title: Soluble transferrin receptor as a diagnostic laboratory test for detection of iron deficiency anemia in acute illness of hospitalized patients.
abstract: BACKGROUND
  Many patients in the internal medicine ward have anemia. The etiology for the anemia may be multifactorial and, in the setting of inflammatory process when the ferritin is increased, it is difficult to diagnose iron deficiency anemia. Soluble transferrin receptor (sTfR) had been suggested as an indicator for iron deficiency. No study has investigated the meaning of high sTfR as the only positive marker of iron deficiency anemia (IDA) caused by gastrointestinal tract (GIT) bleeding in hospitalized patients.
  
  
  OBJECTIVE
  To demonstrate the importance of high levels of sTfR as a marker for further GIT investigation in cases of anemia where the level of ferritin was normal or increased.
  
  
  METHODS
  We retrospectively assessed all patients in an internal medicine ward in our facility who had anemia, high sTfR levels (> 5.0 mg/L) and normal or high ferritin levels and who underwent esophagogastroduodenoscopy and colonoscopy.
  
  
  RESULTS
  Of 32 patients with anemia and normal or high ferritin levels and high sTfR, 22 patients (68%) had findings that explained IDA (in some patients more than one finding). Those findings were colonic polyps (n=9), carcinoma of colon (n=4), duodenal ulcer (n=4), carcinoma of stomach (n=3), colitis (n=3), atrophic gastritis (n=1), erosive gastritis (n=1) and angiodysplasia (n=1).
  
  
  CONCLUSIONS
  High sTfR may be a good indicator of IDA caused by GIT bleeding when the ferritin level is normal or high. GIT investigation is warranted in such cases.
authors: Department of Medicine E, Meir Medical Center, Kfar Saba, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
authors: Tatiana
authors: T
authors: Berlin
authors: Avraham
authors: A
authors: Meyer
authors: Pnina
authors: P
authors: Rotman-Pikielny
authors: Aiman
authors: A
authors: Natur
authors: Yair
authors: Y
authors: Levy
mesh_terms: D000208:Acute Disease; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000150:complications; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011990:Receptors, Transferrin / Q000097:blood*; D012189:Retrospective Studies
chemical_list: D011990:Receptors, Transferrin