pediatrik yaş grubu çeşitli anemik hastalıkların ayırıcı tanısında ...

7. SUMMARY
Diagnostic Significance Of Serum Soluble Transferrin Receptor In Various
Pediatric Anemic Diseases And Relationship Other Haematologic And
Biochemistrycal Parameters
Iron deficiency anemia (IDA), which is the most common cause of anemia
im childhood, also is the most common disease in the world. Having been shown that
iron deficiency occuring in infancy has serious negative effects on development of
neural and motor system, the importance of early diagnosis and treatment of IDA has
become more clear. In spite of its wide occurance, IDA can be difficult to distinguish
from other causes of microcytic hypochromic anemia, notably the anemia of chronic
inflammation, infection, or malignancy. The commonly used laboratory parameters
often do not discriminate between the various causes. Serum soluable transferrin
receptor (sTfR) is a marker which is used to analyse erythropoiesis without an
invazive procedure. sTfR is a reliable parameter in evaluation of functional iron
capacity and erythropoietic activity in adults but there has been few studies to show
the importance of sTfR in anemia. In this study, the importance of sTfR in addition
to hematological and biochemical parameters, and also the reliability of clinically
used parameters were assessed to evaluate erythropoietic activity and existence of
iron deficiency in children with various causes of anemia, such as iron deficiency
anemia, chronic renal failure, anemia of chronic infection, aplastic anemia,
thalassaemia major, acute leukemia, without bone marrow evaluation.
sTfR, unlike ferritin, is not an acute phase reactant.It is used to distinguish
between iron deficiency anemia and anemia due to chronic inflammation, to
diagnose subclinical iron deficiency in pre-anemic stage, and also is used to find out
iron deficiency in chronically active diseases. sTfR value is raised in conditions such
as hemolytic anemia which has high degree of erythropoietic activity, thalassaemias
with ineffective erythropoiesis and in megaloblastic diseases. As opposite, it is
lowered in chronic renal failure, intense cancer treatment, aplastic anemia,
hypertransfusion which cause bone marrow hypoplasia. In addition to stfR value,
evaluating MCV, ferritin and Epo levels add a significant value for diagnosis.
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