Role of intensive method of bone marrow iron assessment and serum Ferritin in prediction of iron deficiency: a study of 143 patients
Journal Title: Indian Journal of Pathology and Oncology - Year 2018, Vol 5, Issue 4
Abstract
Introduction Iron deficiency anemia is a major health problem in developing countries like India The situation is even more grim in economically backward areas of our country like Bundelkhand region The increasing prevalence of coexistence of iron deficiency anemia with chronic diseases makes the use of biochemical markers like serum ferritin challenging in diagnosing cases of inflammation and functional iron deficiency Microscopic evaluation is the gold standard method for assessment of iron stores In this study we tried to correlate the marrow iron stores with serum ferritin so as to facilitate the distinction of iron store deficiency from functional iron deficiencyMaterials and Methods We selected 143 adult patients with anemia In all the patients diagnostic bone marrow examination was done Serum ferritin assay CBC and peripheral blood smear examination was also performed Assessment of bone marrow iron was done by both Gales method and the intensive method and was correlated with serum ferritinResults The Conventional Gales grading revealed hypoferremic state in 4685 cases and normal iron stores in 5315 cases The new Intensive method of grading classifies anemias according to iron status It showed that most common was combined deficiency functional iron stores 4336 followed by normal stores functional iron deficiency and lastly iron stores deficiency in Bundelkhand region We also found a positive correlation of microcytic hypochromic blood picture with SFerritin and iron deficiency anemia Spearmans Rho correlation p value00001 The proposed cutoff value of Sferritin as a surrogate marker for iron deficiency used in our study is Conclusion The new Intensive Bone Marrow Grading Method has greatly improved iron assessment because it provides a useful iron status classification which is of high clinical importance especially in areas with high prevalence of inflammatory conditions coexisting with iron deficiency anemia like Bundelkhand region and remains the gold standard methodKeywords Anemia Ferritin Iron Bone marrow
Authors and Affiliations
Mayank Singh, Swati Raj, Dwijendra Nath, Pallavi Agrawal, Sufiya Ahmed
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