166 - Laboratory diagnosis of iron deficiency
Autor(s): P. Doretto, P. Cappelletti
Issue: RIMeL - IJLaM, Vol. 4, N. 3, 2008 (MAF Servizi srl ed.)
Page(s): 166-177
Nowadays the bone marrow biopsy or aspirate staining with Prussian blue-Perl’s reaction remains the gold standard for the assessment of iron stores. Nevertheless, many other laboratory tests, either biochemical or haemathologic, are available, less harmful and more practical, useful for diagnosis and classification of iron deficiency. The biochemical tests are based on iron metabolism and enable the identification of iron deficiency before the onset of anemia. The haemathologic tests, based on morphological evaluation of red blood cells on blood films, scatter plots or red cell indices as MCV and red cell distribution width (RDW), are more readily available and less expensive. New parameters as CHr and %HYPO detect iron functional deficiency, before anaemia is present. In anaemic subjects such tests are used to confirm or clarify types or causes of anaemia. Unfortunately, it doesn’t exist any “best” test for the diagnosis of iron deficiency with or without anaemia. In fact, each test for iron state evaluation reflects modifications in different compartments of body iron (stores, transport, metabolic-functional), is influenced by different degree of iron depletion and presents an overlap between normal and pathological values. A combination of multiple tests (the best combination would be haemoglobin, serum transferrin receptors, serum ferritin), improves specificity but still underestimates iron deficiency as observed