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Query: UNIPROT:P02794 (ferritin)
 17,525 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The predictive value positive of serum iron studies and erythrocyte indices in differentiating between iron deficiency anemia and the anemia of chronic disease (ACD) were determined in 82 hospitalized patients with an iron-binding saturation of 15 percent or less. Iron deficiency, determined by serum ferritin of 20 ng/mL or less, was present in only 31 percent of patients with a serum iron level of 10 micrograms/dL or less; 39 percent of patients with a transferrin saturation of 5 percent or less, and 54 percent of patients with a total iron-binding capacity (TIBC) of 350 micrograms/dL or greater; conversely, iron deficiency was present in only 3 percent of patients with a TIBC of 250 micrograms/dL or less. Iron deficiency was present in 83 percent of patients with a mean corpuscular volume (MCV) of 75 microns3 or less, but only 2 percent of patients with an MCV of 86 microns3 or greater. It is concluded that the MCV has strong predictive value positive (and negative) when below (or above) the values just cited, but that serum iron studies do not have sufficient predictive value to justify their use in the routine differentiation between iron deficiency anemia and the ACD in hospitalized patients when no other cause for anemia is likely.
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PMID:Differentiation of iron deficiency and the anemia of chronic disease. 396 99

Fifty six patients admitted consecutively to the coronary care unit with ischemic chest pain participated in a controlled prospective study of acute changes in iron metabolism. Following myocardial infarction there were significant reductions of plasma iron by 8.1 mumol/L (P = 0.002), total iron binding capacity by 12.9 mumol/L (P = 0.003), and plasma transferrin by 0.70 g/L (P = 0.007). In contrast, there was a significant elevation of serum ferritin by 218 micrograms/L (P = 0.0005). The magnitude and duration of these acute changes in iron metabolism was greater in patients with higher peak serum creating kinase levels, suggesting that these changes are influenced by the extent of tissue necrosis. Comparison with the control group showed that alteration in dietary iron intake was not a significant factor. The possible mechanisms of these acute changes and their similarity to those observed in the anemia of chronic disease are discussed.
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PMID:Acute changes in iron metabolism following myocardial infarction. 406 89

The anemia of chronic disease (ACD) is defined as a mild anemia associated with a chronic inflammatory, infectious or neoplastic illness and with a characteristic disturbance of iron metabolism. Many of the findings in ACD can be accounted for by release of a monokine called leukocyte endogenous mediator (LEM), endogenous pyrogen, or interleukin-1. This substance is released from "activated" monocytes. Bacterial endotoxins, certain lymphokines and phagocytic challenges are among the factors stimulating its biosynthesis. LEM induces fever, leukocytosis, biosynthesis. LEM induces fever, leukocytosis, and a variety of biochemical changes, including hypoferremia and alterations in plasma protein synthesis, collectively known as the "acute phase response." It is proposed that ACD results from the long-term elaboration of LEM and that release of this material is the common pathogenetic factor found in the illnesses that are associated with ACD. Some suggestions are made for testing the hypothesis. The hypoferremia associated with ACD is probably caused by defective release of iron from cells--particularly from macrophages, but also from hepatocytes and intestinal epithelium. Two possible mechanisms for this abnormality have been proposed: liberation of lactoferrin from neutrophilic leukocytes and induction of apoferritin synthesis. Neither mechanism has been established. Erythrokinetic studies in ACD have detected a modest reduction of erythrocyte survival without an adequate compensatory increase in the rate of red cell production. The reduced erythrocyte survival is probably related to an increase in phagocytic activity by activated macrophages. Impaired bone marrow response is partly related to the restricted iron supply, but there is substantial evidence for an additional defect in erythropoietin secretion. In some malignant diseases, there is evidence of an additional abnormality: impaired marrow response to a normal amount of erythropoietin. The nature of the erythropoietic defects and the relation of LEM to them remain to be established.
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PMID:The anemia of chronic disease. 634 57

Basic ferritin content of red cells has been evaluated with a simplified assay in subjects with various erythroid disorders. In 39 patients with iron deficiency anemia, red cell ferritin was significantly reduced compared with that of normal individuals. Thirty percent of these patients had low normal red cell ferritin content and the MCV for this group was significantly higher than that of patients with reduced red cell ferritin. The mean red cell ferritin of 30 subjects with the anemia of chronic disease was significantly reduced and patients in this group with normal red cell ferritin had higher plasma ferritin levels. In 14 patients with polycythemia vera, the mean red cell ferritin was significantly reduced and showed a positive correlation with the hemoglobin level and percent transferrin saturation. The red cell ferritin content of 9 individuals with acquired immune hemolytic anemia and 10 with acquired sideroblastic anemia was significantly elevated and, in subjects with immune hemolysis, showed a positive correlation with the reticulocyte count. These findings suggest a lack of discriminatory function for red cell ferritin in iron deficiency anemia and anemia of chronic disease. Evaluation of this parameter in the individual patient should take into account the presence of reticulocytosis.
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PMID:Basic ferritin content of red cells of patients with anemia and polycythemia vera. 652 7

