L. Hallberg et al., SCREENING FOR IRON-DEFICIENCY - AN ANALYSIS BASED ON BONE-MARROW EXAMINATIONS AND SERUM FERRITIN DETERMINATIONS IN A POPULATION-SAMPLE OF WOMEN, British Journal of Haematology, 85(4), 1993, pp. 787-798
Efficacy of different methods in screening for iron deficiency was re-
examined in a randomly selected sample of 38-year-old women (n = 203)
with known iron status based on absence/presence of stainable iron in
bone-marrow smears. The study was made in 1968-69. Serum ferritin (SF)
was determined in 1978 in frozen sera using the Ramco IRMA and, in 19
92, samples were re-analysed using a RIA calibrated with the Internati
onal Standard 80/602 for SF determination. The effect of storage on SF
was calculated from a previously established relationship (courtesy o
f Dr Mark Worwood. Cardiff) between the results obtained with the Ramc
o assay and assays calibrated with IS 80/602. The distributions in iro
n replete and iron deficient women showed less overlap (diagnostic eff
iciency 91%) for SF than for other haematological parameters. The best
discrimination was obtained at SF < 16 mug/l (specificity 98%: sensit
ivity 75%). Absence of iron stores was associated with signs of an iro
n deficient erythropoiesis. starting already at SF 25-40 mug/l. Use of
multiple criteria to diagnose iron deficiency falsely reduces prevale
nce figures for iron deficiency.