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CPE-004 · Anemia
ID-11: Iron-deficiency anemia pattern
Iron-deficiency anemia pattern. Evaluates anemia present (ID-AN-01).
Condition
- anemia present (ID-AN-01)
- an iron-deficiency criterion met (ID-ST-01, ID-ST-02, ID-ST-04 or ID-ST-06)
Supportive, not required
- MCV < 80 fL
- MCH < 27 pg
- RDW > 14.5%
- transferrin saturation < 16%
What it reports
- Biochemical pattern compatible with iron-deficiency anemia (stage 3)
Recommended next steps (for physician review)
- Establish the source: menstrual loss, gastrointestinal loss, diet or malabsorption
Never outputs
- a product, dose or duration of iron therapy
Diagnostic boundary
- A pattern for physician review; the cause still has to be found.
Evidence
- EV-WHO-FERR-2020World Health Organization. WHO guideline on use of ferritin concentrations to assess iron status in individuals and populations. Geneva: WHO; 2020.Supports: Ferritin below 15 µg/L indicates iron deficiency in healthy adults A higher cutoff (<70 µg/L) applies in the presence of infection or inflammation
- EV-CAMASCHELLA-2015Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015;372(19):1832-1843.Supports: Stages of iron deficiency, causes and differential diagnosis of microcytic anemia
- EV-LOPEZ-2016Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L. Iron deficiency anaemia. Lancet. 2016;387(10021):907-916.Supports: Risk groups, causes and evaluation of iron deficiency anemia
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
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-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-06
Inflammation with ferritin 48 and TSAT 9
Ferritin looks near normal but sits under the WHO inflammation cutoff of 70.
IRON-FX-09
Heart failure with ferritin 180 and TSAT 14
Ferritin 100–299 with low saturation meets the heart-failure definition.
IRON-FX-13
Severe anemia
Hemoglobin 6.4 g/dL with a ferritin of 4.
IRON-FX-14
Anemia with overt gastrointestinal bleeding
Black stools and Hb 8.9.
IRON-FX-17
Iron-deficiency anemia in pregnancy
A pregnant woman with Hb 10.2 and a ferritin of 11.
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