While the prevalence of iron deficiency has remained relatively constant, there has been continuing refinement in its laboratory recognition, especially with the recent introduction of serum ferritin and FEP measurements. It is helpful to classify iron deficiency into three stages. Storage iron depletion is identified by marrow examination or serum ferritin, iron deficient erythropoiesis by TS, FEP, or MCV, and iron deficiency anemia by hemoglobin concentration or therapeutic iron trial. Combinations of these measurements have been used in prevalence studies to obtain a quantitative measure of body iron stores. The optimal laboratory approach to diagnosing iron deficiency depends on the clinical setting. In the office or outpatient clinic, iron depletion is best recognized by the serum ferritin, although the TS, FEP, and MCV are helpful in gauging its severity. In hospitalized patients with overt anemia, the TS, FEP, and MCV are much less helpful because similar changes are seen in the anemia of chronic disease. Examination of marrow iron remains the method of choice, especially in patients with infection, chronic disease, malignancy, or liver disease, although in many clinical situations the same information can be obtained from a serum ferritin. Serial measurements of serum ferritin have been particularly useful in monitoring patients at high risk of iron deficiency such as those with rheumatoid arthritis, chronic inflammatory bowel disease, or chronic renal failure.
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PMID:Clinical evaluation of iron deficiency. 676 40

Microcytic red blood cells (RBC) are commonly encountered in clinical medicine and are caused by disorders of heme synthesis [usually iron deficiency anemia (IDA) or anemia of chronic disease (ACD)] or disorders of globin synthesis (usually thalassemia syndromes or HbE). Using the clinical history and standard laboratory tests (hematocrit, per cent saturation of transferrin (% sat), serum ferritin, Hb electrophoresis, HBA2, and HbF) we classified 198 adults with microcytic RBC as follows: 48 IDA, 11 probable IDA, 11 iron-deficient erythropoiesis without anemia, 13 ACD, 42 alpha-thalassemia trait, 35 probable alpha-thalassemia trait, 20 beta-thalassemia trait, and 15 unclassified. In addition, we demonstrated that the FEP test reliably (83-90% of the time, depending on FEP methodology) classifies microcytic RBC states into disorders of heme synthesis vs. disorders of globin synthesis. Because of reliability and ease of measurement, we recommend the hematofluorometer FEP as the first step in the clinical laboratory evaluation of microcytic RBC disorders in both adults and children.
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PMID:Free erythrocyte protoporphyrin (FEP) II. The FEP test is clinically useful in classifying microcytic RBC disorders in adults. 684 56

A method of loading macrophages from normal and inflammatory mouse peritoneal exudates with 59Fe using 59Fe, 125I-transferrin-antitransferrin immune complexes is described and the subsequent release of iron and degraded transferrin to the incubation medium has been studied. Release of iron occurred more rapidly from resident macrophages than from thioglycollate broth-induced (stimulated) macrophages, but degradation of the 125I-transferrin in the immune complexes was faster in stimulated cells. A small percentage of the iron released was in the form of ferritin. Desferrioxamine (1 mM) increased the release of iron from both stimulated and resident macrophages, the effect being proportionally greater in the stimulated cells. Ascorbic acid (1 mM) had no effect on the release of iron, nor did the addition of apotransferrin (1 mg/ml) to the culture medium. These results support the concept of a blockade of iron release by reticuloendothelial cells in states of inflammation, and suggest that it may be a primary cause of the anaemia of chronic disease.
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PMID:Release of iron by resident and stimulated mouse peritoneal macrophages following ingestion and degradation of transferrin-antitransferrin immune complexes. 731 89

The assessment of anemia in patients with rheumatoid arthritis may be difficult, especially when iron deficiency and the anemia of chronic disease coexist. The development of a radioimmunoassay for serum ferritin concentration has aided the detection of reduced body iron stores in uncomplicated iron deficiency, but its use is compromised in clinically active rheumatoid arthritis by the tendency of serum ferritin to behave as an acute phase reactant. In this latter role it correlated well with disease activity in the patients we studied. Followed serially, serum ferritin levels fell in patients whose disease activity improved after institution of appropriate therapy. In anemic patients with clinically inactive disease, supplemental iron was associated with a significant rise in hemoglobin when compared to untreated patients. Serum ferritin levels behaved independently of hemoglobin levels. Therefore even in clinically inactive rheumatoid arthritis, serum ferritin does not accurately reflect an iron deficiency.
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PMID:Relationship between serum ferritin, anemia, and disease activity in acute and chronic rheumatoid arthritis. 734 65

Eighteen patients with the anemia of chronic disease were studied to determine the usefulness and accuracy of image processing analysis of erythrocytes for diagnosis. Diagnostic tests used for comparison included estimates of serum ferritin, serum iron and iron-binding capacity, stainable marrow iron, and erythrocyte morphology as determined by standard methods. The findings show that the analyses obtained by image processing were diagnostic for 83% of the patients with chronic disease. Serum ferritin levels were supportive of diagnosis for 33% of the patients, and serum iron levels were useful for approximately 25% of the patients. Cell indices and marrow iron were of limited value. The study demonstrates that quantitative information obtained by digital image processing of erythrocytes can be very useful for the diagnosis of the anemia of chronic disease.
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PMID:Assessment of the anemia of chronic disease by digital image processing of erythrocytes. 740 94

A recent study by Ahluwalia and colleagues used a discriminant statistical analysis approach to determine that a combination of serum ferritin, plasma transferrin receptor concentration, and erythrocyte sedimentation rate was the optimal set of variables for differentiating iron deficiency and the anemia associated with chronic disease in a group of elderly women. Iron deficiency was defined as a significant response in hemoglobin concentration after iron supplementation. The findings of this study suggest that iron deficiency can be relatively common among elderly anemic women with rheumatoid arthritis. Use of these three biochemical measures should be clinically useful to differentiate iron deficiency in the anemia of chronic disease.
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PMID:Plasma transferrin receptor helps to predict iron deficiency in the anemia of chronic disease. 747 11


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