Demir eksikliği anemisi ve kronik hastalık anemisinin ayırıcı tanısında eritrosit indeksleri, eritrosit dağılım genişliği ve serum ferritin düzeylerinin değeri

Demir eksikliği anemisi (DEA) ve kronik hastalık anemisi (KHA) birbirleriyle en çok karışan anemi türleridir. Anemili hasta ve kontrol gruplarında serum ferritin düzeyi eritrosit dağılım genişliği (RDW) ve eritrosit indekslerinin anemilerin ayırıcı tanısındaki rolü araştırıldı. Demir eksikliği anemisi grubu (44 hasta), KHA grubu (41) ve DEA+KHA (17) olan olgular ve kontrol grubu (50) karşılaştırıldı. Tüm olgular hemogram, serum ferritin düzeyleri, sedimantasyon ve KHA’sı hastalar ek olarak kemik iliği demir boyasıyla değerlendirildi. Hem DEA hem de KHA’da ortalama eritrosit volümü (MCV) ve ortalama eritrosit hemoglobin (MCH) düşükse de DEA grubunda bu daha belirgindir (p

Anahtar Kelimeler:

Hemoglobinler, Eritrosit hacmi, Anemi, Kronik hastalık, Eritrosit indeksleri, Ferritin, Anemi, demir eksikliği, Tanı, ayırıcı

The value of erythrocyte indices and red cell volume distribution width in differential diagnosis of iron deficiency anemia and anemia of chronic disease

Iron deficiency anemia (IDA) and anemia of chronic disease are the most commonly confused anemias. We investigate the diagnostic value of erythrocyte indices, red cell volume distribution width, and serum ferritin levels to make differential diagnosis of anemia in controls and anemic patients. Iron deficiency anemia (44 patients), anemia of chronic disease (41), IDA with anemia of chronic disease (17) and control (50) groups were compared. We performed serum ferritin, CBC, and sedimentation rate in all patientsand bone marrow aspiration in patients with anemia of chronic disease. Although mean cell volume (MCV) and mean corpuscular hemoglobin (MCH) are low in IDA and anemia of chronic disease, it is much striking in the former one (p<0.001, p<0.001). Only 7.3% of patients with anemia of chronic disease had a MCV<70 fL and MCH<24 pg, 90.0% of patients with IDA were below that cut-off point. Serum ferritin means were in patients with IDA and anemia of chronic disease were 4.6±3.3 and 489.6 ±519.9 ng/ml, respectively. The probability of IDA is low when RDW is normal in microcytic anemias. RDW is high in half of patients with anemia of chronic disease. Reference values for ferritin must be changed in patients with anemia of chronic disease and IDA. If serum ferritin is 57.6-146.4 ng/ml anemia of chronic disease and iron deficiency must ruled out by other diagnostic tests.

Keywords:

Hemoglobins, Erythrocyte Volume, Anemia, Chronic Disease, Erythrocyte Indices, Ferritins, Anemia, Iron-Deficiency, Diagnosis, Differential,

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