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IDA may be effectively diagnosed by a full blood examination and serum ferritin level in most cases. Serum iron levels should not be used to diagnose iron deficiency.
The following table provides details as to how a full blood examination and serum ferritin can assist in the diagnosis of IDA:
| Initial Tests for Diagnosis of Iron Deficiency Anaemia |
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|
Investigation |
Application |
Notes |
| Full blood examination | - can suggest iron deficiency - Hb g/L value is required to assess severity of anaemia Note: - iron deficiency can occur without anaemia |
- red cell indices such as low MCV and MCH may suggest iron deficiency but can be normal - a constellation of the following findings on full blood count is highly suggestive of iron deficiency anaemia:
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|
Serum ferritin |
- diagnostic test of choice - serum ferritin levels and iron status in adults:
- lower thresholds have been used in children, from 10–12 μg/L |
- ferritin is also an acute phase protein and is elevated in inflammation, infection, liver disease and malignancy - this can result in misleading elevated ferritin levels in iron deficient patients with coexisting systemic illness - markers such as C-reactive protein may help identify coexisting inflammation |
| *Functional iron deficiency is when iron cannot be mobilised for erythropoiesis despite adequate stores. It is most commonly seen in patients with end-stage kidney disease or inflammatory conditions such as rheumatoid arthritis. | ||
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