title: Diagnostic significance of serum soluble transferrin receptors in various anemic diseases: the first multi-institutional joint study in Japan.
abstract: Serum soluble transferrin receptor (sTfR) has been reported to be higher in patients with iron deficiency or with elevated erythropoiesis. In the present study, serum sTfR was measured in various anemic diseases and their clinical significance was examined in a multi-institutional joint study. Serum sTfRs in patients with the following anemic diseases were markedly higher than those in normal healthy adults: non-treated iron deficiency anemia (IDA) (9.13 +/- 7.04 mg/l, n = 52, p < 0.0001), anemia of chronic disorders (ACD) (3.45 +/- 1.38 mg/l, n = 20, p < 0.0001), hemolytic anemia (HA) (5.57 +/- 3.26 mg/l, n = 17, p < 0.0001), and myelodysplastic syndrome (MDS) (4.03 +/- 2.83 mg/l, n = 20, p < 0.0001). There were significant differences between IDA and ACD (p < 0.0001), between aplastic anemia (AA) (1.58 +/- 1.26 mg/l, n = 16) and MDS (p < 0.001), and between AA and MDS with refractory anemia (MDS-RA) (4.16 +/- 3.40 mg/l, n = 9) (p < 0.02). In patients with chronic renal failure (CRF), serum sTfR levels and serum sTfR/log serum ferritin ratios (sTfR/F index) were compared in the two classified groups according to Muirhead's criteria, as IDA and non-IDA groups with or without recombinant human erythropoietin (rHuEPO) treatment. Significantly high levels of both serum sTfR (p < 0.0001) and the sTfR/F index (p < 0.0001) were observed in IDA without rHuEPO treatment. Especially in CRF with rHuEPO treatment, the sTfR/F index showed marked elevation in the IDA group (p < 0.0001) compared with serum sTfR (p < 0.001), indicating more diagnostic efficacy of the sTfR/F index for CRF with IDA. In conclusion, the serum sTfR concentration is a useful diagnostic tool for discrimination between IDA and ACD, and between AA and MDS-RA, and for the detection of iron deficiency in CRF patients in the Japanese population.
authors.affiliation: First Department of Internal Medicine, Saitama Medical School, 38 Morohongo Moroyama, Iruma-Gun, Saitama 350-0495, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Matsuda
authors.forename: Masami
authors.initials: M
authors.lastname: Bessho
authors.forename: Shigehisa
authors.initials: S
authors.lastname: Mori
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takeuchi
authors.forename: Tohru
authors.initials: T
authors.lastname: Abe
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Yawata
authors.forename: Hiraku
authors.initials: H
authors.lastname: Mori
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Omine
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Shinpei
authors.initials: S
authors.lastname: Furusawa
authors.forename: Teiryo
authors.initials: T
authors.lastname: Maeda
authors.forename: Susumu
authors.initials: S
authors.lastname: Haginosita
authors.forename: Yoshihei
authors.initials: Y
authors.lastname: Hirasawa
authors.forename: Eriko
authors.initials: E
authors.lastname: Kinugasa
authors.forename: Tadao
authors.initials: T
authors.lastname: Akizawa
authors.forename: Naohito
authors.initials: N
authors.lastname: Kawakami
authors.forename: Atsuo
authors.initials: A
authors.lastname: Nagata
authors.forename: Kunitake
authors.initials: K
authors.lastname: Hirashima
mesh_terms: D000328:Adult; D000367:Age Factors; D000740:Anemia / Q000097:blood / Q000175:diagnosis*; D000743:Anemia, Hemolytic / Q000097:blood / Q000175:diagnosis; D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000175:diagnosis; D004921:Erythropoietin / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005293:Ferritins / Q000097:blood; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000175:diagnosis; D011933:Reagent Kits, Diagnostic; D011990:Receptors, Transferrin / Q000097:blood*; D011994:Recombinant Proteins; D051437:Renal Insufficiency / Q000097:blood; D012737:Sex Factors; D012995:Solubility
chemical_list: D011933:Reagent Kits, Diagnostic; D011990:Receptors, Transferrin; D011994:Recombinant Proteins; D004921:Erythropoietin; D005293:Ferritins