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Biochemical Assessment of Iron Status

Hemoglobin normal normal low hematocrit normal normal

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Unformatted text preview: f individual red cell • MCH = HB / RBC count • Sensitivity – more sensitive than MCV • Specificity – may distinguish between iron deficiency (low) and B12/folate deficiency (high) Red Cell Distribution Width (RDW) • Measurement of variation in RBC size • RDW (%) = SD of MCV x 100% / MCV • Increases in iron deficiency anemia • Sensitivity – poor • Specificity – not specific for iron deficiency Reticulocyte count (RETIC) • Immature RBCs • Decreases in iron deficiency anemia Serum/Plasma Ferritin • Ferritin is main form of Fe storage • Serum ferritin levels tend to reflect Fe stores • Has been validated as a measure of Fe stores in otherwise healthy persons (by use of quantitative phlebotomy and bone marrow examination) • Real value of ferritin is that a low value in an anemic individual identifies iron deficiency anemia equivocally • High value is useful for excluding iron deficiency anemia as anemia cause • Only measure that can reflect deficient, excess, or normal iron stores • Sensitivity – good • Specificity – problem o Ferritin is an acute phase reactant protein – increased in infection and inflammation o Level is increased by acute and chronic infections, inflammatory dis...
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