Les difficultés d'interprétation du bilan martial

Accurate iron status assessment remains challenging for our laboratories. Iron measurement is performed only to calculate transferrin saturation (TS) which is the screening test for hemochromatosis (TS > 45 %) and can be helpful in iron deficiency diagnosis (TS < 16 %). Ferritine is the key marker for iron deficiency diagnosis. A low ferritin concentration < 15 μg/L (or < 30 μg/L in case of anemia) is sufficient for diagnosis. A ferritin within the normal range, associated with a CRP < 30 mg/L, is an exclusion criteria of iron deficiency. During anemia of chronic disease (CRP > 30 mg/L), soluble transferrin receptor and hypochromic erythrocytes are increased if iron deficiency is associated, whereas reticulocyte haemoglobin content is decresased.