Serum Ferritin and Bone Marrow Biopsy Iron Stores. II: Correlation with Low Serum Iron and Fe/TIBC Ratio Less Than 15%

Abstract

Diseases associated with defective reticuloendothelial release of iron may be difficult to distinguish from the irondeficient state, since serum iron parameters (serum iron, percentage saturation of transferrin > 15%) may overlap. Assessment of the bone marrow biopsy iron stores was often necessary to resolve the diagnosis. Serum ferritin levels have proved very useful in distinguishing the uncomplicated iron-deficient state from other disorders associated with low serum iron and low percentage saturation of transferrin. However, a small percentage of iron-deficient persons may have normal ferritin values, particularly if these persons have liver disease or hematopoietic or lymphoreticular neoplasms. In these cases, assessment of the bone marrow biopsy iron would still be necessary to evaluate the body iron stores.