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Uibc Information and Courses from MediaLab, Inc.

These are the MediaLab courses that cover Uibc and links to relevant pages within the course.

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Hereditary Hemochromatosis
General Overview of Testing

Tests for evaluating iron metabolism are generally used as initial or screening tests for hereditary hemochromatosis (HH) as they will detect the phenotypic expression of HH. These tests include serum iron (SI), transferrin (Tf) or total iron binding capacity (TIBC), serum ferritin (SF), and unsaturated iron binding capacity (UIBC).The serum ferritin assay is also used to assess the effectiveness of HH treatment.Molecular (DNA) analyses for HFE mutations are considered to be confirmatory tests for HH which may be ordered reflexively in patients with elevated iron results. Laboratories should establish their own reference intervals for assays of iron metabolism. In general, reference intervals vary by sex and by method used for the assays discussed in the following section. Typical reference intervals are included in the following sections for instructive purposes only and should not be used for evaluating actual patient data.The results of laboratory tests assessing iron metabolism should be interpreted with caution because a number of pre-analytical and physiologic factors can affect the results. Repeating elevated test results on fasting specimens is often advisable.

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Transferrin Saturation

Transferrin saturation (TS) is usually reported along with the SI and TIBC. TS indicates the percent of iron binding sites on transferrin that are carrying iron. TS is derived from a calculation using the formula:TS =(SI/TIBC) x 100TS results are reported as percentages. Typical reference intervals for TS are 20% to 55% for males and 15% to 50% for females. TS is generally considered to be the most sensitive laboratory test for detecting altered iron metabolism in hereditary hemochromatosis (HH). It may be elevated prior to significant deposition of tissue iron. TS levels increase as additional iron is accumulated.A drawback to using the TS is that it is dependent on performing both the SI and TIBC. The UIBC (see section below) may be a lower cost alternative.The optimal TS criterion for detecting HH is controversial. Using a TS of >60% for males and >50% for females has been found highly accurate in detecting abnormal iron metabolism in persons with HH. Others studies suggest using lower TS levels, e.g. 45%, as a criterion indicating further testing is warranted. Current guidelines from the American College of Physicians include a TS cutoff level of >55% for identifying iron overload. (11)Patients with initially increased TS should be followed by performing a second TS from a fasting morning specimen. The patient should also be advised not to take vitamins supplemented with iron or oral contraceptives for several days prior to the repeated test. TS levels may be affected by diurnal variation, dietary factors, and co-existing disease states such as inflammation and hepatitis. Patients with HH may have falsely normal TS if chronic blood loss or inflammatory disease is present.

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UIBC

Unsaturated iron binding capacity (UIBC) may also be used as a marker for altered iron metabolism. UIBC represents the portion of iron binding sites on transferrin that are not occupied by iron. Therefore, a low UIBC indicates that transferrin is highly saturated with iron, a finding consistent with hereditary hemochromatosis (HH). HH may be suspected when the UIBC is less than 143 micrograms/dL, a criterion suggested by the results of one study.(5)UIBC may be a lower cost alternative to the more complex transferrin saturation (TS). UIBC and SI are both fully automated procedures that are available on widely used laboratory instruments. The TIBC can be calculated by adding UIBC and SI, resulting in a value for TIBC that can be used for determining TS: TS = SI/(SI + UIBC) X 100

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How would you interpret the result of a UIBC test that is less than the lower limit of the reference interval?View Page


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