Skip to main content
PMC home page
British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1984 Sep 15;289(6446):648–650. doi: 10.1136/bmj.289.6446.648

Red cell ferritin content: a re-evaluation of indices for iron deficiency in the anaemia of rheumatoid arthritis.

A Davidson, M B Van der Weyden, H Fong, M J Breidahl, P F Ryan
PMCID: PMC1443116  PMID: 6434023

Abstract

In iron deficiency anaemia basic red cell content of ferritin is appreciably reduced. This variable was determined in 62 patients with rheumatoid arthritis to evaluate conventional laboratory indices for iron deficiency in the anaemia of rheumatoid arthritis. For 23 patients with rheumatoid arthritis and normocytic anaemia irrespective of plasma ferritin concentration, red cell ferritin content did not differ significantly from that for non-anaemic patients with rheumatoid arthritis. For 27 patients with rheumatoid arthritis and microcytic anaemia, the mean red cell ferritin content for patients with a plasma ferritin concentration in the 13-110 micrograms/l range was appreciably reduced. It was indistinguishable from that for patients with rheumatoid arthritis and classical iron deficiency anaemia, indicated by plasma ferritin concentrations of less than 12 micrograms/l. In contrast, the mean red cell ferritin content for patients with rheumatoid arthritis, microcytic anaemia, and plasma ferritin concentrations above 110 micrograms/l did not differ from that for patients with rheumatoid arthritis and normocytic anaemia. Oral treatment with iron in patients with rheumatoid arthritis, microcytic anaemia, and appreciably reduced red cell ferritin concentrations was accompanied by significant increases in haemoglobin concentration (p less than 0.01), mean corpuscular volume (p less than 0.01), and red cell ferritin contents (p less than 0.05). This treatment, however, did not produce any appreciable change in haemoglobin concentration in patients with rheumatoid arthritis, normocytic anaemia, and normal red cell ferritin contents. These findings suggest that the indices for iron deficiency in patients with rheumatoid arthritis and anaemia should include peripheral blood microcytosis together with a plasma ferritin concentration of less than 110 micrograms/l.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bentley D. P., Williams P. Serum ferritin concentration as an index of storage iron in rheumatoid arthritis. J Clin Pathol. 1974 Oct;27(10):786–788. doi: 10.1136/jcp.27.10.786. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Blake D. R., Hall N. D., Bacon P. A., Dieppe P. A., Halliwell B., Gutteridge J. M. The importance of iron in rheumatoid disease. Lancet. 1981 Nov 21;2(8256):1142–1144. doi: 10.1016/s0140-6736(81)90590-0. [DOI] [PubMed] [Google Scholar]
  3. Brink S., van Schalkwyk D. J. Serum ferritin and mean corpuscular volume as predictors of bone marrow iron stores. S Afr Med J. 1982 Mar 20;61(12):432–434. [PubMed] [Google Scholar]
  4. Cazzola M., Dezza L., Bergamaschi G., Barosi G., Bellotti V., Caldera D., Ciriello M. M., Quaglini S., Arosio P., Ascari E. Biologic and clinical significance of red cell ferritin. Blood. 1983 Nov;62(5):1078–1087. [PubMed] [Google Scholar]
  5. Harkness J. A., Blake D. R. Penicillamine nephropathy and iron. Lancet. 1982 Dec 18;2(8312):1368–1369. doi: 10.1016/s0140-6736(82)91272-7. [DOI] [PubMed] [Google Scholar]
  6. Krause J. R., Stolc V. Serum ferritin and bone marrow iron stores. I. Correlation with absence of iron in biopsy specimens. Am J Clin Pathol. 1979 Nov;72(5):817–820. doi: 10.1093/ajcp/72.5.817. [DOI] [PubMed] [Google Scholar]
  7. Lee G. R. The anemia of chronic disease. Semin Hematol. 1983 Apr;20(2):61–80. [PubMed] [Google Scholar]
  8. Lipschitz D. A., Cook J. D., Finch C. A. A clinical evaluation of serum ferritin as an index of iron stores. N Engl J Med. 1974 May 30;290(22):1213–1216. doi: 10.1056/NEJM197405302902201. [DOI] [PubMed] [Google Scholar]
  9. Lipschitz D. A., Cook J. D., Finch C. A. Ferritin in formed blood elements (38539). Proc Soc Exp Biol Med. 1975 Feb;148(2):358–364. doi: 10.3181/00379727-148-38539. [DOI] [PubMed] [Google Scholar]
  10. Mowat A. G. Hematologic abnormalities in rheumatoid arthritis. Semin Arthritis Rheum. 1972 Winter;1(3):195–219. doi: 10.1016/0049-0172(72)90001-7. [DOI] [PubMed] [Google Scholar]
  11. Muirden K. D. Lymph node iron in rheumatoid arthritis. Histology, ultrastructure, and chemical concentration. Ann Rheum Dis. 1970 Jan;29(1):81–88. doi: 10.1136/ard.29.1.81. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Peters S. W., Jacobs A., Fitzsimons E. Erythrocyte ferritin in normal subjects and patients with abnormal iron metabolism. Br J Haematol. 1983 Feb;53(2):211–216. doi: 10.1111/j.1365-2141.1983.tb02013.x. [DOI] [PubMed] [Google Scholar]
  13. Senator G. B., Muirden K. D. Concentration of iron in synovial membrane, synovial fluid, and serum in rheumatoid arthritis and other joint diseases. Ann Rheum Dis. 1968 Jan;27(1):49–54. doi: 10.1136/ard.27.1.49. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Smith R. J., Davis P., Thomson A. B., Wadsworth L. D., Fackre P. Serum ferritin levels in anemia of rheumatoid arthritis. J Rheumatol. 1977 Winter;4(4):389–392. [PubMed] [Google Scholar]
  15. Sternberg J. C. A rate nephelometer for measuring specific proteins by immunoprecipitin reactions. Clin Chem. 1977 Aug;23(8):1456–1464. [PubMed] [Google Scholar]
  16. Van Der Weyden M. B., Fong H., Salem H. H., Batey R. G., Dudley F. J. Erythrocyte ferritin content in idiopathic haemochromatosis and alcoholic liver disease with iron overload. Br Med J (Clin Res Ed) 1983 Mar 5;286(6367):752–754. doi: 10.1136/bmj.286.6367.752. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Van der Weyden M. B., Fong H., Hallam L., Breidahl M. J. A rapid and simple assay for human erythrocyte ferritin. Clin Chim Acta. 1983 Feb 7;127(3):397–401. doi: 10.1016/0009-8981(83)90167-5. [DOI] [PubMed] [Google Scholar]

Articles from British Medical Journal (Clinical research ed.) are provided here courtesy of BMJ Publishing Group

RESOURCES