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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