An unusual case of iron deficiency anemia is associated with extremely low level of transferrin receptor.
A case study of a female patient, diagnosed with iron deficiency anemia, was unresponsive to oral iron treatment and only partially responsive to parenteral iron therapy, a clinical profile resembling the iron-refractory iron deficiency anemia (IRIDA) disorder. However, the patient failed to exhibit microcytic phenotype, one of the IRIDA hallmarks. Biochemical assays revealed that serum iron, hepcidin, interluekin 6, and transferrin saturation were within the normal range of references or were comparable to her non-anemic offspring. Iron contents in serum and red blood cells and hemoglobin levels were measured, which confirmed the partial improvement of anemia after parenteral iron therapy. Strikingly, serum transferrin receptor in patient was almost undetectable, reflecting the very low activity of bone-marrow erythropoiesis. Our data demonstrate that this is not a case of systemic iron deficiency, but rather cellular iron deficit due to the low level of transferrin receptor, particularly in erythroid tissue.
Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University Nanjing, China.
Shuangying
S
Hao
Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University Nanjing, China.
Huihui
H
Li
Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University Nanjing, China.
Xiaoyan
X
Sun
Department of Hematology, Nanjing Drum Hospital, The Affiliated Hospital of Nanjing University Medical School Nanjing, China.
Juan
J
Li
Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University Nanjing, China.
Kuanyu
K
Li
D061605:Administration, Intravenous; D000284:Administration, Oral; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy; D015415:Biomarkers / Q000097:blood; D015536:Down-Regulation; D005260:Female; D006801:Humans; D007501:Iron / Q000008:administration & dosage / Q000097:blood*; D011990:Receptors, Transferrin / Q000097:blood* / Q000172:deficiency; D016896:Treatment Outcome
D015415:Biomarkers; D011990:Receptors, Transferrin; D007501:Iron
Iron deficiency anemia; hepcidin; iron therapy; soluble transferrin receptor