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CPE-004 · synthetic case IRON-FX-23
Borderline ferritin with fatigue
Ferritin 38, Hb 12.8 and fatigue.
Purpose: Ferritin 38, Hb 12.8 and fatigue.
Inputs the engine received
Iron studies
- Ferritin
- 38 ng/mL
CBC
- Hemoglobin
- 12.8 g/dL
Patient
- Age
- 36 years
- Sex
- Female
Symptoms and findings
- Fatigue
- Yes
What the engine reports
Detected clinical pattern
Borderline Ferritin — Interpret in Context
Ferritin is under the AGA 2020 cutoff of 45 ng/mL with anemia or symptoms present. This is not on its own an iron-deficiency criterion.
- Anemia: No anemia (Hb 12.8 g/dL)
Why this pattern was identified
- Borderline ferritin (30 to 44 ng/mL). Ferritin 38 ng/mL sits under the AGA 2020 cutoff of 45 ng/mL, with symptoms present. This is not on its own an iron-deficiency criterion.
Evidence and rule trace · 1 rules
ID-ST-03Borderline ferritin (30 to 44)
Inputs: ferritin 38 ng/mL · iron-related symptoms
Borderline ferritin: AGA 2020 diagnostic cutoff is 45 ng/mL.
Evidence
- EV-AGA-2020 · Ko CW, Siddique SM, Patel A, et al. AGA Clinical Practice Guidelines on the Gastrointestinal Evaluation of Iron Deficiency Anemia. Gastroenterology. 2020;159(3):1085-1094.
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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