iron (Fe+2/Fe+3) in serum
Contraindications
- microcytic anemia in menstruating women with prior normal blood hemoglobin (MKSAP19)*
* treat for iron-deficiency anemia without testing (MKSAP19)
Reference interval
Principle
The Kodak Ektachem Clinical Chemistry Slide (FE) is a dry, multilayered, self-contained analytical element coated on a clear polyester support.
A 10 microliter drop of sample deposited on the slide is evenly distributed by the white & isotropically porous spreading layer.
Iron (as ferric iron) is removed from transferrin at acidic pH & migrates to the reducing & scavenger layer where the reducing agent ascorbic acid reduces it to a ferrous iron.
The ferrous iron then is bound to the dye & forms a colored complex in the reagent layer.
After the addition of the sample, the slide is incubated at 37 degrees celsius. two reflection density measurements at 600 nm are made at 54 & 297 seconds. The rate of change in reflection density is proportional to the iron concentration in the sample.
Clinical significance
Most body iron is found in hemoglobin. Measurement of serum iron is useful in the differential diagnosis of anemia, iron deficiency anemia, thalassemia, possible sideroblastic anemia, & iron poisoning. Total iron-binding capacity (TIBC), representing transferrin concentration in iron-binding capacity, is a useful index of nutritional iron status. The combination of a low serum FE, high TIBC &/or transferrin & low saturation of iron binding capacity usually indicates iron deficiency.
Increases
- hemosiderosis
- hemolytic anemias
- thalassemia
- sideroblastic anemias
- hepatitis
- acute hepatic necrosis
- hemochromatosis
- inappropriate iron therapy
- iron poisoning
Decreases
- insufficient dietary iron
- chronic blood loss
- inadequate absorption of iron
- impaired release of iron stores, resulting from
- inflammation
- infection
- chronic diseases
Specimen
No special patient preparation is required.
Sample Preparation: Serum or heparinized plasma samples should be collected by standard laboratory procedures in recloseable containers to avoid contamination & evaporation. If analysis cannot be performed on the day of collection, refrigerate the sample at 2-8 degrees celsius. Samples are stable for 7 days when refrigerated. For longer term storage, sample should be frozen at -20 degrees celsius for no longer than 3 months.
Sample requirements: Minimum- 0.5mL serum or heparinized plasma. Optimum: 1mL serum or heparinized plasma.
Interferences
- EDTA, NaF/potassium oxalate, & citrate plasmas should not be used.
- Desferol (Deferoxamine Mesylate) at a concentration of 250mg/dL & higher, results in iron values below the analyzer range.
- Cupramine (penicillamine) results in a negative bias of 8% for each mg/dL of added Cupramine.
- Imferon produces a positive iron bias of 20 ug/dL for each 100 mg/dL of Imferon.
More general terms
Additional terms
Component of
- iron studies
- iron/transferrin in serum
- iron/total iron binding capacity in serum
- iron/hemochromatosis panel
- anemia panel
References
- ↑ Kodak Ektachem 700 Test Methodologies Manual, Kodak Clinical Products, Rochester, N.Y., 1990.
- ↑ Kodak Ektachem 700 Operators Manual, Kodak Clinical Products, Rochester, N.Y., 1987.
- ↑ Package Insert, Kodak Ektachem Special Calibrators, Kodak Clinical Products, Rochester, N.Y., 1985.
- ↑ Package Insert, Bio-Rad Liquichek Controls, Bio-Rad ECS Division, Anaheim, CA., 1992.
- ↑ Iron, Serum or Plasma Laboratory Test Directory ARUP: http://www.aruplab.com/guides/ug/tests/0020037.jsp
- ↑ Panel of 4 tests Laboratory Test Directory ARUP: http://www.aruplab.com/guides/ug/tests/0020420.jsp