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
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