Iron deficiency blood test

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Iron Deficiency Blood Test: Key Diagnostic Methods and Innovations

Introduction to Iron Deficiency Anemia (IDA)

Iron deficiency anemia (IDA) is a widespread nutritional disorder affecting over a billion people globally. It can lead to severe health issues such as cognitive impairment in children, fatigue in adults, and complications during pregnancy . Accurate and timely diagnosis is crucial for effective management and treatment.

Traditional Diagnostic Methods for Iron Deficiency

Serum Ferritin Radioimmunoassay

The serum ferritin radioimmunoassay is considered the most powerful test for diagnosing iron deficiency anemia. It has a high diagnostic accuracy with an area under the receiver operating characteristic curve of 0.95 . Serum ferritin levels provide a reliable measure of iron stores in the body, making it a critical marker for diagnosing IDA .

Complete Blood Count (CBC)

A complete blood count (CBC) is a common initial test for diagnosing anemia. It measures various parameters, including hemoglobin levels, mean cell volume (MCV), and red blood cell count. However, CBC alone has limitations in specificity and sensitivity for diagnosing iron deficiency .

Reticulocyte Hemoglobin Content (CHr)

Reticulocyte hemoglobin content (CHr) is an early indicator of functional iron deficiency. It measures the hemoglobin content in reticulocytes, the youngest red blood cells in circulation. CHr is particularly useful in detecting iron deficiency in patients with normal or high MCV and in monitoring response to iron therapy 49.

Innovative Diagnostic Approaches

Aqueous Multiphase Systems (AMPS)

A novel, low-cost method for diagnosing IDA involves using aqueous multiphase systems (AMPS). This technique utilizes biocompatible polymers and salts to create discrete density layers in a microhematocrit tube. A drop of blood from a fingerstick is centrifuged, and the test results are read visually. This method has shown a sensitivity of 84% and specificity of 78%, making it a promising point-of-care diagnostic tool .

ironPhone: Mobile Device-Coupled Diagnostics

The ironPhone is a portable diagnostic platform that quantifies serum ferritin levels using a smartphone accessory, an app, and a disposable test strip. It provides rapid results from a fingerprick blood sample and has demonstrated high sensitivity (over 90%) for predicting iron deficiency. This innovation offers a convenient and accessible solution for iron status assessment, especially in low-resource settings .

Challenges in High HIV Prevalence Settings

In regions with high HIV prevalence, traditional tests for iron deficiency may lead to misdiagnosis. For HIV-positive patients, ferritin levels can be misleading due to inflammation. In such cases, bone marrow aspirates remain the most accurate method for diagnosing iron deficiency. For HIV-negative patients, a higher ferritin cut-off value improves diagnostic accuracy .

Conclusion

Accurate diagnosis of iron deficiency anemia is essential for effective treatment and management. While traditional methods like serum ferritin radioimmunoassay and complete blood count remain valuable, innovative approaches such as AMPS and ironPhone offer promising alternatives, especially in resource-limited settings. Understanding the strengths and limitations of each diagnostic method is crucial for improving patient outcomes.

Sources and full results

Most relevant research papers on this topic

Diagnosis of iron deficiency anemia using density-based fractionation of red blood cells.

The AMPS test, using aqueous multiphase systems and machine learning, provides a low-cost, rapid method for diagnosing iron deficiency anemia in low-resource settings.

2016·

20citations

·Jonathan W. Hennek et al.

Laboratory diagnosis of iron-deficiency Anemia: An overview

Serum ferritin radioimmunoassay is the most powerful test for diagnosing iron-deficiency anemia, with a 0.95 area under the receiver operating characteristic curve and can be applied to all patients.

Systematic ReviewHighly Cited

1992·

386citations

·G. Guyatt et al.

Diagnosis of iron-deficiency anemia in the elderly.

Serum ferritin is the best test for diagnosing iron-deficiency anemia in elderly patients, with values up to 45 micrograms/L increasing the likelihood of iron deficiency and values over 45 micrograms/L decreasing the likelihood of iron deficiency.

Observational StudyHighly Cited

1990·

269citations

·G. Guyatt et al.

Clinical utility of the reticulocyte hemoglobin content in the diagnosis of iron deficiency.

Reticulocyte hemoglobin content (CHr) has the highest sensitivity and specificity for predicting iron deficiency in bone marrow, especially when excluding patients with high mean cellular volume or red cell disorders.

Observational StudyHighly Cited

2002·

247citations

·A. Mast et al.

Interpreting tests for iron deficiency among adults in a high HIV prevalence African setting: routine tests may lead to misdiagnosis.

In high HIV prevalence African settings, ferritin is the most accurate blood test for iron deficiency in HIV-negative patients, while bone marrow aspirates are necessary for diagnosing iron deficiency in HIV-positive patients.

Observational Study

2007·

25citations

·D. K. Lewis et al.

An Effective and Efficient Testing Protocol for Diagnosing Iron-deficiency Anemia Preoperatively

The preprocedure anemia evaluation effectively diagnoses more patients with iron-deficiency anemia than traditional complete blood counts, improving preoperative care and reducing morbidity and mortality.

Observational Study

2020·

14citations

·O. Okocha et al.

ironPhone: Mobile device-coupled point-of-care diagnostics for assessment of iron status by quantification of serum ferritin.

The ironPhone is a portable diagnostics device that accurately quantifies serum ferritin concentrations from fingerprick blood, demonstrating potential for point-of-care iron status assessment.

2018·

54citations

·Balaji Srinivasan et al.

Iron Deficiency Anemia.

Iron deficiency is a common cause of anemia, with symptoms including fatigue, hair loss, and restless legs.

Highly Cited

2017·

106citations

·T. Deloughery

The Role of Reticulocyte Hemoglobin Content for Diagnosis of Iron Deficiency and Iron Deficiency Anemia, and Monitoring of Iron Therapy: a Literature Review.

Reticulocyte hemoglobin content (CHr) is an effective, easy-to-use test for diagnosing iron deficiency and monitoring iron therapy, but requires standardized cutoff values for accurate diagnosis.

Systematic Review

2019·

30citations

·Yemataw Gelaw et al.

Diagnosis and management of iron-deficiency anaemia.

Optimal diagnosis of iron deficiency is based on measuring serum ferritin and serum transferrin receptor, with oral iron treatment being the first choice and parenteral iron treatment when necessary.

Highly Cited

2005·

437citations

·J. Cook

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