[24.] Yamanishi H, lyama S, Yamaguchi Y, Kanakura Y, Iwatani Y Total iron-binding capacity
calculated from serum transferrin concentration or serum iron concentration and unsaturated iron-binding capacity
Normal Values of Iron Indices * Iron Iron Iron Normal Deficiency Deficiency ParameterIron Assessed Range (Absolute) (Functional) TIBC, [micro]g/dl Functional 240-450 ([dagger]) ([dagger]) Serum iron, [micro]g/dl Functional 50-150 ([dagger]) ([dagger]) TSAT, % Functional 20-50 <20 <20 Serum ferritin, ng/ml Storage 30-200 <100 >100 CHr, pg Functional 25.9-33.9 <29 <29 TIBC indicates total iron-binding capacity
; TSAT, transferrin saturation; and CHr, reticulocyte hemoglobin content.
Although iron and cholesterol assays are deemed moderately complex, iron-binding capacity
and HDL cholesterol tests are complex because they require a pretreatment step.
The relation between chemically measured total iron-binding capacity
concentrations and immunologically measured transferrin concentrations in human serum.
Sideroblastic anemias are characterized by a high saturation of the serum iron-binding capacity
(sometimes approaching 80%) and high iron levels in the presence of anemia.
Laboratory evaluation revealed a hemoglobin of 10.2 g/dL (102 g/L); mean corpuscular volume, 69 fL; serum iron, 14 [mu]g/dL (2.5 [mu]mol/L); serum iron-binding capacity
, 364 [mu]g/dL (65 [mu]mol/L); vitamin [B.sub.12], 150 pg/mL (111 pmol/L); and folic acid, 3.6 ng/mL (8 nmol/L).
Another frequent and costly mistake is the grouping of procedures that should be coded separately-an iron and iron-binding capacity
, for example.
Iron-deficiency anemia should be suspected if the patient has a low serum ferritin, high total iron-binding capacity
, low serum iron, and low transferrin saturation.
Additional assays for aldolase, al-antitrypsin, amylase, angiotensin-converting enzyme (ACE), bile acids, direct bilirubin, ceruloplasmin, complement C4, complement C3, high-sensitivity C-reactive protein, creatine kinase, fructosamine, HDL-cholesterol, haptoglobin, iron, lipoprotein(a), lipase, LDL-cholesterol, magnesium, prealbumin, pancreatic amylase, phospholipids, transferrin, triglycerides, total iron-binding capacity
, and unbound iron-binding capacity
were performed only on the Roche Modular P analyzer.
Low serum iron and ferritin, and high total iron-binding capacity
TIBC: The sum of the serum iron plus the unsaturated iron-binding capacity
. Note: This article is supported by a financial grant from Amgen Inc.
For those elderly patients with anemia and normal red blood cell indices, the questionnaire asked which further test would be ordered (options included blood smear, reticulocyte count, stool for blood, serum iron levels, iron-binding capacity
, serum ferritin levels, serum vitamin B[.sub.12] levels, folate levels, or other).