title: Clinical relevance of erythrocyte ferritin in microcytic anemias.
abstract: BACKGROUND
  Erythrocyte ferritin (EF) reflects the balance between iron supply and its utilization for hemoglobin synthesis. This balance is altered in microcytosis. We aimed to evaluate the diagnostic value of both EF and the ratio (FRR) plasma ferritin (PF)/EF in these disorders.
  
  
  METHODS
  A total of 231 subjects participated in the study. Samples from 93 adult patients with different causes of microcytosis, 57 healthy subjects and 81 full-term newborns were analyzed to determine EF and PF concentrations and other hematological parameters.
  
  
  RESULTS
  In patients with iron deficiency, and in contrast to PF, EF decreased only in the presence of anemia and in direct correlation with the degree of microcytosis (Pearson's p<0.001). EF values for thalassemia patients were higher than those observed in controls (p<10e-5), while PF concentrations were similar between these groups. This EF increase was more marked in the delta-beta thalassemia group (p<0.05). Finally, FRR was much higher in patients with anemia of inflammation than in those with thalassemia (p<10e-5), thus helping to discriminate between these disorders.
  
  
  CONCLUSIONS
  EF and FRR are tools that may be useful in the diagnosis of the main causes of microcytosis.
authors.affiliation: Service of Hematology, Infanta Cristina Hospital, Badajoz, Spain. Electronic address: jvagacev@gmail.com.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Vagace
authors.affiliation: Service of Hematology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Antonio
authors.initials: A
authors.lastname: Peças
authors.affiliation: Service of Hematology, Infanta Cristina Hospital, Badajoz, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Groiss
authors.affiliation: Service of Hematology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Celeste
authors.initials: C
authors.lastname: Bento
authors.affiliation: Service of Hematology, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
authors.forename: Maria Leticia
authors.initials: ML
authors.lastname: Ribeiro
authors.affiliation: Department of Surgical and Medical Therapeutics, University of Extremadura, Badajoz, Spain.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Gervasini
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000097:blood* / Q000175:diagnosis; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D005293:Ferritins / Q000097:blood*; D006761:Hospitals; D006801:Humans; D007231:Infant, Newborn; D007501:Iron / Q000378:metabolism; D008297:Male; D013789:Thalassemia / Q000097:blood* / Q000175:diagnosis
chemical_list: D005293:Ferritins; D007501:Iron
keywords: Anemia; Erythrocyte ferritin; Iron deficiency; Microcytosis; Thalassemia