Diagnosing Iron Deficiency Is Not Always Straightforward

Low ferritin correlated well with low bone marrow iron stores, but no feasible ferritin cutoff ruled out iron deficiency anemia with high certainty.

Bone marrow aspiration with iron staining is the gold standard for diagnosing iron deficiency anemia. However, because it is invasive, clinicians instead usually rely on iron markers, such as serum iron, iron binding capacity, transferrin saturation, ferritin, mean corpuscular volume (MCV), and occasionally, soluble transferrin receptor. To identify the best-performing parameter, investigators retrospectively compared results of these tests and bone marrow aspiration in 6610 patients with hematologic disorders.

Ferritin correlated best with bone marrow iron stores and was superior to transferrin saturation, soluble transferrin receptor, transferrin, hemoglobin, and MCV. A ferritin cutoff of 30 µg/L was highly specific for iron deficiency ane…

Reviewing Author

Brady L. Stein, MD, MHS

Disclosures

Leadership Positions in Professional SocietiesAmerican Society of Hematology (Senior Editor, ASH Self-Assessment Program; guideline development)

Brady L. Stein, MD, MHS

Disclosures

Leadership Positions in Professional SocietiesAmerican Society of Hematology (Senior Editor, ASH Self-Assessment Program; guideline development)

Diagnosing Iron Deficiency Is Not Always Straightforward

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Reviewing Author