Iron Studies in Microcytic Anaemia

Diagnosis Serum Iron Total Iron Binding Capacity Transferrin1 Serum Ferritin2
Iron deficiency anaemis Low High or Normal <16% <12ng/mL
Anaemia of Chronic Disease Normal Low or Normal ≥16% High or normal
β-Thalasaemia Trait, HbE, HbC Normal Normal ≥16% Normal
Sideroblastic Anaemia High Normal High High
  1. Two causes of microcytic anaemia may co-exist e.g. thalassaemia trait with iron deficiency anaemia or anaemia of chronic disease with iron deficiency anaemia. When iron deficiency exists with other forms of microcytic anaemia the transferrin saturation is <16%
  2. Patients with low ferritin (<12ng/ml) always have iron deficiency. Higher values of ferritin do not exclude iron deficiency particularly in patients with anaemia of chronic disease. There are no guidelines about the ferritin levels that exclude iron deficiency in patients of anaemia of chronic disease. The reported values vary between 60-100ng/ml.
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