Ramli, Marini
(2006)
Detection of iron deficiency anaemia in anaemia of chronic disease patients in HUSM : a preliminary case control study.
Masters thesis, Universiti Sains Malaysia.
Abstract
Detecting iron deficiency anaemia (IDA) in anaemia of chronic disease (ACD) patients is
not easy, as the conventional laboratory indices of iron status are often influenced by
acute phase responses. The aim of the study is to determine the prevalence of iron
deficiency in ACD patients using various haematological tests and to compare with the
normal control.
Sixty ACD patients were purposively recruited while 25 controls were healthy volunteers
among the HUSM staffs. Both groups had to fulfill their inclusion and exclusion criteria
before they were tested to determine the iron status. Investigations for iron status
consisted of full blood picture with other haematological indices, serum ferritin, soluble
transferrin receptor (sTfR) and Transferrin receptor-ferritin index (TfR-F index).
Results showed that none of the controls were having iron deficiency anaemia.
Coexisting IDA in ACD group were detected 20% by sTfR, 16.7% by TfR-F index and
none using serum ferritin. There were significantly lower mean corpuscular volume
(MCV) and serum ferritin but higher for red cell distribution width (RDW) and sTfR. in
ACD group compared to the normal controls (P<O.OOl)
Comparing IDA cases and the non-IDA cases in the ACD group, there were significantly
lower mean corpuscular volume (MCV),mean cell haemoglobin concentration (MCHC)
and serum ferritin but higher for red cell distribution width (RDW) and sTtR (P<O.OOl),
The findings above pointed towards "IDA-like" profile and support the possibility of coexisting
iron deficiency anaemia. The mean sTtR level was not significantly different
between males and females in the control group. However, a weak correlation was noted
between age and sTfR levels.
In conclusion, a proportion of ACD patients had coexisting IDA and knowing this
coexistence will be beneficial, as it will assist in better management of these patients.
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