Laboratory Findings in Initial Presentation of Iron Deficiency Anemia

Abstract

To evaluate the laboratory findings in patients with iron deficiency anemia(IDA) at initial presentation and to define useful screening tests such as RBC indices and markers of serum iron, we studied 130 patients with the diagnosis of IDA who visited Ajou University Hospital from July 1994 to January 1996. The results of the study are as follows; 1) The mean age of IDA patients were 36.3±11.6 years old and ranged from 12 to 65 years old. 2) The mean laboratory values at initial visits were hemoglobin 8.3±2.0 g/dl, hematocrit 26.0±5.4%, mean corpuscular volume 68.8±11.3 fl, mean corpuscular hemoglobin 21.8±4.6 pg, RDW 18.5±4.0%, serum iron 25.0±15.1 ug/dl, TIBC 422.0±62.7 ug/dl and serum ferritin 6.7-2.3 ug/dl. 3) Frequent symptoms and signs were menorrhagia(369%), dizziness(34.6%), headache(32.3%), easy fatigability(17.7%) and G-I trouble(16.9%). 4) Frequent causes of IDA were menorrhagia in 75(57.7%) cases, gastrointestinal ulcer in 18(13.8%) cases, increased demand for iron. due to pregnancy and growth spurt in 19(14.6%) cases, hemorrhoidal bleeding in 11(8.5%) cases. 5) When patients were divided into two groups(Hb³9 g/dl as mild, Hb<9 g/dl as severe anemia), the group with Hb³9 g/dl showed a significant correlation between hemoglobin and MCV(r=0.6584, p<0.05). However, in the group with Hb<9 g/dl, there was a significant correlation between hemoglobin and MCHC(r=0.4305,p<0.05). 5) Negative correlation was observed between MCV and RDW in both groups, 0.05)> indicating more microcytic in RBC index and anisocytosis in RBC shape. 6) MCV/RDW ratio was correlated significantly with Fe/TIBC saturation(r=0.4763, p<0.005) and MCV/RDW ratio of less than 5.1. This is to be the most sensitive index in the diagnosis of IDA, sensitivity 85.4% in both mild and severe groups. In conclusion, in addition to serum iron markers, MCV, MCHC and RDW have been used as screening tests and prediction for IDA. We suggest that the ratio of MCV/RDW(fl/%) less than 5.1 is one of the most sensitive index in screening and diagnosing IDA with 85.4% sensitivity rate.