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CPE-004 · synthetic case IRON-FX-12
Restless legs with ferritin 52
Ferritin is above the usual cutoffs but under the restless-legs threshold.
Purpose: Ferritin is above the usual cutoffs but under the restless-legs threshold.
Inputs the engine received
Iron studies
- Ferritin
- 52 ng/mL
- Serum iron
- 40 µg/dL
- TIBC
- 235 µg/dL
CBC
- Hemoglobin
- 13 g/dL
Patient
- Age
- 44 years
- Sex
- Female
Symptoms and findings
- Restless legs
- Yes
What the engine reports
Detected clinical pattern
No Iron-Deficiency Criterion Met
No iron-deficiency criterion is met with the values entered.
- Anemia: No anemia (Hb 13 g/dL)
Why this pattern was identified
- Restless legs and iron. Ferritin 52 ng/mL is within the range (≤75 ng/mL or TSAT <20%) at which the IRLSSG considers iron.
Calculations
- Transferrin saturation
- 17%
Serum iron ÷ TIBC × 100.
Recommended next steps
For physician consideration. Urgent review always comes first.
- 1Consider ferritin and transferrin saturation in the evaluation of restless legs.IRLSSG 2018.
Evidence and rule trace · 2 rules
ID-RLS-01Restless legs and iron status
Inputs: restless legs · ferritin 52 ng/mL · TSAT 17%
Iron status is relevant to restless legs.
Evidence
- EV-IRLSSG-2018 · Allen RP, Picchietti DL, Auerbach M, et al. Evidence-based and consensus clinical practice guidelines for the iron treatment of restless legs syndrome/Willis-Ekbom disease in adults and children. Sleep Med. 2018;41:27-44.
- EV-MENTZER-1973 · Mentzer WC Jr. Differentiation of iron deficiency from thalassaemia trait. Lancet. 1973;1(7808):882.
Physician adjudication required. Clinical decision support for physician review. This output identifies laboratory patterns and safety considerations. It does not diagnose, find a cause, or select an iron product, dose or route. Physician adjudication is required.
Change the values
The same engine, starting from this case. Change any value and watch the pattern and the rule trace react.
Stage of iron deficiency
○ 1 · Stores depleted
Low ferritin, normal CBC
○ 2 · Iron-deficient erythropoiesis
Low TSAT or reticulocyte Hb, Hb still normal
○ 3 · Anemia
Hemoglobin below the WHO threshold
No stage is assigned for the values entered.
Against typical reference intervals
Iron studiesDrag or type
- <15 depleted
- 15–29 low
- 30–44 borderline
- 45–299
- 300–999 high
- >1000 very high
Calculated from iron ÷ TIBC when both are entered.
Above 5 mg/L the engine reads ferritin as inflammation-affected.
CBC
- <7 severe
- 7–11.9 anemia range
- 12–12.9 (men <13)
- ≥13
Patient
Symptoms and findings
Conditions and risk groups
Work-up and treatment context
More iron cases
IRON-FX-01
Classic iron-deficiency anemia in a premenopausal woman
A 34-year-old with heavy periods, Hb 9.8, MCV 72 and a ferritin of 6.
IRON-FX-02
Normal CBC, low ferritin, fatigue and hair loss
A 29-year-old with a normal CBC and a ferritin of 18.
IRON-FX-03
Iron-deficiency anemia in a man
A 61-year-old man with Hb 10.9, MCV 76 and a ferritin of 9.
IRON-FX-04
Iron-deficiency anemia after menopause
A 67-year-old woman, postmenopausal, Hb 10.6, ferritin 11.
IRON-FX-05
Rheumatoid arthritis: ferritin 85, TSAT 12
Hb 10.4 with a ferritin that looks normal and a CRP of 18.
IRON-FX-06
Inflammation with ferritin 48 and TSAT 9
Ferritin looks near normal but sits under the WHO inflammation cutoff of 70.
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