Diagnostic Utility of the Soluble Transferrin Receptor/Log Ferritin Index in Distinguishing Iron Deficiency Anemia from Anemia of Chronic Disease in Inflammatory Bowel Disease: A Cross-Sectional Study

 Document Type : Scientific Research

Authors

1 Internal Medicine Department, Ain Shams University, Cairo, Egypt.

2 Internal Medicine Department, Armed Forces College of Medicine, Cairo, Egypt.

3 Internal Medicine Department, Ghamra Military Hospital, Cairo, Egypt.

4 Clinical Pathology Department, Military Medical Academy, Cairo, Egypt.

5 Internal Medicine Department, Gastroenterology and Hepatology Unit, Ain Shams University, Cairo, Egypt.

6 Internal Medicine Department, Armed Forces College of Medicine, Cairo, Egypt

Abstract

Background: Anemia is a prevalent complication of inflammatory bowel disease (IBD). Anemia of chronic disease (ACD) and iron deficiency anemia (IDA) are the two most common subtypes encountered. Although serum ferritin level is the classic determinant of IDA, it increases in IBD activity as an acute-phase reactant, thereby impairing its diagnostic utility. Patients and methods This cross-sectional study included 79 cases of IBD and anemia, distributed into three groups based on serum ferritin levels: Group 1 (<30 µg/L: n = 19), Group 2 (30-100 µg/L: n = 30), and Group 3 (>100 µg/L: n = 30). Laboratory tests, including iron studies, inflammatory markers, and the soluble transferrin receptor/log ferritin Index (sTfR-F), were measured and compared. Aim: To determine the ability of sTfr-F to differentiate between IDA and ACD in Egyptian patients with IBD. Results: Baseline demographics, IBD type, and inflammatory markers showed no significant differences among the 3 groups (P > 0.05). While hematological parameters, including hemoglobin, iron, ferritin, TIBC, and sTfR-F, differed significantly (p ≤ 0.01). The sTfR-F ranged from 3.5 ± 0.67 in group 1 to 2.45 ± 0.68 in group 2 to 1.46 ± 0.42 in group 3. It identified ACD in 20% of group 2 patients and occult IDA in 26.7% of group 3 patients. It showed an ROC-AUC of 0.999, with 97.8% sensitivity and 92.9% specificity, for differentiating IDA from ACD at a cut-off value of 2.1. Conclusion: The sTfR-F is superior to ferritin in differentiating IDA from ACD in IBD patients. It can also exclude IDA in patients with moderate ferritin elevation (30-100 µg/L) and confirm IDA in patients with high ferritin levels (>100 µg/L). This allows treatment optimization.

Comments

Post a Comment