Iron status during anti-TNF therapy in children with juvenile idiopathic arthritis
Clinical Rheumatology, 10/05/2010
Aalto K et al. – The aim of the study was to evaluate the effect of anti-tumor necrosis factor (TNF) therapy on their iron status.
Twenty children with JIA treated with either etanercept (n=8) or infliximab (n=12) for 12 months
Iron status assessed during anti-TNF treatment by Hgb, mean corpuscular volume of red blood cells (MCV), sFe, ferritin, percent transferrin saturation (sTrfesat) and serum transferrin receptor concentration (sTfR)
sTfR/log ferritin index (TfR/logF) also used
Prior to therapy, Hgb and MCV 118±15.5 g/L and 79±7.7 fl in infliximab group, and 113±12.5 g/L and 78±5.8 fl in etanercept group
In whole group of patients, sFe 6.3±4.1 μmol/L and sTrfesat was 9%±6%
During anti-TNF therapy, Hgb and MCV improved significantly without use of iron supplementation, and sFe and sTrfesat increased from low to normal levels while inflammation markers decreased, except in 1 patient, in whom sTfR stayed elevated and TfR/logF index value was high
In patients with active JIA associated with anaemia, low levels of sFe and sTrfesat cannot be used as markers for iron deficiency
sTfR together with TfR/logF useful in assessing iron deficiency
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