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A ferritin level >50 microg/L is frequently consistent with iron deficiency.
Eur J Intern Med. 2009 Mar; 20(2):168-70.EJ

Abstract

BACKGROUND

The British Society of Gastroenterology (BSG) suggests that a serum ferritin level <or=50 microg/L is still consistent with iron deficiency in the presence of coexistent pathology (inflammation, infection or malignancy), by implication excluding iron deficiency above this level. We aim to examine the validity of this cut-off level in three different groups of patients.

METHODS

We used the soluble transferrin receptor/Log(10)ferritin ratio (sTfR-F Index or Index) as a determinant of body iron stores. If the Index was equal or more than 2, the patients were considered iron deficient. Patients were considered iron replete if Index was <or=1. The data was prospectively collected over a period of 3 years. All patients had normocytic anaemia.

RESULTS

We collected data for 198 patients. Ninety-three had a sTfR-F Index >or=2 and 17 had Index <or=1. If a ferritin level <or=50 microg/L was used as the cut-off value for iron deficiency, the negative predictive value (NPV) of ferritin test was 22% and the positive predictive value (PPV) 100%; if the level is raised to 100 microg/L the NPV of ferritin test rose to 34.8% and the PPV was 97%.

CONCLUSION

Patients with normocytic anaemia who have ferritin levels above 50 microg/L should not automatically be considered to have adequate iron stores. We suggest that the integration of sTfR-F Index in the diagnostic workup of these patients can improve patient care.

Authors+Show Affiliations

Warrington General Hospital, Lovely Lane, WA5 1QG, Warrington, Cheshire, UK. akoulaouzidis@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

19327606

Citation

Koulaouzidis, Anastasios, et al. "A Ferritin Level >50 microg/L Is Frequently Consistent With Iron Deficiency." European Journal of Internal Medicine, vol. 20, no. 2, 2009, pp. 168-70.
Koulaouzidis A, Cottier R, Bhat S, et al. A ferritin level >50 microg/L is frequently consistent with iron deficiency. Eur J Intern Med. 2009;20(2):168-70.
Koulaouzidis, A., Cottier, R., Bhat, S., Said, E., Linaker, B. D., & Saeed, A. A. (2009). A ferritin level >50 microg/L is frequently consistent with iron deficiency. European Journal of Internal Medicine, 20(2), 168-70. https://doi.org/10.1016/j.ejim.2007.09.024
Koulaouzidis A, et al. A Ferritin Level >50 microg/L Is Frequently Consistent With Iron Deficiency. Eur J Intern Med. 2009;20(2):168-70. PubMed PMID: 19327606.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A ferritin level >50 microg/L is frequently consistent with iron deficiency. AU - Koulaouzidis,Anastasios, AU - Cottier,Russell, AU - Bhat,Shivaram, AU - Said,Elmuhtady, AU - Linaker,Barry D, AU - Saeed,Athar A, Y1 - 2008/08/05/ PY - 2007/01/30/received PY - 2007/09/08/revised PY - 2007/09/26/accepted PY - 2009/3/31/entrez PY - 2009/3/31/pubmed PY - 2009/6/19/medline SP - 168 EP - 70 JF - European journal of internal medicine JO - Eur J Intern Med VL - 20 IS - 2 N2 - BACKGROUND: The British Society of Gastroenterology (BSG) suggests that a serum ferritin level <or=50 microg/L is still consistent with iron deficiency in the presence of coexistent pathology (inflammation, infection or malignancy), by implication excluding iron deficiency above this level. We aim to examine the validity of this cut-off level in three different groups of patients. METHODS: We used the soluble transferrin receptor/Log(10)ferritin ratio (sTfR-F Index or Index) as a determinant of body iron stores. If the Index was equal or more than 2, the patients were considered iron deficient. Patients were considered iron replete if Index was <or=1. The data was prospectively collected over a period of 3 years. All patients had normocytic anaemia. RESULTS: We collected data for 198 patients. Ninety-three had a sTfR-F Index >or=2 and 17 had Index <or=1. If a ferritin level <or=50 microg/L was used as the cut-off value for iron deficiency, the negative predictive value (NPV) of ferritin test was 22% and the positive predictive value (PPV) 100%; if the level is raised to 100 microg/L the NPV of ferritin test rose to 34.8% and the PPV was 97%. CONCLUSION: Patients with normocytic anaemia who have ferritin levels above 50 microg/L should not automatically be considered to have adequate iron stores. We suggest that the integration of sTfR-F Index in the diagnostic workup of these patients can improve patient care. SN - 1879-0828 UR - https://www.unboundmedicine.com/medline/citation/19327606/A_ferritin_level_>50_microg/L_is_frequently_consistent_with_iron_deficiency_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0953-6205(08)00192-1 DB - PRIME DP - Unbound Medicine ER -