Year: 2017
Type: article
Abstract: In this issue of the Brazilian Journal of Hematology and Hemotherapy, Babaei et al. 1 investigated the cut-off level for serum ferritin that would better discriminate between elderly patients with and without iron deficiency anemia (IDA).IDA is a common manifestation among the elderly population.It has often been associated to gastrointestinal bleeding caused by esophagitis, gastritis, peptic ulcer, cancer, and intestinal polyps.[2][3][4][5] Although a bone marrow examination is the gold standard test to assess iron stores, it is an invasive method with no practical applicability.6,7 A recent systematic review showed that all guidelines recommend the measurement of serum ferritin to diagnose IDA. 8 Serum ferritin is considered a first-line diagnostic tool not only due to its availability, but also because its plasmatic levels accurately reflect overall iron storage, with 1 ng of ferritin per mL indicating approximately 10 mg of total iron stores.1,9 While serum ferritin under 10-15 ng/mL has 99% of specificity in the diagnosis of IDA, normal or elevated ferritin levels do not exclude IDA, since ferritin is an acute phase protein and may increase during inflammation, cancer, and with aging.8,10 Hence, some studies provide data supporting the use of higher ferritin thresholds for diagnosis, such as 30 or 100 ng/mL.11,12 Elderly people often have many morbidities some of which can potentially lead to anemia, making the diagnosis of IDA particularly challenging in this population.13 Moreover, in individuals with chronic diseases, anemia of inflammation
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W2605485700