John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive

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Iron deficiency: diagnostic methods based on a pathophysiological approach Volume 25, issue 4, Avril 2018

Author
1 Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, Département Hospitalo-Universitaire I2B, F-75005, Paris, France
2 Groupe Hospitalier Pitié-Salpêtrière, Service de médecine interne et immunologie clinique, 83 boulevard de l’hopital, 75013 Paris, France
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Numerous tests have been proposed as a diagnostic method for iron deficiency, with sometimes variable thresholds depending on the populations. Biomarkers are used to analyze the state of iron stocks according to the compartments where it is present. The state of intracellular iron stores is analyzed by hemoglobin levels, microcytosis, reticulocyte levels, hypochromic erythrocyte levels, and reticulocyte hemoglobin content. The iron storage compartments are analyzed via ferritin levels and myelogram data. The transport iron can be analyzed by the transferrin saturation, the soluble transferrin receptor level, and the transferrin/ferritin soluble receptor ratio. The biological formula will be different depending on the type of deficiency: absolute iron deficiency (low ferritin, low transferrin saturation factor), functional iron deficiency (normal or high ferritin, but low transferrin saturation), or even mixed deficiency (for example, absolute deficiency due to blood loss and functional deficiency due to inflammation). After martial supplementation (oral or parenteral), the markers described above will also be useful to confirm (or deny) the effectiveness of treatments. The kinetics of correction of abnormalities is as follows: transferrin saturation factor, hemoglobin level, ferritin level, and finally microcytosis.

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