er oft erfitt
að greina jámskort með blóðrannsóknum. Af
þeim blóðrannsóknum sem fjallað er um í
þessari könnun reyndust Tómasartafla og sTfR-
ferritín-vísir vera áreiðanlegustu mælikvarðarnir á
jámskort. Fyrrnefnda aðferðin skipar sjúklingum í
fjóra flokka eftir járnhag og er sögð gagnleg við val
á meðferð við blóðleysi og til þess að meta árangur
af þeirri meðferð. Notkrm þessara mælikvarða
getur dregið úr þörf á því að taka mergsýni til þess
að meta járnbirgðir.
Þakkir
Vísindasjóður læknaráðs FSA fær þakkir fyrir
styrk til könnunarinnar. Guðlaug H. Isaksdóttir,
lífeindafræðingur, fær þakkir fyrir mælingar á
sTfR.
Heimildir
1. Mattman A, Huntsman D, Lockitch G, et al. Transferrin
receptor 2 (TfR2) and HFE mutational analysis in non-C282Y
iron overload: identification of a novel TfR2 mutation. Blood
2002; 100:1075-7.
2. Worwood M. Serum transferrin receptor assays and their
application. Ann Clin Biochem 2002; 39: 221-30.
3. Punnonen K, Irjala K, Rajamáki A. Serum transferrin
receptor and its ratio to serum ferritin in the diagnosis of
iron deficiency. Blood 1997; 89:1052-7.
4. Beguin Y. Soluble transferrin receptor for the evaluation of
erythropoiesis and iron status. Clin Chim Acta 2003; 329:
9-22.
5. Feelders RA, Kuiper-Kramer EPA, van Eijk HG. Structure,
function and clinical significance of transferrin receptors.
Clin Chem Lab Med 1999; 37:1-10.
6. Thomas C, Thomas L. Anemia of chronic disease:
pathophysiology and laboratory diagnosis. Lab Hematol
2005; 11:14-23.
7. Thomas C, Thomas L. Biochemical markers and hematologic
indices in the diagnosis of functional iron deficiency. Clin
Chem 2002; 48:1066-76.
8. Thomas C, Kirschbaum A, Boehm D, Thomas L. The
diagnostic plot: a concept for identifying different states
of iron deficiency and monitoring the response to epoetin
therapy. Med Oncol 2006; 23: 23-36.
9. Cook JD. Diagnosis and management of iron-deficiency
anaemia. Best Pract Res Clin Haematol 2005; 18: 319-32.
10. Baillie FJ, Morrison AE, Fergus I. Soluble transferrin
receptor: a discriminating assay for iron deficiency. Clin Lab
Haematol 2003; 25: 353-7.
11. Das Gupta A, Abbi A. High serum transferrin receptor
level in anemia of chronic disorder indicates coexistent iron
deficiency. Am J Hematol 2003; 72:158-61.
12. Juncá J, Fernández-Avilés F, Oriol A, et al. The usefulness of
the serum transferrin receptor in detecting iron deficiency
in the anemia of chronic disorders. Haematologica 1998; 83:
676-80.
13. Ervasti M, Kotisaari S, Romppanen J, Punnonen K. In
patients who have stainable iron in the bone marrow an
elevated plasma transferrin receptor value may reflect
functional iron deficiency. Clin Lab Haematol 2004; 26: 205-
9.
14. Means RT, Allen J, Sears DA, Schuster SJ. Serum soluble
transferrin receptor and the prediction of marrow aspirate
iron results in a heterogenous group of patients. Clin Lab
Haematol 1999; 21:161-7.
15. Joosten E, Van Loon R, Billen J, Blanckaert N, Fabri R,
Pelemans W. Serum transferrin receptor in the evaluation of
the iron status in elderly hospitalized patients with anemia.
Am J Hematol 2002; 69:1-6.
16. Hanif E, Ayyub M, Anwar M, Ali W, Bashir M. Evaluation
of serum transferrin receptor concentration in diagnosis
and differentiating iron deficiency anaemia from anaemia of
chronic disorder. J Pak Med Assoc 2005; 55:13-6.
17. Lee EJ, Oh EJ, Park YJ, Lee HK, Kim BK. Soluble transferrin
receptor (sTfR), ferritin, and sTfR/log ferritin index in
anemic patients with nonhematologic malignancy and
chronic inflammation. Clin Chem 2002; 48:1118-21.
18. Song JS, Park W, Bae SK, et al. The usefulness of serum
transferrin receptor and ferritin for assessing anemia in
rheumatoid arthritis: comparison with bone marrow iron
study. Rheumatol Int 2001; 21: 24-9.
19. Dacie JV, Lewis SM. Practical Haematology, 6. útgáfa.
Churchill Livingstone 1984.
20. Gale E, Torrance J, Bothwell T. The quantitative estimation
of total iron stores in human bone marrow. J Clin Invest
1963; 42:1076-82.
21. Markovi M, Majki -Singh N, Subota V. Usefulness of soluble
transferrin receptor and ferritin in iron deficiency and
chronic disease. Scand J Clin Lab Invest 2005; 65:571-6.
22. Vernet M, Doyen C. Assessment of iron status with a new
fully automated assay for transferrin receptor in human
serum. Clin Chem Lab Med 2000; 38: 437-42.
23. O'Broin S, Kelleher B, Balfe A, Mc Mahon C. Evaluation
of serum transferrin receptor assay in a centralized iron
screening service. Clin Lab Haematol 2005; 27:190-4.
24. Fluss R, Faraggi D, Reiser B. Estimation of the Youden Index
and its associated cutoff point. Biom J 2005; 47: 458-72.
25. Fishbane S, Galgano C, Langley RC Jr, Canfield W, Maesaka
JK. Reticulocyte hemoglobin content in the evaluation of
iron status of hemodialysis patients. Kidney Int 1997; 52:
217-22.
LÆKNAblaðið 2010/96 1 7