Estrategias diagnósticas utilizadas para detectar deficiencias de hierro subclínicas y asociadas a enfermedades crónicas
Diagnostic strategies for detecting subclinical iron deficiencies and associated to chronic diseases
NOVA por http://www.unicolmayor.edu.co/publicaciones/index.php/nova se distribuye bajo una Licencia Creative Commons Atribución-NoComercial-SinDerivar 4.0 Internacional.
Así mismo, los autores mantienen sus derechos de propiedad intelectual sobre los artículos.
Mostrar biografía de los autores
La homeostasis y las variaciones fisiológicas horarias en el metabolismo del hierro se constituyen en verdaderos desafíos para los expertos, quienes intentan diseñar pruebas altamente sensibles y específicas que cuantifiquen los niveles circulantes y de depósito de este elemento, su repercusión en la eritropoyesis, cuantificación de las proteínas, transportadores y receptores involucrados en el proceso, a fin de descartar la presencia de estados carenciales. Las deficiencias de hierro pasan por tres fases; las dos primeras son las más difíciles de identificar porque son subclínicas, más aún, cuando pueden cursar simultáneamente con enfermedades crónicas inflamatorias, infecciosas y neoplásicas que de por sí son anemizantes. En este trabajo se revisarán las principales pruebas de laboratorio utilizadas para la identificación de deficiencias de hierro, sensibilidad, especificidad, ventajas y limitaciones para su uso.
Visitas del artículo 280 | Visitas PDF 117
Descargas
- Instituto Nacional de Salud de Colombia. Deficiencia de hierro, vitamina A y prevalencia de parasitismo intestinal en la población infantil y anemia nutricional en mujeres en edad fértil. Santa Fe de Bogotá, Ministerio Nacional de Salud; 1996.
- Agudelo G, Cardona O, Posada M, Montoya M, Ocampo M, Marín C, et al. Prevalencia de anemia ferropénica en escolares y adolescentes, Medellín, Colombia, 1999. Pan Am J Public Health 2003; 13(6):376-86.
- De Maeyer E, Adiels-Tegman M. The prevalence of anaemia in the world. World Health Stat Q 1985; 38:302-16.
- Dallman PR, Yip R. Changing characteristics of childhood anemia (especial article). J Pediatr 1989; 114:161.
- Cook JD, Skikne BS. Estimates of iron sufficiency in the US population. Blood 1986; 68:726-31.
- Bothwell TH, Charlton RW. A general approach of the problems of iron deficiency and iron overload in the population at large. Seminars in Hematology 1982; 19:54.
- Birgegard G, Hellgran R, Killander A, Stromberg A, Venge P, Wide L. Serum ferritin during infection. Scand J Haematol 1978; 21: 333-40.
- Ferguson BJ, Skikne BS, Simpson KM, Baynes RD, Cook JD. Serum transferrin receptor distinguishes the anemia of chronic disease from iron deficiency anemia. J Lab Clin Med 1992; 119: 385-90.
- Noe G, Augustin J, Hausdolf S, Rich IN, Kubaneck B. Serum erythropoietin and transferrin receptor levels in patients with rheumatoid arthritis. Clin Exp Rheumatoid1995; 13:445-51.
- Ali M, Luxton AW, Walker W. Serum ferritin concentration and bone marrow iron stores: a prospective study. Scan Med Assoc J 1978; 118: 945-46.
- Pigeon C. A new mouse liver specific gene, encoding a protein homologous to human antimicrobial peptide hepcidin, is overexpressed during iron overload. J Biol chem 2001; 276:7806-10.
- Schaible U, Collins H, Priem F, Kaufman S. Correction of the iron overload defect in beta-2-microglobulin Knockout mice by lactoferrin abolishes their increased susceptibility to tuberculosis. J Exp Med 2002; 196:1507-13.
- Lipschitz DA, Cook JD, Finch CA. A clinical evaluation of serum ferritin as an index of iron stores. N Engl J Med 1974; 290:1213-6.
- Cook JD, Lipschitz DA, Miles LE, Finch CA. Serum ferritin as measure of iron stores in normal subjets. Am J Clin Nutr 1974; 27:681-7.
- Mast A, Blinder M, Gronowsky A, Shumley C, Scott M. Clinical Utility of the Soluble transferrin receptor and comparison with serum ferritin in several populations. Clin Chem 1998; 44:45-51.
- United Nations Children.s Fund, United Nations University, World Health Organization. Iron deficiency anaemia
- assessment, prevention and control. A guide for programme managers. Geneva: WHO; 2001.
