VALUE OF SERUM TRANSFERRIN RECEPTOR LEVELS IN ASSESSING IRON STATUS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Background: It is difficult to assess iron status in patients with chronic inflammatory conditions such as inflammatory bowel disease (IBD). Currently available tests including serum ferritin and transferrin saturation have limitations in differentiating Iron Deficiency Anaemia (IDA) from Anaemia of Chronic Disease (ACD). Serum soluble transferrin receptor (sTfR) level has been proposed as a potential tool to identify iron deficiency in patients with chronic inflammation.  sTfR levels are not influenced by inflammation and high levels are thought to represent iron deficiency. Methods: The aim of our study was to examine the value of sTfR in the assessment of iron status in patients with IBD. The study comprised of 154 patients with IBD, diagnosed on clinical, endoscopic, histological and/or radiological findings. They were compared with age and sex matched healthy controls (n=209). All patients and controls had blood investigations comprising haemoglobin (Hb), serum B12, red cell folate, ferritin, transferrin, serum iron and sTfR.  Iron deficiency was considered to be present in anaemic patients  ( IDA group ) if both ferritin and serum iron levels were low,  0.05 ) or with IBD patients without anaemia (n=93) 1.62 +/_ 0.78 mg/l ( P>0.05 ). These results were also not significantly different to healthy controls (n=209) 1.55 +/_ 0.60 mg/l. Conclusions: Anaemia is common in patients with inflammatory bowel disease. There were no significant differences in the sTfR levels in patients with inflammatory bowel disease irrespective of iron status compared with healthy controls. The early promise of sTfR as a useful tool in differentiating iron deficiency anaemia from anaemia of chronic disease has not been confirmed.