鉄欠乏性貧血の検査としてTIBCはいらないのか？
鉄欠乏性貧血を疑った時に、血清鉄とTIBC（総鉄結合能）、フェリチンをオーダーするのは必須だと思っていました。血清鉄とフェリチンしかオーダーしない先生がいる（それも一人ではない）ので調べてみました。私は必ずTIBCもオーダーしてTSAT（トランスフェリン飽和率）も計算しています。TSAT＝血清鉄/TIBC×100です。
こちらのガイドラインをレビューした文献をご覧ください。英語が得意な方は、そちらを読んでいただけば私の解説など不要です。以下、いくつか抜粋します。
TSAT to define ID（Iron deficiency）
With respect to TSAT, about one-half of selected guidelines (10 of 22) proposed various thresholds.
Three guidelines proposed the 15–16% threshold for TSAT; indications included IBD (n = 2) (4, 43), CKD (n = 1) (26), and the general population (n = 1) (43).
Seven guidelines proposed the 20% threshold for TSAT in CKD (n = 5) (19, 22, 32, 42, 45), the general population (n = 2) (18, 22), children (n = 1) (45), and IBD (n = 1) (4).
Other guidelines proposed higher thresholds for TSAT, such as 25% (n = 1) (18) and 30% (n = 1) (45) in patients with CKD, whether undergoing hemodialysis or not. The highest threshold was reported in the situation of functional ID in chemotherapy-induced anemia, because TSAT may rise to 50% (ferritin be- tween 30 and 800 mg/L) in these patients (n = 1) (25).
途中に出てくるFunctional IDとabsolute IDは以下のように定義されています。
Functional ID is defined by serum ferritin concentrations .100 mg/L and TSAT ,20%, whereas absolute ID is defined by serum ferritin concentrations ,100 mg/L and TSAT ,20%.
こちらのガイドラインをレビューした文献をご覧ください。英語が得意な方は、そちらを読んでいただけば私の解説など不要です。以下、いくつか抜粋します。
TSAT to define ID（Iron deficiency）
With respect to TSAT, about one-half of selected guidelines (10 of 22) proposed various thresholds.
Three guidelines proposed the 15–16% threshold for TSAT; indications included IBD (n = 2) (4, 43), CKD (n = 1) (26), and the general population (n = 1) (43).
Seven guidelines proposed the 20% threshold for TSAT in CKD (n = 5) (19, 22, 32, 42, 45), the general population (n = 2) (18, 22), children (n = 1) (45), and IBD (n = 1) (4).
Other guidelines proposed higher thresholds for TSAT, such as 25% (n = 1) (18) and 30% (n = 1) (45) in patients with CKD, whether undergoing hemodialysis or not. The highest threshold was reported in the situation of functional ID in chemotherapy-induced anemia, because TSAT may rise to 50% (ferritin be- tween 30 and 800 mg/L) in these patients (n = 1) (25).
途中に出てくるFunctional IDとabsolute IDは以下のように定義されています。
Functional ID is defined by serum ferritin concentrations .100 mg/L and TSAT ,20%, whereas absolute ID is defined by serum ferritin concentrations ,100 mg/L and TSAT ,20%.
