What does an iron level of 15 umol/L, a ferritin level of 464 ug/L, a transferrin level of 2.4 g/L, and a transferrin saturation of 0.25 indicate for the patient's health?

From the Guidelines

These laboratory values suggest a condition called anemia of chronic disease (also known as anemia of inflammation), where the body has adequate iron stores but cannot effectively utilize them for red blood cell production due to an underlying chronic condition. The iron level of 15 umol/L is within normal range, but the elevated ferritin level of 464 ug/L indicates increased iron storage, likely due to inflammation, as supported by the study 1. The transferrin level of 2.4 g/L is normal, and the transferrin saturation of 0.25 (25%) is at the lower end of normal. According to the most recent guideline 1, in the presence of biochemical or clinical evidence of inflammation, the diagnostic criteria for anemia of chronic disease are a serum ferritin >100 mg/L and transferrin saturation <20%. Given the patient's ferritin level is significantly higher than 100 mg/L, it is likely that the patient has anemia of chronic disease. The patient should undergo further evaluation to identify the underlying cause, which could include chronic infections, autoimmune disorders, kidney disease, or malignancy. Complete blood count, inflammatory markers (CRP, ESR), and kidney function tests would be appropriate next steps. Treatment should focus on addressing the underlying condition rather than iron supplementation, which could be harmful in this scenario, as iron supplementation is recommended only when iron-deficiency anemia is present 1. Iron supplementation should be avoided unless true iron deficiency is confirmed, as the elevated ferritin suggests adequate or excessive iron stores. The patient should follow up with their healthcare provider to discuss these results and develop a comprehensive diagnostic and treatment plan. Key considerations include:

• Elevated ferritin levels indicating inflammation
• Normal iron levels but decreased transferrin saturation
• Need for further evaluation to identify underlying cause
• Avoidance of iron supplementation unless true iron deficiency is confirmed
• Focus on treating underlying condition rather than anemia alone, as recommended by the recent study 1.

From the Research

Iron Level Interpretation

The patient's iron level is 15 umol/L, which falls within the normal range of 10-30 umol/L.

Ferritin Level Interpretation

The patient's ferritin level is 464 ug/L, which is slightly above the normal range of 20-450 ug/L. According to 2, a markedly elevated serum ferritin level can be associated with inflammatory conditions, malignancy, or iron-overload syndromes. However, the patient's ferritin level is not significantly elevated, and other factors such as inflammation or liver disease may also contribute to elevated ferritin levels.

Transferrin and Transferrin Saturation Interpretation

The patient's transferrin level is 2.4 g/L, which falls within the normal range of 1.7-3.4 g/L. The transferrin saturation is 0.25, which is within the normal range of 0.15-0.50. According to 3, transferrin saturation is a marker of iron availability, and a level less than 20% can indicate iron deficiency. However, the patient's transferrin saturation is above this threshold, suggesting that iron availability is not significantly impaired.

Potential Health Implications

Based on the patient's iron, ferritin, transferrin, and transferrin saturation levels, there is no clear indication of iron deficiency or iron overload. However, the slightly elevated ferritin level may suggest the presence of inflammation or other underlying conditions. As noted in 4, patients with inflammatory conditions may have restricted iron availability despite normal or high ferritin levels. Further evaluation and testing may be necessary to determine the underlying cause of the patient's slightly elevated ferritin level and to assess their overall iron status.

Key Points to Consider

• The patient's iron level is within the normal range.
• The patient's ferritin level is slightly above the normal range, which may indicate inflammation or other underlying conditions.
• The patient's transferrin and transferrin saturation levels are within the normal range, suggesting that iron availability is not significantly impaired.
• Further evaluation and testing may be necessary to determine the underlying cause of the patient's slightly elevated ferritin level and to assess their overall iron status, as discussed in 5 and 6.