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AL VALUES: Adult Aged Child. Newborn to 2 years 4 months Mayor TRANSFERRIN • • • Adult: 200-400 mg / 100 ml Newborns: 130-275 mg / 100 ml Children: 203-360 mg / 100 ml 250-450 ¶ g/100 ml and adults 60 ¶ g/100 ml -175 100-400 350-400 ¶ g/100 ml ¶ g/100 ml Iron is needed to produce hemoglobin, the iron is stored in different components . Transferrin, also called siderofilina is a beta globulin carrier protein that regulates the absorption of iron. The abundance of transferrin is related to the ability of the body to attack certain infections. The iron-binding capacity is correlated with serum transferrin, but this relationship is not linear. A test o f serum iron and transferrin without CFTH has very limited value with exceptions in cases of iron poisoning. Transferrin saturation is a better index of iron sa turation values as follows. Saturation = serum iron x 100 / CFTH Iron enters the body in the ferrous state. Once absorbed it transports a protein called the iro n. It combined the iron combines its ferric state. The ability to combine with i ron transferrin is measured as iron-binding capacity and its concentration has a constable consistency. Usually, but not always, conditions that lower concentra tions of serum iron increases the total fixation, ie, the more iron available to bind, the greater the number of total binding sites, that is, the more iron ava ilable to bind, the greater the number of empty binding sites. The ability to se t transferrin iron is about three times the normal serum iron. Usually the perce ntage saturation of TFH is calculated when the latter practice. This percentage represents the ratio of serum iron with the concentration CTHF. It follows a diu rnal pattern to a large extent, similar to serum iron, with its highest value du ring the morning and the lowest, in the late afternoon and start the evening. Va lues below 15% indicate a deficiency of iron deficiency anemia or iron-deficient erythropoiesis. CLINICAL UTILITY • The combination of transferrin, iron and CFTH is very useful in the differential diagnosis of anemia in the assessment of iron deficiency ane mia and thalassemia, and sideroblastic anemias of hemochromatosis. CLINICAL SIGN IFICANCE transferrin increases in: • iron deficiency anemia. • Pregnancy. • estr ogen therapy. • Contraceptives. Transferrin decreases in • macrocytic anemia of chronic disease. • protein deficiency or loss of burns. • Chronic infection. • M alnutrition. • Kidney. • genetic deficiency. The iron-binding capacity increases in: • iron deficiency. • Use of contraceptives. • Pregnancy. • Chronic and acut e hemorrhage. • Acute hepatitis. The iron-binding capacity decreases in • Hypopr oteinemia (malnutrition and burns). • Hemochromatosis. • Anemia (infection and c hronic diseases). • Cirrhosis of the liver. • nephrosis and other renal disease. • Anemias indefinite non-iron. PREPRACION PATIENT: No s e required. Ferritin serum iron Introduction ferritin, ferric hodroxido complex and a protein, apoferririna, ori ginates in the system reticuloendoelial. Ferritin reflects iron stores and is a good indicator on the study of these stores. METHODS • SAMPLE • Serum Assay (ELI SA) test fluoroenzimunometrico, colorimetric, inmunoenzimometrico, radiometrito. STORAGE • Room temperature: 8 hours Refrigerated: 2 days, Frozen: 3 months. CON TRAINDICATIONS • Sera severely hemolysates not repeatedly freeze and thaw the sa mples. Strongly mixing may denature ferritin. NORMAL VALUES AGE 0-6 months 7-36 months 3-14 years 20-29 years 15-19 years 30-39 years 40-49 years> 50 years MEN 6-400 ng / ml 12-57 ng / mL 14-80 ng / ml 20-155 ng / ml 38-270 ng / ml 48-420 n g / ml 30-490 ng / ml 30-530 ng / mL WOMEN 6-430 ng / ml 12-60 ng / ml 12-73 ng / ml 12-90 ng / ml 12-114ng/ml 12-160ng/ml 12-240ng/ml 18-340ng/ml Ferritin is a major iron storage in the body, is a high molecular weight protein that correlates with total body stores of iron. It is found in all body cells, but mainly in the cytoplasm of reticuloendothelial cells and liver. Its
measurement (quantification) is an accurate reflection of intracellular stores o f iron. When performed along with measurements of serum iron and CTHF, there is a more complete diagnostic picture, which can eliminate the need for bone marrow examination for the diagnosis of iron deficiency. In the presence of liver dise ase, with inflammation in rheumatoid arthritis as in malignant diseases appearin g or iron therapy, iron deficiency may not be reflected by low levels of serum f erritin. Ferritin determinations are not reliable in children who are under trea tment with iron. The bone marrow aspirate may be necessary in some pictures, suc h as low or normal ferritin and serum iron in the presence of chronic anemia, lo w or normal ferritin in the presence of liver disease. The serum ferritin is ano ther more reliable indicator of body iron stores. When combined serum iron and p ercentage saturation binding capacity and transferrin, they can differentiate mi crocytic hypochromic anemias of iron deficiency anemia (low ferritin, low iron, low saturation, high binding capacity, transferrin high), the anemia of chronic disease (normal or high ferritin, low iron, transferrin binding capacity is norm al or low) or thalassemia (ferritin normal or high). The deficiency of iron, the distribution width of red blood cells is increased, while this is normal in het erozygous alpha or beta thalassemia. Erythrocyte corpuscular volume is reduced b y iron deficiency and beta and alpha thalassemia. In adults, ferritin levels les s than or equal to 10 ng / ml indicate iron deficiency. It has been shown that ferritin declines during adolescence due to the onset of menarche as a result more like the accompaniment of growth. High ferritin levels in patients with cancer and are associated with very poor prognosis, partly due to the biological effects of tumor ferritin on the role of lymphocytes and gran ulocytes. There are many data accumulated about the nature of the isoferritinas and the relationship and its possible use in the assessment of malignancy. An im munological test using mixtures of monoclonal anti-H subunit and anti-L has been shown to recognize isoferritinas intermediate but have not found significant ap plication in monitoring the tumor. CLINICAL UTILITY test is used to differentiat e iron deficiency anemia other hypochromic microcytic anemias s, it is a specifi c indicator that other standard tests. Can also be used to monitor iron stores i n hemodialysis patients with chronic renal failure, or to monitor therapy for pa tients with a deficiency or iron overload. Diagnosis hypochromia, microcytic ane mia. Decrease in iron deficiency anemia and increased iron overload. Ferritin le vels are correlated and are used in the evaluation of the total deposits of iron in the body. In hemochromatosis, both the ferritin and iron saturation are incr eased. Ferritin levels in hemochromatosis can be greater than 1000 ng / ml. Ferritin concentrations increased: The levels of serum ferritin levels may be as sociated with inflammation, liver disease, megaloblastic anemia, hemolytic anemi a, sideroblastic anemia, thalassemia, iron overload (hemochromatosis, hemosidero sis), and malignancies. Oral or injected iron increases levels of ferritin. When this increased serum ferritin may be a risk of primary hepatocellular carcinoma . Primary hemochromatosis is inherited as an autosomal recessive undertakes prel iminary evidence that the gene locus linked to histocompatibility complex on chr omosome 6. An inappropriate increase in the absorption of iron deposits in paren chymal tissue, may eventually indicate liver cirrhosis, diabetes, testicular atr ophy with very high levels of ferritin. The red cell ferritin in conjunction wit h plasma ferritin can be used to differentiate iron deficiency iron overload in patients with beta-thalassemia.