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- Title
Detecting iron deficiency in anemic patients with concomitant medical problems.
- Authors
Kis, Anne M.; Carnes, Molly; Carnes; Kis, A M; Carnes, M
- Abstract
<bold>Objective: </bold>To determine the sensitivity and specificity of mean corpuscular volume, transferrin saturation, total iron-binding capacity, and ferritin level in determining iron deficiency in a population of anemic veterans with a wide variety of general medical diagnoses.<bold>Design: </bold>Retrospective chart review.<bold>Setting: </bold>Hospitals of the Department of Veterans Affairs in Madison and Milwaukee, Wisconsin.<bold>Participants: </bold>One hundred one anemic veterans with any medical condition who underwent bone marrow aspiration and serum iron studies.<bold>Measurements and Main Results: </bold>Using the presence or absence of bone marrow hemosiderin as the reference standard, the sensitivity and specificity of the following serum iron indicators were calculated: mean corpuscular volume, transferrin saturation, total iron-binding capacity, and ferritin level. Of these patients, 41 (40.6%) were categorized as iron deficient, with no stainable bone marrow hemosiderin. A serum ferritin level < or =100 microg/L provided the best sensitivity (64.9%) and specificity (96.1%) for evaluating iron stores in this patient population. When performed within 24 hours of bone marrow examination, a serum ferritin level < or =100 microg/L was 100% accurate in separating iron-deficient from iron-sufficient patients. None of the other serum iron indicators alone or in combination performed better than ferritin level alone.<bold>Conclusions: </bold>In a population of anemic veterans with a wide variety of concomitant medical problems, a serum ferritin level < or =100 microg/L was optimal for determining iron deficiency. This is higher than the ferritin level of < or =50 microg/L cited in standard textbooks as evidence of iron deficiency in patients with inflammation, infection, or malignancy.
- Subjects
WISCONSIN; UNITED States; IRON deficiency anemia diagnosis; MEDICAL care; FERRITIN; CLINICAL chemistry
- Publication
JGIM: Journal of General Internal Medicine, 1998, Vol 13, Issue 7, p455
- ISSN
0884-8734
- Publication type
journal article
- DOI
10.1046/j.1525-1497.1998.00134.x