- Punnonen K, Irjala K, Rajamäki A. Serum Transferrin Receptor and Its Ratio to Serum Ferritin in the Diagnosis of
- Iron Deficiency. Blood 1997; 89(3): 1052-7.
- Lee E, Oh EJ, Park YJ, Lee H, Kim B. Soluble Transferrin Receptor (sTfR), Ferritin and sTfR/log Ferritin Index in
- Anemic Patients with Nonhematologic Malignancy and Chronic Inflammation. Clin Chem 2002; 48:1118-21.
- Loria A, Hershko C, Konijin A. Serum ferritin in an elderly population. J Gerontol 1979; 34:521-4.
- Casale G, Bonora C, Migliavacca A, Zurita I, de Nicola P. Serum ferritin and aging. Age Ageing 1981; 10:119-22.
- Holyoake TL, Stott Dj, McKay PJ, Hendry A, McDonald JB, Lucie NP. Use of plasma ferritin concentration to diagnose iron deficiency in elderly patients. J Clin Pathol 1993; 46:857-60.
- Joosten E, Ghesquiere B, Linthoudt H. Upper and lower gastrointestinal evaluation of elderly inpatients who are iron deficient. Am J Med 1999; 107:24-9.
- Ruivard M, Boursiac M, Mareynat G. Diagnosis of iron deficiency: evaluation of the .soluble transferrin receptor/
- transferrin. ratio. Rev Med Interne 2000; 21:837-43.
- Worwood M, Thorpe SJ, Health A, Flowers C, Cook J. Stable lyophilized reagents for the serum ferritin assay. Clin
- Haematol 1991; 13:297-305.
- Flowers CH, Cook JD. Assessment of a Whole blood Spot method for the measurement of ferritin and transferrin receptor. FASEB J 1996; 10:A243.
- Ahluwalia N, Bulux J, Solomons N, Romero-Abal ME, Hernández M, Boy E. Ferritin concentrations in dried serum spots prepared by Standard compared whith simplified approaches: a validation study in Guatemala City. Am J. Clin
- Nutr 2005; 81: 1366-71.
- Ahluwalia N, Silva A, Atukorala S, Weaver V, Molls R. Ferritin concentrations in dried serum spots from capillary and venous blood in children in Sri Lanka: a validation study. Am J Clin Nutr 2002; 75: 289-94.
- Ahluwalia N, Lönnerdal B, Lorenz S, Allen L. Spot ferritin assay for serum simples dried on filter paper. Am J Clin Nutr 1998; 67:88-92.
- Flowers CH, Cook JD. Dried Plasma Spot Measurements of Ferritin and Transferrin Receptor for Assessing Iron Status. Clin Chem 1999; 45:1826-32.
- Haddad E, Moura I C, Arcos-Fajardo M, Macher MA, Baudouin V, Alberti O, et al. Enhanced expression of the CD71 mesangial Ig A1 receptor in Berger disease and Henoch- Schonlein nephritis: association between CD71 expressionand Ig A deposits. J Am Soc Nephrol 2003; 14 (2): 327-37.
- Brekelmans P, Van Soest P, Voerman J, Platenburg PP, Leenen PJ, Van Ewijk W. Transferrin receptor expression as a marker of immature cycling thymocytes in the mouse. Cell Inmunol 1994; 159 (2): 331-9.
- Vannelli BG, Orlando C, Barni T, Natali A, Serio M, Balboni GC. Immunostaining of transferrin and transferrin receptor in human seminiferous tubules. Fertil Steril 1986; 45 (4): 536-41.
- Zalata A, Hafez T, Schoonjans F, Comhaire F. The possible meanning of transferrin and its soluble receptors in seminal plasma as markers of the seminiferous epithelium. Hum Reprod 1996; 11 (4): 761-4.
- Moos T. Brain iron homeostasis. Dan Med Bull 2002; 49 (4): 279-301.
- Hayes GR, Williams A, Costello CE, Enris CA, Lucas JJ. The critical glycosylation site of human transferring receptor contains a high-mannose oligosaccharide. Glycobiology 1995; 5 (2): 227-32.
- Gross S, Helm K, Gruntmeir JJ, Stillman WS, Pyatt DW, Irons RD. Characterizacion and phenotypic analysis of
- differenciacing CD34+ human bone marrow cells in liquid culture. Eur J Haematol 1997; 59 (5); 318-26.
