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==Overview==
==Overview==
Iron studies are conducted if microcytic hypochromic anemia is found on complete blood count and peripheral blood film. Iron studies are helpful in making the diagnosis of iron deficiency anemia, with serum ferritin levels being the most widely used test.
Iron studies are conducted if [[microcytic]] [[hypochromic]] [[anemia]] is found on [[complete blood count]] and peripheral blood film. Iron studies are helpful in making the diagnosis of iron deficiency anemia, with serum [[ferritin]] levels being the most widely used test.
==Laboratory Findings==
==Laboratory Findings==
* Complete blood count- Hb <10.5mg/dl and MCV <95fL<ref name="pmid26637694">{{cite journal| author=Camaschella C| title=Iron deficiency: new insights into diagnosis and treatment. | journal=Hematology Am Soc Hematol Educ Program | year= 2015 | volume= 2015 | issue=  | pages= 8-13 | pmid=26637694 | doi=10.1182/asheducation-2015.1.8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26637694  }} </ref><ref name="pmid25946282">{{cite journal| author=Camaschella C| title=Iron-deficiency anemia. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 19 | pages= 1832-43 | pmid=25946282 | doi=10.1056/NEJMra1401038 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25946282  }} </ref><ref name="pmid26314490">{{cite journal| author=Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L| title=Iron deficiency anaemia. | journal=Lancet | year= 2016 | volume= 387 | issue= 10021 | pages= 907-16 | pmid=26314490 | doi=10.1016/S0140-6736(15)60865-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26314490  }} </ref><ref name="pmid22288902">{{cite journal| author=Khadem G, Scott IA, Klein K| title=Evaluation of iron deficiency anaemia in tertiary hospital settings: room for improvement? | journal=Intern Med J | year= 2012 | volume= 42 | issue= 6 | pages= 658-64 | pmid=22288902 | doi=10.1111/j.1445-5994.2012.02724.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22288902  }} </ref>.
* Complete blood count- Hb <10.5mg/dl and MCV <95fL<ref name="pmid26637694">{{cite journal| author=Camaschella C| title=Iron deficiency: new insights into diagnosis and treatment. | journal=Hematology Am Soc Hematol Educ Program | year= 2015 | volume= 2015 | issue=  | pages= 8-13 | pmid=26637694 | doi=10.1182/asheducation-2015.1.8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26637694  }} </ref><ref name="pmid25946282">{{cite journal| author=Camaschella C| title=Iron-deficiency anemia. | journal=N Engl J Med | year= 2015 | volume= 372 | issue= 19 | pages= 1832-43 | pmid=25946282 | doi=10.1056/NEJMra1401038 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25946282  }} </ref><ref name="pmid26314490">{{cite journal| author=Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L| title=Iron deficiency anaemia. | journal=Lancet | year= 2016 | volume= 387 | issue= 10021 | pages= 907-16 | pmid=26314490 | doi=10.1016/S0140-6736(15)60865-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26314490  }} </ref><ref name="pmid22288902">{{cite journal| author=Khadem G, Scott IA, Klein K| title=Evaluation of iron deficiency anaemia in tertiary hospital settings: room for improvement? | journal=Intern Med J | year= 2012 | volume= 42 | issue= 6 | pages= 658-64 | pmid=22288902 | doi=10.1111/j.1445-5994.2012.02724.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22288902  }} </ref>.
* Microcytic and hypochromic anemia on peripheral blood film.
* Microcytic and hypochromic anemia on peripheral blood film.
* Red cell distribution width increased.
* Red cell distribution width increased.
* Reticulocyte count is low.
* [[Reticulocyte]] count is low.
* Iron studies:
* Iron studies:
** Iron stain (prussian blue staining) of erythroid precursors (sideroblasts) on marrow spicules shows ack of stainable iron in erythroid precursors.
** Iron stain (prussian blue staining) of erythroid precursors (sideroblasts) on marrow spicules shows lack of stainable iron in erythroid precursors.
** Serum ferittin levels < 30ng/ml, and serum ferritin <41 ng/mL in a patient with anemia and comorbidities (chronic diseases/inflammation)
** Serum [[ferritin]] levels < 30ng/ml, and serum ferritin <41 ng/mL in a patient with anemia and comorbidities (chronic diseases/inflammation)
** Serum iron '''<60 mcg/dL.'''
** Serum iron '''<60 mcg/dL.'''
** Total iron binding capacity/ serum transferrin- TIBC is calculated by multiplying serum transferrin by 1.389. It is increased in iron deficiency anemia and decreased in anemia of chronic disease. TIBC>'''350 to 400 mcg/dL''' is diagnostic of iron deficiency.
** Total iron binding capacity/ serum transferrin- TIBC is calculated by multiplying serum [[transferrin]] by 1.389. It is increased in iron deficiency anemia and decreased in anemia of chronic disease. TIBC>'''350 to 400 mcg/dL''' is diagnostic of iron deficiency.
** Transferrin saturation (TSAT) is the ratio of serum iron to TIBC: (serum iron  ÷  TIBC  x  100). It is <15% in iron deficiency (normal is 25-40%).
** [[Transferrin]] saturation (TSAT) is the ratio of serum iron to TIBC: (serum iron  ÷  TIBC  x  100). It is <15% in iron deficiency (normal is 25-40%).
* Elevated erythrocyte (RBC) zinc protoporphyrin (eg, >80 mcg/dL).
* Elevated [[Red blood cell|erythrocyte]] (RBC) zinc [[protoporphyrin]] (eg, >80 mcg/dL).
* Decreased iron stain on eryhtroid precursors.
* Decreased iron stain on eryhtroid precursors.


