Author/Editor     Preložnik-Zupan, Irena; Lenart, Katarina
Title     Klinični pomen novih metod (količina hemoglobina v retikulocitih in hipokromni eritrociti) za oceno pomanjkanja železa v telesu
Translated title     Clinical utility of new diagnostic approaches (reticulocyte hemoglobin content and hypochromic red cells) for iron deficiency states
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 73, št. 6
Publication year     2004
Volume     str. 499-502
Language     slo
Abstract     Background. Classical iron deficiency does not represent a particular diagnostic challenge for the clinicians. However, in several more complicated clinical conditions, classical biochemical indices such as serum iron, transferrin saturation and ferritin may not be informative enough to reflect transient iron-deficient states and functional iron de ficiency. It is defined as an imbalance between iron needs of the erythroid marrow and the iron supply. Two hematological parameters, the proportions of hypochromic red cells (hypoE) and reticulocyte hemoglobin content (CHr), have major value in this setting. Conclusions. CHr and hypoFprovide a useful new approach to the diagnosi,s of iron-deficient states. CHr is an early marker of functional iron deficiency, as reticulocytes exist in the circulation for only 1-2 days. Because erythrocytes have a lifespan about 120 days, the hypoE is able to provide information over a several month period and is a late indicator of iron-restricted erythropoiesis. With these new parameters identification of iron deficiency could be improved in some clinical conditions such as erythropoietin therapy, anemia of chronic disease, iron deficiency of early childhood and in the illicit use of erythropoietin for blood doping of competitive athletes. We have already introduced both new methods in clinical practice with cooperation between Department of hematology and Institut for Clinical Chemistry and Biochemistry.
Summary     Izhodišča. Anemija zaradi pomanjkanja železa ne predstavlja posebnega diagnostičnega problema za zdravnika. V bolj zapletenih stanjih pa klasični biokemični kazalci pomanjkanja železa, kot so koncentracija železa, nasičenost transferina in koncentracija feritina v serumu, niso dovolj zanesljivi za oceno stanj s prehodnim, funkcionalnim pomanjkanjem železa. Gre za neravnovesje med potrebami in oskrbo kostnega mozga z železom. V takšnih stanjih sta v pomoč dva hematološka kazalca: količina hemoglobina v retikulocitih (KHr) in delež hipokromnih eritrocitov (hipoE). Zaključki. KHr in hipoE sta pomembna nova diagnostična kazalca za oceno pomanjkanja železa v telesu. KHr je zgodnji kazalec zlasti prehodnega, funkcionalnega pomanjkanja železa, ker je življenjska doba retikulocitov v krvi 2-2 dni. HipoE dajejo oceno večmesečnega obdobja, ker je življenjska doba eritrocitov okoli 120 dni in so pozni kazalec okrnjene eritropoeze zaradi pomanjkanja železa. Z njima lahko izboljšamo oceno pomanjkanja železa, še posebej v stanjih, kot so zdravljenje z eritropoetinom, anemija pri kroničnih boleznih, pomanjkanje železa v zgodnjem otroštvu in odkrivanje nedovoljene uporabe eritropoetina v športu. Obe metodi smo ob sodelovanju Kliničnega oddelka za hematologijo in Kliničnega inštituta za klinično kemijo in biokemijo že uvedli v klinično uporabo.
Descriptors     IRON
ANEMIA, IRON-DEFICIENCY
ANEMIA, HYPOCHROMIC
RETICULOCYTE COUNT
HEMOGLOBINOMETRY
RETICULOCYTES
ERYTHROPOIETIN, RECOMBINANT