Low ferritin is most indicative of which condition?

Low ferritin is most indicative of which condition?

• A. Iron deficiency anemia
• B. Aplastic anemia
• C. Pernicious anemia
• D. Hemolytic anemia

Answer: (A)

Ferritin reflects the body's iron stores, so when stores are depleted, ferritin falls and becomes a sensitive indicator of iron deficiency. A low ferritin level therefore most strongly points to iron deficiency anemia, especially if accompanied by a microcytic, hypochromic picture and other iron studies consistent with low iron. In contrast, aplastic anemia centers on bone marrow failure with low blood counts, not depleted iron stores, so ferritin is not characteristically low (it may be normal or even high if there have been transfusions or inflammation). Pernicious anemia is a vitamin B12 deficiency and ferritin is usually normal or elevated rather than reduced. Hemolytic anemia involves destruction of red cells; iron is released from destroyed cells and ferritin may be normal or elevated rather than low.

Ferritin reflects the body's iron stores, so when stores are depleted, ferritin falls and becomes a sensitive indicator of iron deficiency. A low ferritin level therefore most strongly points to iron deficiency anemia, especially if accompanied by a microcytic, hypochromic picture and other iron studies consistent with low iron.

In contrast, aplastic anemia centers on bone marrow failure with low blood counts, not depleted iron stores, so ferritin is not characteristically low (it may be normal or even high if there have been transfusions or inflammation). Pernicious anemia is a vitamin B12 deficiency and ferritin is usually normal or elevated rather than reduced. Hemolytic anemia involves destruction of red cells; iron is released from destroyed cells and ferritin may be normal or elevated rather than low.