Determination of soluble transferrin receptor (sTfR) and transferrin index (TfR-index) seem to be reliable tools in diagnostics. Data of 425 patients with different diagnoses have been examined to obtain basic parameters of their Fe metabolism. In 153 of them anemia was diagnosed. In 111 patients the TfR index was determined while anemia was diagnosed in 27 individuals. In the case of anemia diagnosis based on hemoglobin values and morphological classification of mean cell volume (MCV) the most important indicators proved to be transferrin and ferritin with Fe binding capacity. The Mann-Whitney U-test revealed that this patient group showed significantly lower average values of transferrin, Fe, folate and higher values of sTfR. The sTfR and TfR index are appropriate tools in the diagnosis of anemia in heterogeneous populations.
Anémia u pacientov s chronickými infekčnými, zápalovými a neoplastickými ochoreniami, ktorá nie je v dôsledku prvotného ochorenia kostnej drene, je známa ako anémia chronických ochorení (ACD) a je jednou z najbežnejších syndrómov v medicíne. Spoločným znakom ochorení združených s ACD je zvýšená produkcia cytokínov ktoré sprostredkovávajú imunitnú alebo zápalovú odpoveď a ACD môže byť vysvetlená systémovým efektom zápalu, ktorý vedie k anémii depresiou erytropoézy. Všetky procesy, zúčastňujúce sa vo vývoji ACD vrátane skráteného prežívania erytrocytov, zníženej odpovede erytropoetinu (EPO) na anémiu, porušenej odpovede erytroidných prekurzorov na EPO a abnormálnej mobilizácie zásob retikuloendote-liálneho železa, môžu byť prisudzované cytokínom. Rozvoj ACD je modifikovaný základným ochorením. ACD je často nesprávne hodnotená, a preto zle liečená. Správne rozpoznanie tohto syndrómu je dôležité pre adekvátnu liečbu.
Anemia in patients with chronic infectious, inflammatory and neoplastic diseases, which is not the consequence of primary bone marrow disorders, is known as anemia of chronic disease (ACD) and it is one of the most common syndromes in medicine. The common sign of diseases associated with ACD is the overproduction of cytokins, which mediate the immune and inflammatory response, and ACD can be elucidated as a systemic effect of inflammation, which leads to anemia through erythropoiesis depression. All processes which take place in the development of ACD, including erythrocyte survival shortening, decreased erythropoietin (EPO) response to anemia, impaired erythrocyte progenitor response to EPO and abnormal mobilisation of deposited reticuloendothelial iron, may be a consequence of cytokine action. Development of ACD is also modificated by the underlyind disease. ACD is often misdiagnosed and consequently treated inadequately.The good recognition of this syndrome is very important for adequate therapy.
