title: The soluble transferrin receptor (sTfR)-ferritin index is a potential predictor of celiac disease in children with refractory iron deficiency anemia.
abstract: The soluble transferrin receptor (sTfR) distinguishes iron deficiency anemia from other types of anemia. Refractory iron deficiency anemia is often the onset symptom in malabsorption-induced celiac disease. We evaluated whether sTfR levels distinguish celiac disease-associated iron deficiency anemia from iron deficiency anemia of other origin. To this aim we measured sTfR and ferritin levels and their ratio (the sTfR/ferritin index) and other hematological parameters in 42 anemic children (20 with and 22 without celiac disease) vs. 22 non-anemic children with celiac disease and 31 healthy controls (age range 4-12 years). Hemoglobin parameters, mean cell volume, and serum iron and ferritin levels were decreased to a similar extent in the anemic patients (celiac and non-celiac). The sTfR level in non-anemic celiac patients was similar to that of normal controls (1.7+/-0.35 mg/L), whereas it was significantly increased in non-celiac and celiac anemic patients (2.2+/-0.5 mg/L, p<0.05 and 2.7+/-1.2 mg/L, p<0.001, respectively). The sTfR/ferritin index was also increased more in the anemic celiac patients (mean 4.4, range 1.5-12.0) than in anemic non-celiac children (mean 2.6, range 1.4-4.0) compared with non-anemic children (mean 1.2, range 0.7-2.0). Differences were more pronounced when ferritin was <5 ng/mL. Thus, the sTfR/ferritin index may be a predictive measure in discriminating anemic patients with celiac disease from those without celiac disease.
authors.affiliation: Department of Biochemistry and Medical Biotechnology, University Federico II, Naples, Italy. decateri@cds.unina.it
authors.forename: Maurizio
authors.initials: M
authors.lastname: De Caterina
authors.forename: Ernesto
authors.initials: E
authors.lastname: Grimaldi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Di Pascale
authors.forename: Giuliana
authors.initials: G
authors.lastname: Salerno
authors.forename: Assunta
authors.initials: A
authors.lastname: Rosiello
authors.forename: Maria
authors.initials: M
authors.lastname: Passaretti
authors.forename: Francesco
authors.initials: F
authors.lastname: Scopacasa
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000209:etiology; D002446:Celiac Disease / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004909:Erythrocyte Indices; D005260:Female; D005293:Ferritins / Q000097:blood; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007501:Iron / Q000097:blood; D008297:Male; D011237:Predictive Value of Tests; D011990:Receptors, Transferrin / Q000097:blood*; D012189:Retrospective Studies; D012737:Sex Factors; D012995:Solubility
chemical_list: D006454:Hemoglobins; D011990:Receptors, Transferrin; D005293:Ferritins; D007501:Iron