Serum iron and plasma fibrinogen concentrations as indicators of systemic inflammatory diseases in horses.
Authors: Borges Alexandre S, Divers Thomas J, Stokol Tracy, Mohammed O Hussni
Journal: Journal of veterinary internal medicine
Summary
# Editorial Summary: Serum Iron as a Marker for Systemic Inflammation in Horses Identifying systemic inflammation in horses remains diagnostically challenging, yet timely recognition is crucial for appropriate clinical management. Borges and colleagues conducted a retrospective analysis of 97 hospitalised horses with systemic inflammatory disease, 22 with localised inflammation, and 12 healthy controls, comparing plasma iron and fibrinogen concentrations as inflammatory indicators. Horses with systemic inflammation demonstrated markedly reduced plasma iron (64 ± 45 µg/dL) compared to both localised inflammation cases (123 ± 45 µg/dL) and healthy horses (143 ± 29 µg/dL), with iron proving slightly more sensitive (90%) than fibrinogen (82%) for detecting systemic inflammation. Notably, continued iron decline during hospitalisation correlated with poor prognosis similarly to rising fibrinogen, yet iron concentration appeared more responsive to acute inflammatory processes. For practitioners, routine measurement of plasma iron alongside traditional fibrinogen assessment offers enhanced diagnostic sensitivity and may provide additional prognostic information during monitoring of hospitalised cases.
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Practical Takeaways
- •Plasma iron measurement is more sensitive than fibrinogen for identifying systemic inflammation in hospitalized horses, supporting its use as a screening tool for acute systemic disease
- •Both low iron and high fibrinogen are useful clinical indicators, but iron better reflects the acute phase response and may guide treatment urgency decisions
- •Monitoring trends in plasma iron during hospitalization provides prognostic information—continued decreases suggest worse outcomes and may warrant treatment reassessment
Key Findings
- •Plasma iron concentration (64 ± 45 µg/dL) was significantly lower in horses with systemic inflammation compared to localized inflammation (123 ± 45 µg/dL) and healthy horses (143 ± 29 µg/dL), P = 0.001
- •Plasma iron had 90% sensitivity for detecting systemic inflammation versus 82% sensitivity for fibrinogen concentration
- •Low plasma iron was a better indicator of acute inflammation than fibrinogen, better reflecting the acuity of systemic inflammatory disease
- •Continued decrease in iron concentration during hospitalization correlated with worse prognosis (Rsp = 0.239), similar to fibrinogen increases (Rsp = 0.280)