thank you roy and richard, according to this book, iron need to me measured in this context and not transferrin one can agree with this recommendation because high iron concentrations in the blood may harm the patients whereas low transferrin is not supposed to harm the patients why in this case do your physicians request transferrin measurements? Dr Joseph Watine, PH, AIHP, PharmD, AAHU, EurClinChem Laboratoire de Biologie Polyvalente Centre Hospitalier Général 12027 Rodez Cedex 9 France ________________________________ Date: Thu, 3 Apr 2008 09:03:43 +0100 From: [log in to unmask] Subject: Re: Monitoring haemochromatosis treatment To: [log in to unmask] Joesph, It states that " The aim of treatment is to bring the plasma ferritin concentration within the reference range(< 200 ug/L) and the plasma iron < 30 umol/L. The plasma iron begins to fall only when available iron stores are depleted which may take 1-2 years of therapy in patients with markedly increased iron stores". Thanks for your replies so far and references to guidelines, indicating some lack of consensus. I was aware of some of these. However, guidelines are sometimes not always followed and so I was particularly interested to know whether most laboratories were measuring iron and transferrin as well as ferritin. Roy >>> Joseph WATINE 02/04/2008 17:28>>> richard, please could you tell us what this book says? many thanks in advance, joseph Dr Joseph Watine, PH, AIHP, PharmD, AAHU, EurClinChem Laboratoire de Biologie Polyvalente Centre Hospitalier Général 12027 Rodez Cedex 9 France ________________________________ Date: Wed, 2 Apr 2008 14:28:41 +0100 From: [log in to unmask] Subject: Re: Monitoring haemochromatosis treatment To: [log in to unmask] See also page 66 in : Liver Disease and Laboratory Medicine. I. McFarlane, A. Bomford, and R. Sherwood. London: ACB Venture Publications, 2000. with best wishes Richard Richard Mainwaring-Burton Consultant Biochemist Queen Mary's Hospital Sidcup, Kent 020-8308-3084 -----Original Message----- From: Joseph WATINE [mailto:[log in to unmask]] Sent: 02 April 2008 14:12 To: [log in to unmask] Subject: Re: Monitoring haemochromatosis treatment In France, the guidelines published by "la Haute Autorité de Santé" ("HAS") recommend that ferritin (and hemoglobin) be measured in this context. The targets to be reached are "not below 11" for hemoglobin and "below 50" for ferritin. According to this governmental organisation, iron and transferrin saturation are useless in this context. Some other organisations do recommend to measure iron and transferrin saturation and the target to be reached is generally "below 50%" for transferrin saturation. I would rather trust these other organisations more than the "HAS", because it seems to me that if transferrin saturation is not monitored, high levels of free iron might cause some harm to the patients. Best regards, Dr Joseph Watine, PH, AIHP, PharmD, AAHU, EurClinChem Laboratoire de Biologie Polyvalente Centre Hospitalier Général 12027 Rodez Cedex 9 France _________________________________________________________________ Créez votre disque dur virtuel Windows Live SkyDrive, 5Go de stockage gratuit ! http://www.windowslive.fr/skydrive/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual and they are responsible for all message content. 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