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==References==
==References==
{{reflist|2}}
{{reflist|2}}
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[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Primary care]]
[[Category:Endocrinology]]
[[Category:Endocrinology]]
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{{WS}}

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.D. [2]

Overview

Iron studies are conducted if microcytic hypochromic anemia is found on complete blood count and peripheral blood film. Iron studies are helpful in making the diagnosis of iron deficiency anemia, with serum ferritin levels being the most widely used test.

Laboratory Findings

  • Complete blood count- Hb <10.5mg/dl and MCV <95fL[1][2][3][4].
  • Microcytic and hypochromic anemia on peripheral blood film.
  • Red cell distribution width increased.
  • Reticulocyte count is low.
  • Iron studies:
    • Iron stain (prussian blue staining) of erythroid precursors (sideroblasts) on marrow spicules shows lack of stainable iron in erythroid precursors.
    • Serum ferritin levels < 30ng/ml, and serum ferritin <41 ng/mL in a patient with anemia and comorbidities (chronic diseases/inflammation)
    • Serum iron <60 mcg/dL.
    • Total iron binding capacity/ serum transferrin- TIBC is calculated by multiplying serum transferrin by 1.389. It is increased in iron deficiency anemia and decreased in anemia of chronic disease. TIBC>350 to 400 mcg/dL is diagnostic of iron deficiency.
    • Transferrin saturation (TSAT) is the ratio of serum iron to TIBC: (serum iron  ÷  TIBC  x  100). It is <15% in iron deficiency (normal is 25-40%).
  • Elevated erythrocyte (RBC) zinc protoporphyrin (eg, >80 mcg/dL).
  • Decreased iron stain on eryhtroid precursors.
Change in lab values in iron deficiency anemia
Change Parameter
Decrease ferritin, hemoglobin, MCV
Increase TIBC, transferrin, RDW

References

  1. Camaschella C (2015). "Iron deficiency: new insights into diagnosis and treatment". Hematology Am Soc Hematol Educ Program. 2015: 8–13. doi:10.1182/asheducation-2015.1.8. PMID 26637694.
  2. Camaschella C (2015). "Iron-deficiency anemia". N Engl J Med. 372 (19): 1832–43. doi:10.1056/NEJMra1401038. PMID 25946282.
  3. Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L (2016). "Iron deficiency anaemia". Lancet. 387 (10021): 907–16. doi:10.1016/S0140-6736(15)60865-0. PMID 26314490.
  4. Khadem G, Scott IA, Klein K (2012). "Evaluation of iron deficiency anaemia in tertiary hospital settings: room for improvement?". Intern Med J. 42 (6): 658–64. doi:10.1111/j.1445-5994.2012.02724.x. PMID 22288902.

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