A common issue with multiple etiologies, the following test results will help to confirm your clinical suspicion:

  1. ↓ Ferritin (If low, virtually diagnostic, but cannot rule out if low/normal)
  2. ↓ MCV (typically <80fL)
  3. ↓ Hematocrit (Hct) and RBC countƒƒ
  4. ↓ Serum iron (*note this value can vary on a daily basis and with any iron supplementation)
  5. ↓ TSAT (Transferrin saturation)
  6. ↑ TIBC, Transferrin, RDWnormal-rbc-vs-iron-def-anemia
  7. Peripheral blood smear that shows microcytic, hypochromic RBCs [could also have anisocytosis and
    ƒ target cells]
  8. NOTE: There is commonly a mild thrombocytosis associated with Iron deficiency anemia

*Bone marrow iron stores is the gold standard for the diagnosis of Iron deficiency anemia (rarely done)

rbc-iron-def-anemia

REFERENCES

  1. Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015 May;372(19):1832-43.
  2. Lynch EC. Peripheral Blood Smear. In: Walker HK, Hall WD, Hurst JW, editors. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd edition. Boston: Butterworths; 1990. Chapter 155.
  3. Short MW, Domagalski JE. Iron deficiency anemia: evaluation and management. Am Fam Physician. 2013 Jan 15;87(2):98-104.

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