[THE DIFFERENTIAL DIAGNOSTIC POSSIBILITIES IN EVALUATION OF IRON-DEFICIENT CONDITION UNDER ANEMIAS]

The article presents data concerning differential diagnostic possibilities of evaluation of genuine iron-deficient anemia and anemia of chronic diseases. The variety of mechanisms of development of anemia of chronic diseases is demonstrated, including effect of humoral inhibitors of erythropoiesis, disorder of iron metabolism at the expense of its redistribution into cells of macrophage system, suppression of erythropoiesis resulted in redistributed or functional iron deficiency. The data is presented concerning significance in diagnostic of anemia of chronic diseases of such factors as content of ferritin, dissolving receptors of transferrin and role of hepcidin protein in pathogenesis of anemia of chronic diseases. The analysis of scientific publications demonstrated that hepcidin is a negative regulator of iron metabolism. Under iron-deficient anemia its level in blood decreases that contribute to extensive absorption of iron in gastrointestinal tract. On the contrary, under anemia of chronic diseases its content drastically increases and results in blocking of iron transport everywhere, including internal epithelium, macrophages, placenta and other types of cells. The hyper-production of hepcidin during infection and inflammation is responsible for anemia of chronic diseases. The perspectives of development of pharmaceuticals decreasing level of hepcidin for treatment of anemia of chronic diseases is demonstrated.