[Serum ferritin in differential diagnosis of anemia (author's transl)]

The concentration of ferritin in the serum of normal males (n = 79) was 98 micrograms/l (geometric mean) with a 95% confidence range of 21-447 micrograms/l. In non-menstruating healthy females (n = 39), the concentration was 85 (26-279) micrograms/l. In menstruating females, serum ferritin was less than 30 micrograms/l only when the duration of menstruation was more than or equal to 4 days. Patients with uncomplicated iron-deficiency anemia had a serum ferritin level less than 20 micrograms/l. After oral or parenteral iron therapy, serum ferritin was greater than 20 micrograms/l in 7 to 17 patients. Serum ferritin was greater than 20 micrograms/l in 8 of 12 patients with a simultaneous inflammatory or malignant disease. Of patients with iron-deficiency anemia, 86% had a serum ferritin level lower than 40 micrograms/l. A serum ferritin level less than 40 micrograms/l was only observed in patients with iron-deficiency anemia and not in patients with other forms of anemia. Of patients with iron-deficiency anemia and a hemoglobin concentration lower than 100 g/l, 80% had a serum iron level less than 13 mumol/l and a total iron binding capacity higher than 70 mumol/l. Anemia of chronic disorders was diagnosed with a sensitivity of 0.93 and a specificity of 0.92 in patients with serum iron less than 13 mumol/l, total iron binding capacity less than 60 mumol/l, erythrocyte sedimentation rate greater than 25 mm in the first hour, and serum fibrinogen greater than 4 g/l. Somewhat better was the same combination except with the serum ferritin level greater than 50 micrograms/l instead of the iron binding capacity. However the predictive value using both combinations was too low.