Ratio serum transferrin receptor/serum ferritin in the diagnosis of iron deficiency.

Objective. - This study was aimed at determining the diagnostic value of co nventional laboratory tests regarding the iron status and serum transferrin receptor in hospitalized patients. Methods. - Patients who had to undergo bone marrow aspirate examination wer e included in this 8-month prospective study. Iron deficiency was defined a s the absence of stainable iron on bone marrow examination. Patients with s tainable iron were included in the control group. The higher value of diagn ostic efficacy determined the cut-off Value for each parameter of the iron status. Results. - Twenty-one patients (17 females, four males) (mean age: 52 years ) with iron deficiency and 33 central subjects (20 females, 13 males) (mean age: 60 years) were included in the study The ratio serum transferrin rece ptor/serum ferritin had the best diagnostic efficiency (78%) with a sensiti vity of 81% and a specificity of 97%. Serum ferritin alone with a cut-off v alue of 60 mug/L had the same specificity (97%) but a lower sensitivity (76 %). The diagnostic Value of ail other analyzed tests was below 66% (transfe rrin alone, mean corpuscular Volume, transferrin saturation, iron, serum tr ansferrin receptor alone, red cell distribution width). Conclusion. - Among in-patients ferritin remains the first intention test t o diagnose iron deficiency, but the cut-off Value should be increased (60 m ug/L in this study). The ratio "serum transferrin receptor to serum ferriti n" provides the highest specificity with a higher cost and should be used o nly in doubtful cases. (C) 2000 Editions scientifiques et medicales Elsevie r SAS.