Hepatitis promotes an increase in serum ferritin in response to the inflammatory stimulus , such that functional iron deficiency
The results of the present study confirm that it is important to treat absolute iron deficiency in patients with heart failure, but suggest that it may not be useful to give iron supplements to heart failure patients with functional iron deficiency
Functional iron deficiency
is diagnosed when serum ferritin is 100-200% ng/ml.
In a prospective cohort study of 1506 patients with chronic CHF, 753 patients had absolute or functional iron deficiency
according to the above definition.
Fragment and macrophage iron reflect iron stores while iron in the erythroblast is indicative of utilizable iron which is diminished in functional iron deficiency
ESA therapy and decreased transferrin can cause functional iron deficiency
, which may ultimately lead to absolute iron deficiency (Fishbane, Mittal, & Maesaka, 1999).
The functional iron deficiency
observed in healthy individuals treated with r-HuEPO is associated with early and significant changes in CHr.
The combined effect results in reduced iron availability for erythropoiesis, creating a "functional iron deficiency
Finally, EPO therapy stimulates a supraphysiological production of RBCs that, in turn, increases iron utilization and leads to functional iron deficiency
. Functional iron deficiency
occurs when the need for an increase in iron to support Hb synthesis is greater than the amount that can be released from iron stores (NKF, 2001).
He has described the appearance of functional iron deficiency
in healthy individuals treated with recombinant human erythropoietin (r-HuEPO) based on the particular flow cytometric characteristics of erythrocytes and reticulocytes.
Studies in patients on dialysis have shown that hepcidin levels correlate with functional iron deficiency
and Epoetin alfa hyporesponsiveness.
Biochemical markers are also less effective in diagnosing functional iron deficiency
, a transient discrepancy between iron supply and utilization that is mostly seen in individuals treated with recombinant human erythropoietin (r-HuEPO).