From the Guidelines
To enter an anemia panel with the specified values, you should access your electronic health record (EHR) or laboratory information system and navigate to the lab order section, selecting "Anemia Panel" or "Iron Studies" and entering each value individually: ferritin 989 ng/mL, Total Iron Binding Capacity (TIBC) 64 μg/dL, iron level 44 μg/dL, and transferrin 50 mg/dL. These values suggest iron overload, as the ferritin is significantly elevated while TIBC and transferrin are low, indicating possible hemochromatosis or another condition causing iron accumulation, as supported by the expert consensus guidelines 1. The transferrin saturation (calculated as iron divided by TIBC multiplied by 100) is approximately 69%, which is elevated and further supports iron overload. According to the guidelines, a ferritin level above 100 ng/mL in the presence of inflammation indicates anaemia of chronic disease (ACD) 1, but in this case, the ferritin level is significantly higher, suggesting iron overload rather than ACD. It's essential to consider the patient's clinical context, including any signs of inflammation, to accurately interpret these results, as ferritin levels can be affected by acute-phase reactions 1. After entering these values, save the information and submit the order according to your system's protocol. If you're unsure about the specific steps for your particular EHR system, consult your facility's IT support or laboratory department for assistance with the exact workflow. It's also crucial to monitor the patient's response to any treatment, including iron parameters and hemoglobin concentrations, as outlined in the expert consensus guidelines 1. In patients with iron overload, it's essential to avoid transferrin saturation levels above 80% to prevent toxicity, as suggested by the guidelines 1. Regular monitoring and adjustments to treatment should be made to ensure the patient's iron levels remain within a safe range, prioritizing their morbidity, mortality, and quality of life.
From the Research
Entering Anemia Panel Results
To enter an anemia panel, including a ferritin level of 989, a TIBC (Total Iron-Binding Capacity) of 64, and an iron level of 44, with a transferrin level of 50, consider the following steps:
- Identify the laboratory information system or software used to record patient results.
- Locate the section for entering laboratory results, specifically the anemia panel.
- Enter the ferritin level of 989, which is significantly elevated, indicating potential iron overload 2, 3, 4, 5.
- Enter the TIBC of 64, which is lower than the normal range, also suggesting iron overload 2, 3, 4, 5.
- Enter the iron level of 44 and the transferrin level of 50, which can help calculate the transferrin saturation percentage, an important indicator of iron overload 2, 3, 4, 5.
Interpreting Results
When interpreting these results, consider the following:
- Elevated ferritin levels can indicate iron overload, which may be due to genetic or secondary causes 3, 4, 5.
- Low TIBC and high iron levels can also suggest iron overload 2, 3, 4, 5.
- Transferrin saturation percentage can help confirm the diagnosis of iron overload 2, 3, 4, 5.
Clinical Implications
The clinical implications of these results include:
- Potential for organ damage due to iron overload, such as liver or heart damage 2, 3, 4, 5.
- Need for further testing, such as genetic testing or liver biopsy, to confirm the diagnosis and guide treatment 3, 5.
- Importance of monitoring and managing iron levels to prevent long-term complications 2, 3, 4, 5.