Fast Five Quiz: Signs and Symptoms of Iron Deficiency Anemia

James L. Harper, MD


October 22, 2021

During workup, iron deficiency anemia must be differentiated from other microcytic anemias, such as anemia of chronic disease and hemoglobinopathies. A low serum iron level, high iron-binding capacity, and low serum ferritin level are generally seen in iron deficiency anemia. When differentiating iron deficiency anemia from iron-transport deficiency anemia, transferrin saturation is typically < 10 as opposed to 0; microcytosis is more common than hypochromia; the serum ferritin level is usually < 12 ng/mL (< 27 pmol/L) as opposed to normal; and marrow iron is not present.

Notably, in the context of chronic kidney disease, the criteria used to define iron deficiency are different than in other patients. In patients with chronic kidney disease, iron deficiency is diagnosed when the transferrin saturation is ≤ 20% and the serum ferritin concentration is ≤ 100ng/mL (patients in predialysis and peritoneal dialysis) or ≤ 200ng/mL (patients in hemodialysis).

Learn more about the workup of iron deficiency anemia.

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