Визначення рівня ендогенного еритропоетину сироватки для диференційної діагностики справжньої поліцитемії та симптоматичних еритроцитозів

Автор(и)

  • O. M. Kostyukevych ДНУ «Науково-практичний центр профілактичної та клінічної медицини» Державного управління справами, Україна

DOI:

https://doi.org/10.26641/2307-0404.2013.2.15950

Ключові слова:

еритропоетин, справжня поліцитемія, симптоматичний еритроцитоз

Анотація

The article deals with determining possibility of the assessment
of the level of endogenous serum erythropoietin (EPO) for differential diagnosis of polycythemia vera (PV) and
secondary erythrocytosis (SE). The determination of subnormal level of this cytokine for the diagnosis of PV has been
detected. The relation between the level of endogenous erythropoietin and iron metabolism also has been analyzed. The
study involved 88 patients with PV and 119 patients with SE. Statistically significant decrease in EPO concentration
level has been detected in PV patients. The mean EPO level was equal to 6.38 ± 0.84 mIU/mL and 17.98 ±2.48 mIU/mL
in PV and SE patients respectively. In control group of individuals EPO concentration was equal to 9,81 ±0,58
mIU/mL, the significant difference was found between all studied groups (р<0.01). According to our data, EPO was
increased in 28 SE patients (23.53%), it was not observed in control group and in group of PV patients
(φ*emp = 4.355, р<0.01). The decrease of EPO level in PV patients has been detected more often than in SE patients
(84.09% versus 11.76% , φ*emp = 5.218, р<0.01), it has not been observed in control group. Only 14 (15.91%) PV 

patients had normal EPO level, in contrast 77 (64.71%) SE patients demonstrated normal EPO level (φ*emp = 4.578,
р<0.01). The average level of ferritin was equal to 57.41 ± 9.74 ng/mL in PV patients and 199.77 ± 14.32 ng/mL in SE
patients (р<0.01). Significantly more patients with PV demonstrated decrease of ferritin level (31.81% versus 7.56%,
φ*emp = 4.438, р<0.01). Patients with SE more often had raised level of EPO than PV patients (15.12% versus 4.54%,
φ*emp = 2.453, р<0.01). The sensitivity of test with detecting of the reduced level of EPO for the diagnosis of PV was
84.1%, specificity - 87.4%, positive predictive value - 83.1%, negative predictive value - 88.1%. Normal range of EPO
significantly (rs = 0,5494) correlated with decreased levels of serum ferritin in patients with polycythemia vera, which
was caused by iron deficiency in a certain number of patients with PV.

Біографія автора

O. M. Kostyukevych, ДНУ «Науково-практичний центр профілактичної та клінічної медицини» Державного управління справами

Науковий відділ внутрішньої медицини
(зав. – д. мед. н. А.М. Кравченко)

Посилання

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Mesa RA. Navigating the evolving paradigms in the diagnosis and treatment of myeloproliferative disorders. Hematol. 2007;93:355–62.

Patnaik MM, Teffery A. The complete evaluation of erythrocytosis: congenital and acquired. Leukemia. 2009;23(5):834-44.

Barbui T, Barosi G, Birgegard G. Philadelphia-negative classical myeloproliferative neoplasms: critical concepts and management recommendations from European Leukemia Net. J Clin Oncol. 2011;29(6):761-70.

Messinezy M. Serum erythropoetin values in erythrocytosis and primary thrombocytaemia. Br J Haematol. 2002;117(1):47-53.

Spivak JL. Polycythemia vera: myths, mecha-nisms and management. Blood. 2002;100(13):4272-90.

Tefferi A, Vardiman JW. Classification and diag-nosis of myeloproliferative neoplasms: The 2008 World Health Organization criteria and point-of-care diagnostic algorithms. Leukemia. 2008;22:14–22.

Tefferi A, Vainchenker W. Myeloproliferative Neo¬plasms: Molecular Pathophysiology, Essential Clini-cal Understanding, and Treatment Strategies. J Clin Oncol. 2011;29(2):573-82.

Thiele J, Kvasnicka HM. The 2008 WHO Diag-nostic Criteria for Polycythemia Vera, Essential Throm-bocythemia, and Primary Myelofibrosis. Current Hema-tologic Malignancy Reports. 2009;4:33-40.

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Опубліковано

2013-07-30

Як цитувати

1.
Kostyukevych OM. Визначення рівня ендогенного еритропоетину сироватки для диференційної діагностики справжньої поліцитемії та симптоматичних еритроцитозів. Med. perspekt. [інтернет]. 30, Липень 2013 [цит. за 17, Липень 2024];18(2):66-73. доступний у: https://journals.uran.ua/index.php/2307-0404/article/view/15950

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