Which laboratory pattern is most consistent with iron deficiency anemia?

Which laboratory pattern is most consistent with iron deficiency anemia?

• A. Increased ferritin with decreased TIBC
• B. Decreased serum iron, decreased ferritin, increased TIBC, decreased MCV
• C. Normal ferritin with microcytosis
• D. Increased transferrin saturation

Answer: (B)

Iron deficiency anemia produces a lab pattern of depleted iron stores with a compensatory rise in transferrin production. Ferritin reflects stored iron, so ferritin is low; serum iron is low; total iron-binding capacity (TIBC) is increased as the body makes more transferrin to capture available iron; and red cells become microcytic (low MCV). Therefore, the pattern that fits best is low serum iron, low ferritin, high TIBC, and low MCV. This contrasts with anemia of chronic disease, which tends to have high or normal ferritin and low TIBC, or with patterns seen in thalassemia (microcytosis with normal or high ferritin) or iron overload (high serum iron).

Iron deficiency anemia produces a lab pattern of depleted iron stores with a compensatory rise in transferrin production. Ferritin reflects stored iron, so ferritin is low; serum iron is low; total iron-binding capacity (TIBC) is increased as the body makes more transferrin to capture available iron; and red cells become microcytic (low MCV).

Therefore, the pattern that fits best is low serum iron, low ferritin, high TIBC, and low MCV. This contrasts with anemia of chronic disease, which tends to have high or normal ferritin and low TIBC, or with patterns seen in thalassemia (microcytosis with normal or high ferritin) or iron overload (high serum iron).