Is a child with a hemoglobin (Hgb) level of 128, hematocrit (Hct) of 0.39, and ferritin level of 25 still considered to have iron deficiency anemia?

From the Guidelines

A child with a hemoglobin level of 128 g/L, hematocrit of 0.39, and ferritin level of 25 ng/mL does not have iron deficiency anemia. These laboratory values are within normal ranges for a pediatric patient. Iron deficiency anemia is diagnosed when there is both evidence of iron deficiency (typically ferritin <12 ng/mL) and anemia (low hemoglobin for age) 1. In this case, the hemoglobin and hematocrit values indicate adequate red blood cell mass, and the ferritin level, while on the lower end of normal, is still above the threshold that would indicate iron depletion. However, it's worth noting that the ferritin level of 25 ng/mL, though not diagnostic of iron deficiency anemia, is somewhat low and could potentially indicate early iron depletion without anemia. Some key points to consider include:

• The child's iron saturation is 0.29, which is below the normal range, but the ferritin level is still above the threshold for iron deficiency 1.
• The child's transferrin level is 2.91, which is within normal ranges.
• Ensuring adequate dietary iron intake would be prudent, with foods rich in iron including lean meats, fortified cereals, beans, and leafy green vegetables. Regular follow-up with the child's healthcare provider would be appropriate to monitor these values if there are ongoing concerns about iron status.

From the Research

Iron Deficiency Anemia Diagnosis

• The child's hemoglobin (Hgb) level is 128, which is within the normal range for their age, indicating that the anemia has been resolved 2, 3.
• The hematocrit (Hct) level is 0.39, which is also within the normal range, further supporting the resolution of anemia 2, 3.
• The ferritin level is 25, which is below the normal range for children, indicating that iron deficiency is still present 4, 5.
• The iron saturation level is 0.29, which is low, also indicating iron deficiency 4, 5.

Iron Deficiency Without Anemia

• According to the studies, it is possible for a child to have iron deficiency without anemia, as iron deficiency can exist even when hemoglobin levels are normal 4, 6.
• The child's iron deficiency can still be treated with iron supplementation to improve their iron stores and prevent future anemia 2, 3.
• Intermittent iron supplementation has been shown to be effective in reducing anemia and improving iron stores in children 2, 3, 6.

Treatment and Management

• The child's iron deficiency should be treated with iron supplementation to improve their iron stores and prevent future anemia 4, 2, 5, 3, 6.
• The treatment regimen should be tailored to the child's specific needs and monitored regularly to ensure effectiveness and minimize side effects 6.