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Tests we should abandon
S20
Pathology (2011), 43(S1)
PATHOLOGY 2011 ABSTRACT SUPPLEMENT
IRON METABOLISM AND TESTING Greg Anderson Iron Metabolism Laboratory, Queensland Institute of Medical Research, Brisbane, Qld, Australia Over the last 15 years there have been enormous advances in our understanding of body iron homeostasis with the identification of key proteins involved in iron transport and its regulation. The most significant advance has been the recognition that the liver-derived peptide hepcidin acts as a master controller of iron traffic into and around the body by regulating how much iron most body cells deliver to the plasma. Measurements of serum iron, transferrin saturation and serum ferritin continue to be mainstays for assessing body iron status, and they have been supplemented in recent years by soluble transferrin receptor measurements. Quantitation of serum hepcidin has great potential as a new marker of iron status; however, it has proved difficult to develop a reliable immunoassay for hepcidin and most current studies rely on more demanding mass spectrometry techniques. The interpretation of iron values may require testing for inherited disorders of iron homeostasis and the identification of many iron-related genes has
made this possible. Most inherited iron loading (haemochromatosis) results from mutations in the HFE gene, whereas cases of refractory iron deficiency can often be ascribed to mutations in TMPRSS6. TESTS WE SHOULD ABANDON Peter Hickman Chemical Pathology, ACT Pathology, and ANU Medical School, Canberra, ACT, Australia Pathology departments are very good at adding new tests to their repertoire so that they can be at ‘the cutting edge’. For various reasons there is a reluctance to drop older tests. One reason is sensible caution – we need to be sure that the new test is indeed an improvement and that there are no unsuspected unpleasant surprises with its use. However, as time passes and we find that the new test is indeed an improvement, the older test may remain on the books. I will consider a number of analytes. Whilst some are now clearly second-class tests, others may not provide the information we think they do and their performance should be looked at very carefully.
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.
Pathology (2011), 43(S1)
PATHOLOGY 2011 ABSTRACT SUPPLEMENT
IRON METABOLISM AND TESTING Greg Anderson Iron Metabolism Laboratory, Queensland Institute of Medical Research, Brisbane, Qld, Australia Over the last 15 years there have been enormous advances in our understanding of body iron homeostasis with the identification of key proteins involved in iron transport and its regulation. The most significant advance has been the recognition that the liver-derived peptide hepcidin acts as a master controller of iron traffic into and around the body by regulating how much iron most body cells deliver to the plasma. Measurements of serum iron, transferrin saturation and serum ferritin continue to be mainstays for assessing body iron status, and they have been supplemented in recent years by soluble transferrin receptor measurements. Quantitation of serum hepcidin has great potential as a new marker of iron status; however, it has proved difficult to develop a reliable immunoassay for hepcidin and most current studies rely on more demanding mass spectrometry techniques. The interpretation of iron values may require testing for inherited disorders of iron homeostasis and the identification of many iron-related genes has
made this possible. Most inherited iron loading (haemochromatosis) results from mutations in the HFE gene, whereas cases of refractory iron deficiency can often be ascribed to mutations in TMPRSS6. TESTS WE SHOULD ABANDON Peter Hickman Chemical Pathology, ACT Pathology, and ANU Medical School, Canberra, ACT, Australia Pathology departments are very good at adding new tests to their repertoire so that they can be at ‘the cutting edge’. For various reasons there is a reluctance to drop older tests. One reason is sensible caution – we need to be sure that the new test is indeed an improvement and that there are no unsuspected unpleasant surprises with its use. However, as time passes and we find that the new test is indeed an improvement, the older test may remain on the books. I will consider a number of analytes. Whilst some are now clearly second-class tests, others may not provide the information we think they do and their performance should be looked at very carefully.
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.