This is more of a critical care than pulmonary question. It came up today in discussion with renal...
The gold satndard for iron-def. anemia has been staining the bone marrow for iron stores. Nobody does that much anymore as first test since ferritin has such a good correlation with iron stores. The discussion was whether you can have iron-deficiency anemia with good normal ferritin (not normal-low, low-normal, borderline, etc.). Even though ferritin is an acute phase reactant and may mak a borderline ferritin level seem normal it shouldn't push it to the mid-high range. (ferritin will roughly triple as an acute phase marker, Ann Rheum Dis 1986 Jul;45(7):596-602)
Do you look at the iron/iron sat or do you trust the ferritin?
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I had occasion to attend a recent local med school conference on iron issues.The hematologist stated that in his opinion that the ferretin is a better test for fe def than the b/m iron stain and the ferritin is the gold standard.None of the 5 hematologists present disagreed and two stated that it was also better than the newer transferrin receptor assay.
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