Detection of Iron Deficiency Anemia

Abstract

<h3>To the Editor.</h3> — Iron deficiency is a common disorder in ambulatory subjects.^1,2While most such subjects are neither anemic nor symptomatic, even early iron deficiency reflects abnormal blood loss (usually due to bleeding) that requires medical attention. To screen such subjects for early iron deficiency rapidly, inexpensively, and accurately, serum transferrin saturation or ferritin values are too expensive. Since an isolated high red cell distribution width (RDW) has been shown to precede other blood count abnormalities during development of iron deficiency,³we studied the value of the automated blood cell count as a screening instrument in 783 unselected asymptomatic outpatient adult volunteers (57% women, 81% white, 19% black). Simultaneous serum ferritin, folate, and vitamin B₁₂levels were determined. The blood cell count was determined on a Coulter Counter S-Plus Sr (Coulter Electronics, Hialeah, Fla).⁴Iron deficiency was defined as a serum ferritin level of less