Question
Which of the following test is best in differentiating between anemia of chronic inflammation and IDA?
| A. |
Serum transferrin receptor
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| B. |
TIBC
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| C. |
Serum ferritin
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| D. |
Transferrin saturation
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Show Answer
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Correct Answer � A
Explanation
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- Ans.A. Serum transferrin receptor
- The serum transferrin receptor is elevated in IDA but not in ACD. Serum Ferritin is an acute-phase reactant that can be falsely elevated.
- It has been shown by many studies that the Transferrin Receptor/log of ferritin is more accurate in differentiating between IDA and ACD The gold standard for IDA is absent stainable iron in BM aspirate but it has drawbacks, for example, it is invasive procedure and difficulty in differentiating from artifacts within macrophages.
- Iron in bone marrow aspirate (stained with Prussian blue) can be found as storage Iron in the cytoplasm of macrophages or as functional iron (siderosome) in the nucleated red cell (sideroblast).
- Approximately 1/3rd of nucleated red cells contain 1- 4 fine blue inclusion bodies (siderosome). Both sideroblast and macrophage iron is increased in ACD.
