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Anemia of chronic disease: which tests?

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by aquariusgirl, Jun 24, 2012.

  1. aquariusgirl

    aquariusgirl Senior Member

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    hi, i suspect i have anemia of chronic disease. I would like to run some blood tests to confirm this. I was thinking ferritin, ZPP, TIBC. Not sure if I need serum iron. Any thoughts? Thanks.
     
  2. Ema

    Ema Senior Member

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    Serum iron, TIBC/UIBC, %sat, and ferritin should be sufficient.
     
  3. Emootje

    Emootje Senior Member

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    I think that ZPP is the best test to diagnose anemia of chronic disease because it is a end point control of the whole iron metabolism.

    "ZPP is not a simple parameter of iron deficiency but rather
    a screening parameter of iron deficient erythropoiesis, surveying
    all steps of the iron metabolism from iron uptake to
    its utilization. Thus, the ZPP determination can serve as a
    kind of “end point control” of the whole iron metabolism,
    which detects real iron deficiency as well as derangements of
    iron metabolism in chronic inflammatory and neoplastic
    disease in sideroblastic disorders, eg, myelodyplasias,
    or after lead poisoning"
    http://bloodjournal.hematologylibrary.org/content/81/5/1200.full.pdf
     
    merylg likes this.
  4. Emootje

    Emootje Senior Member

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    Hepcidin could also be helpful.
     
  5. Ema

    Ema Senior Member

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    I agree that the ZPP test can be interesting but the serum iron, TIBC/UIBC and ferritin are more key in my opinion. I had a mildly high ZPP test.

    A full iron panel is only about $25 whereas the ZPP test is a lot more expensive and doesn't provide any additional information from a practical (do i need iron and how much?) standpoint.

    Further the ZPP test does not provide any information about the body's ability to safely supplement and store iron. So even if the ZPP was high, one would still need the TIBC/UIBC to know how much iron to take without getting unpleasant symptoms of free iron.
     
  6. Emootje

    Emootje Senior Member

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    I think it's best to test them all (iron, transferritin, ferritin and ZPP).
    In the Netherlands the ZPP test is about 17 euro, so it's affordable.
    My ZPP test was also mildly high...
     
  7. aquariusgirl

    aquariusgirl Senior Member

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    Ok, thanks.
     

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