iron deficiency anaemia

investigation features

  • ↓ ferritin
  • ↓ serum iron (naturally)
  • ↑ transferrin
  • ↓ transferrin saturation
  • ↑ TIBC

what's up with ferritin?

  • low serum iron → ferritin transported as transferrin to erythroblasts in the bone marrow.
  • along with its bound iron, it is ingested into the erythroblasts by endocytosis
  • transferrin delivers the iron directly to the mitochondria, where heme is synthesized
    (copied shamelessly from Guyton + Hall)

ACD vs IDA

Hepcidin (acting as an acute phase protein) reduces iron absorption

Anaemia of chronic disease Iron deficiency anaemia
normochromic hypochromic
normal ferritin ↓ ferritin
↓ transferrin ↑ transferrin
↓ transferrin saturation ↓↓ transferrin saturation
Normal/↓ TIBC ↑ TIBC
normal reticulocytes