Iron deficiency

Question 1

Iron deficiency:

How ferritin and transferrin interact?

Answer 1

Reduced ferritin = elevated/normal transferrin (to mobilise iron) = iron deficiency anaemia

Elevated ferritin = reduced/normal transferring (down regulate transport)
*this is normal
UNLESS iron is low = suggesting anaemia of chronic disease (change in systemic inflammatory signals resulting in the inaccessibility of iron despite stores)

Question 2

Iron deficiency:

Ferritin interpretation Pearl?

Answer 2

Ferritin is rarely >100 if a person is iron deficient EVEN if there is an inflammatory response

*Normally inflammation will result in a ferritin of 200 - 500

Question 3

Iron deficiency:

Expected response to iron supplementation in anaemia?

Answer 3

After 4 - 6 weeks post iron therapy the haemoglobin should increase by 10g/L (IF this occurs then the anaemia is likely due to iron deficiency)