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Soluble transferrin receptor as an index of iron status in Zaïrian children with malaria
S Kuvibidila1, J A Mark, R P Warrier
1Louisiana State University Medical Center, Pediatrics, Division of Hematology/Oncology, New Orleans 70112, USA.
Insights
Soluble transferrin receptor (sTfR) may be a more sensitive indicator of iron deficiency in children with malaria than serum ferritin. Despite overlap, some children with malaria showed elevated sTfR levels, suggesting potential iron status issues.
Area of Science:
- Pediatrics
- Hematology
- Infectious Diseases
Background:
- Iron deficiency is a common nutritional problem in children.
- Malaria can affect iron status and lead to anemia.
- Accurate assessment of iron status is crucial for effective treatment.
Purpose of the Study:
- To evaluate soluble transferrin receptor (sTfR) as an index of iron status in children with and without malaria.
- To compare the sensitivity of sTfR and serum ferritin in detecting iron deficiency in this population.
Main Methods:
- Enzyme-immunoassay was used to measure sTfR.
- Haemoglobin and ferritin levels were measured using cyanmethaemoglobin and radioimmunoassay, respectively.
- Study included children aged 0.5-16 years with symptomatic malaria, asymptomatic malaria, and healthy controls.
Main Results:
- Mean haemoglobin was lower and ferritin higher in children with symptomatic malaria compared to controls.
- sTfR concentrations showed considerable overlap across all groups, including healthy adults.
- Elevated sTfR levels, above adult normal ranges, were observed in some children with malaria and controls.
Conclusions:
- Soluble transferrin receptor (sTfR) may be a more sensitive indicator of iron deficiency than serum ferritin in children with malaria.
- Further research is needed to establish normal sTfR ranges for healthy children.
- sTfR could be a valuable tool for assessing iron status in pediatric malaria patients.
Abstract:
This study was designed to evaluate soluble transferrin receptor (sTfR) as an index of iron status in 0.5-16-year-old Zaïrian children: 17 with symptomatic malaria, 8 with asymptomatic malaria, and 15 controls. sTfR was also measured in 20 plasma samples obtained from iron sufficient laboratory employees. sTfR, haemoglobin and ferritin were measured by enzyme-immunoassay, cyanmethaemoglobin method, and radioimmunoassay respectively. Mean haemoglobin levels were lower and ferritin higher (P < 0.001) in children with clinical symptoms of malaria than in those without malaria, and they were intermediate in those with asymptomatic malaria. Mean sTfR concentrations were similar among the three groups of children and laboratory controls. There was a considerable overlap in sTfR concentrations between the three groups of children (1.8-10.2, 2.9-11.6 and 2.97-8.95 mg 1(-1) in symptomatic malaria, asymptomatic malaria and control groups, respectively) as well as laboratory controls (1.2-7.30 mg l-1). Despite the overlap, 6 children with malaria (24%) and one control child (6.7%) had sTfR concentrations above the highest concentration found in laboratory controls. No child had serum ferritin < 12 micrograms l-1 (suggestive of iron deficiency). As expected, sTfR negatively correlated with ferritin (r = -0.230) in the overall study population of children, and with haemoglobin in children with asymptomatic malaria (r = -0.943, P < 0.05), as well as in control children (r = -0.363). All children with sTfR above normal were also anaemic. Although the upper limit of normal sTfR concentration in healthy children is unknown, using the cut-off value of adults, we conclude that sTfR might be a more sensitive index of iron deficiency than serum ferritin in patients with malaria.
