Iron deficiency anemia diagnostic study of choice: Difference between revisions

	Iron deficiency anemia Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Iron deficiency anemia from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Iron deficiency anemia diagnostic study of choice On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Iron deficiency anemia diagnostic study of choice All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Iron deficiency anemia diagnostic study of choice
CDC on Iron deficiency anemia diagnostic study of choice
Iron deficiency anemia diagnostic study of choice in the news
Blogs on Iron deficiency anemia diagnostic study of choice
Directions to Hospitals Treating Iron deficiency anemia
Risk calculators and risk factors for Iron deficiency anemia diagnostic study of choice

Newer edit →

VisualWikitext

Revision as of 16:56, 22 August 2018

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

Overview

Diagnostic Study of Choice

Study of choice

Iron stain (Prussian blue stain) of bone marrow macrophages and erythroid precursors (sideroblasts) on marrow spicules is the gold standard test for the diagnosis of iron deficiency anemia.
Serum ferittin is the most widely used test for the diagnosis of iron deficiency anemia as it is non invasive.
Iron studies are performed to look for the cause of iron deficiency.
Iron deficency studies are performed if anemia is found on CBC and microcytic or normocytic anemia found on peripheral blood film.

Diagnostic results

The findings of various test results that confirm iron deficiency are:

Iron stain (prussian blue staining) of erythroid precursors (sideroblasts) on marrow spicules shows ack of stainable iron in erythroid precursors.
Serum ferittin levels < 15ng/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).

Sequence of Diagnostic Studies

The various investigations must be performed in the following order:

Complete blood count
Peripheral blood film
Iron studies:
- Serum ferittin
- Serum iron
- Serum transferrin/ total iron binding capacity
- Transferrin saturation
Iron stain (prussian blue stain) on bone marrow aspirate

Diagnostic Criteria

References

Template:WH Template:WS

@@ Line 7: / Line 7: @@
 === Study of choice ===
-[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
+* Iron stain (Prussian blue stain) of bone marrow macrophages and erythroid precursors (sideroblasts) on marrow spicules is the gold standard test for the diagnosis of iron deficiency anemia.
+* Serum ferittin is the most widely used test for the diagnosis of iron deficiency anemia as it is non invasive.
-OR
+* Iron studies are performed to look for the cause of iron deficiency.
+* Iron deficency studies are performed if anemia is found on CBC and microcytic or normocytic anemia found on peripheral blood film.
-The following result of [gold standard test] is confirmatory of [disease name]:
-* [Result 1]
-* [Result 2]
-OR
-[Name of the investigation] must be performed when:
-* The patient presents with [symptom/sign 1], [symptom/sign 2], and [symptom/sign 3].
-* A [name of test] is positive for [sign 1], [sign 2], and [sign 3] in the patient.
-OR
-[Name of the investigation] is the gold standard test for the diagnosis of [disease name].
-OR
-The diagnostic study of choice for [disease name] is [name of the investigation].
-OR
-There is no single diagnostic study of choice for the diagnosis of [disease name].
-OR
-There is no single diagnostic study of choice for the diagnosis of [disease name], but [disease name] can be diagnosed based on [name of the investigation 1] and [name of the investigation 2].
-OR
-[Disease name] is primarily diagnosed based on the clinical presentation.
-OR
-Investigations:
-* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most specific test for the diagnosis.
-* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most sensitive test for diagnosis.
-* Among the patients who present with clinical signs of [disease name], the [investigation name] is the most efficient test for diagnosis.
-==== The comparison of various diagnostic studies for [disease name] ====
-{|
-|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" | Test
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Sensitivity
-! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Specificity
-|-
-! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 1
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-|-
-! style="background: #696969; color: #FFFFFF; text-align: center;" |Test 2
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-| style="background: #DCDCDC; padding: 5px; text-align: center;" |...%
-|}
-<small> [Name of test with higher sensitivity and specificity] is the preferred investigation based on the sensitivity and specificity</small>
 ===== Diagnostic results =====
-The following finding(s) on performing [investigation name] is(are) confirmatory for [disease name]:
+The findings of various test results that confirm iron deficiency are:
-* [Finding 1]
+* Iron stain (prussian blue staining) of erythroid precursors (sideroblasts) on marrow spicules shows ack of stainable iron in erythroid precursors.
-* [Finding 2]
+* Serum ferittin levels < 15ng/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).
 ===== Sequence of Diagnostic Studies =====
-The [name of investigation] must be performed when:
-* The patient presented with symptoms/signs 1, 2, and 3 as the first step of diagnosis.
-* A positive [test] is detected in the patient, to confirm the diagnosis.
-OR
 The various investigations must be performed in the following order:
-* [Initial investigation]
+* Complete blood count
-* [2nd investigation]
+* Peripheral blood film
+* Iron studies:
-=== Name of Diagnostic Criteria ===
+** Serum ferittin
+** Serum iron
-'''It is recommended that you include the criteria in a table. Make sure you always cite the source of the content and whether the table has been adapted from another source.'''
+** Serum transferrin/ total iron binding capacity
+** Transferrin saturation
-[Disease name] is primarily diagnosed based on clinical presentation. There are no established criteria for the diagnosis of [disease name].
+* Iron stain (prussian blue stain) on bone marrow aspirate
-OR
-There is no single diagnostic study of choice for [disease name], though [disease name] may be diagnosed based on [name of criteria] established by [...].
-OR
-The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
-OR
-The diagnosis of [disease name] is based on the [criteria name] criteria, which includes [criterion 1], [criterion 2], and [criterion 3].
-OR
-[Disease name] may be diagnosed at any time if one or more of the following criteria are met:
-* Criteria 1
-* Criteria 2
-* Criteria 3
-OR
-'''IF there are clear, established diagnostic criteria'''
-The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met: [criterion 1], [criterion 2], [criterion 3], and [criterion 4].
-OR
-The diagnosis of [disease name] is based on the [criteria name] criteria, which include [criterion 1], [criterion 2], and [criterion 3].
-OR
-The diagnosis of [disease name] is based on the [definition name] definition, which includes [criterion 1], [criterion 2], and [criterion 3].
-OR
-'''IF there are no established diagnostic criteria'''
-There are no established criteria for the diagnosis of [disease name].
+=== Diagnostic Criteria ===
 ==References==