The soluble transferrin receptor (sTfR)-ferritin index is a potential predictor of celiac disease in children with refractory iron deficiency anemia

Clin Chem Lab Med. 2005;43(1):38-42. doi: 10.1515/CCLM.2005.005.

Abstract

The soluble transferrin receptor (sTfR) distinguishes iron deficiency anemia from other types of anemia. Refractory iron deficiency anemia is often the onset symptom in malabsorption-induced celiac disease. We evaluated whether sTfR levels distinguish celiac disease-associated iron deficiency anemia from iron deficiency anemia of other origin. To this aim we measured sTfR and ferritin levels and their ratio (the sTfR/ferritin index) and other hematological parameters in 42 anemic children (20 with and 22 without celiac disease) vs. 22 non-anemic children with celiac disease and 31 healthy controls (age range 4-12 years). Hemoglobin parameters, mean cell volume, and serum iron and ferritin levels were decreased to a similar extent in the anemic patients (celiac and non-celiac). The sTfR level in non-anemic celiac patients was similar to that of normal controls (1.7+/-0.35 mg/L), whereas it was significantly increased in non-celiac and celiac anemic patients (2.2+/-0.5 mg/L, p<0.05 and 2.7+/-1.2 mg/L, p<0.001, respectively). The sTfR/ferritin index was also increased more in the anemic celiac patients (mean 4.4, range 1.5-12.0) than in anemic non-celiac children (mean 2.6, range 1.4-4.0) compared with non-anemic children (mean 1.2, range 0.7-2.0). Differences were more pronounced when ferritin was <5 ng/mL. Thus, the sTfR/ferritin index may be a predictive measure in discriminating anemic patients with celiac disease from those without celiac disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anemia, Iron-Deficiency / diagnosis*
  • Anemia, Iron-Deficiency / etiology
  • Celiac Disease / complications*
  • Child
  • Child, Preschool
  • Erythrocyte Indices
  • Female
  • Ferritins* / blood
  • Hemoglobins / analysis
  • Humans
  • Iron / blood
  • Male
  • Predictive Value of Tests
  • Receptors, Transferrin / blood*
  • Retrospective Studies
  • Sex Factors
  • Solubility

Substances

  • Hemoglobins
  • Receptors, Transferrin
  • Ferritins
  • Iron