среди госпитализированных, только ферритин мог выявить дефицит железа как отсутствие железа в костном мозге: ферритин менее 80 указывал на жд без воспаления; с воспалением СРБ более 5 - ферритин менее 200 и железо/ожсс менее 13%; данная работа выполнена на реагентах Рош, поэтому ферритин 80 = еквивалентен 50, а 200 = ~ 125
The study included 139 patients. 42 had BM ID, with a median serum ferritin (SF) of 48.5 μg/L. 96 of 134 (72%) had inflammation with a CRP >5 mg/L. An SF of <80 μg/L had optimal sensitivity (69%) and specificity (94%) for ID diagnosis in the whole group (odds ratio 23.5; 95% confidence interval 4.3-129). In patients without inflammation, an SF cut-off of 80 μg/L had high sensitivity (93%) and specificity (96%). An SF <200 μg/L indicated ID in those with inflammation (sensitivity 78%, specificity 74%). A transferrin saturation of <13% in those with inflammation increased the diagnostic specificity (92%). The reticulocyte haemoglobin was unhelpful in diagnosing ID in this setting. In this hospital population, SF was the best parameter to diagnose ID, even in the presence of inflammation.
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Pathology. 2024 Sep 18:S0031-3025(24)00232-0.
From the marrow to the blood: optimising the diagnosis of iron deficiency in the setting of inflammation.
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