- Taylor A, Hogan BLM, Watt FM. Biosynthesis of EGF receptor,
- transferrin receptor and collagen by cultured human
- Keratinocytes and the effect of retinoid acid. Exp Cell Res
- ; 159: 47-54.
- Shih YJ, Baynes RD, Hudson BG, Flowers CH, Skikne BS, Cook JD. Serum transferrin receptor is a truncated form of tissue receptor. J Biol Chem 1990; 265(31): 19077-81.
- Kato J, Kobune M, Kohgo Y, Fujikawa R, Takimoto R, Torimoto Y. Ratio of Transferrin (Tf) to Tf-Receptor
- Complex in Circulation Differs Depending on Tf Iron Saturation. Clin Chem 2002; 48:181-3.
- Ahn J, Johnstone RM. Origin of a soluble truncated transferrin receptor. Blood 1993; 81: 2442-5.
- Baynes RD, Skikne BS, Cook JD. Circulating transferring receptors and assessment of iron status. J Nutr Biochem 1994; 5:322.
- Hoffbrand V, Lewis MS, Tuddenham E. Postgraduate Haematology. 4th en. London: Butterworth Heinemann
- International Editions, 1999, p 23-46.
- Kohgo Y, Niitsu Y, Kondo H. Serum transferrin receptor as a new index of erithropoiesis. Blood 1987; 70: 1955-8.
- Flowers CH, Skikne BS, Covell AM, Cook JD. The clinical measurement of serum transferrin receptor. J Lab Clin Med 1989; 114:368-77.
- Skikne B, Flowers C, Cook J. Serum transferrin receptor: A quantitative measure of tissue iron deficiency. Blood 1990; 75:1870-6.
- Ferguson BJ, Skikne BS, Simpson KM, Baynes RD, Cook JD. Serum transferrin receptor distinguishes the anemia of chronic disease from iron deficiency anemia. J Lab Clin Med 1992; 19: 385-90.
- Huebers HA, Beguin Y, Pootrakul P, Einspahr D, Finch CA. Intact transferrin receptors in human plasma and their relation to erythropoiesis. Blood 1990; 75: 102-7.
- Khumalo H, Gomo Z, Moyo V., Gordeuk V, Saungweme T, Rouault T, et al. Serum transferrin receptors are decreased in the presence of iron overload. Clin Chem 1998; 44:40-4.
- Beguin Y, Clemens GK, Pootrakul P, Fillet G. Quantitative assessment of erythropoiesis and fuctional classification of anemia based on measurement of serum transferrin receptor and erythropoietin. Blood 1993; 81:1067-76.
- Carmel R, Skikne BS. Serum transferrin receptor in the megaloblastic anemia of cobalamin deficiency. Eur J Haematol 1992; 49:246-50.
- Vikstedt R, Lode P, Takala T, Irjala K, Peltola O, Pettersson K, et al. Rapid One-Step Immunofluorometric Assay for
- Measuring Soluble Transferrin Receptor in Whole Blood. Clin Chem 2004; 50(10): 1831-3.
- Zeng L, Sharieff W. Comments on Use of Combined Measures from Capillary Blood to Assess Iron Deficiency in Rural Kenyan Children. J Nutr 2004; 134:1844-5.
- Rimon E, Levy S, Sapir A, Gelzer G, Peled R, Ergas D, et al. Diagnosis of iron deficiency anemia in the elderly by transferrin receptor . ferritin index. Arch Intern Med 2002; 162: 445-9.
- Looker AC, Loyevsky M, Gordeuk VR. Increased Serum Transferrin Saturation Is Associated with Lower Serum Transferrin Receptor Concentration. Clin Chem 1999; 45: 2191-9.
- Dowlati A, R´Zik S, Fillet G, Beguin Y. Anaemia of Lung cancer is due to impaired erythroid marrow response to
- erythropoietin stimulation as well as relative inadequacy of erythropoietin production. Br J Haematol 1997; 97:297-9.
- Suominen P, Punnonoen K, Rajamäki A. Serum transferrin receptor and transferrin receptor.ferritin. Index Identify
- Healthy Subjects with subclinical iron deficits. Blood 1998; 92 (8): 2934-39.
- Fairbanks VF, Beutler E. Iron deficiency. In: Beutler E, Lichtman MA, Coller BS, et al, edts. Williams Hematology.
- th ed. New York, NY: Mc Graw Hill Medical Publishing Division; 2001:447-70.
- ----------------------------------------------------------------------------
- DOI: http://dx.doi.org/10.22490/24629448.337