Prevalence of Iron Deficiency Anemia in Biochemically Defined Moderate to Severely Anemic patients in a Tertiary Care Centre

INTRODUCTION: Anemia due to iron deficiency and chronic diseases is a common occurrence in a developing country like Nepal, the latter seen in patients with various inflammatory, autoimmune, and malignant disorders (functional iron deficiency). The Intensive method of marrow iron examination, which this study has employed, provides a clinically useful iron status classification in cases of functional iron deficiency. The aim of the study is find out the prevalence of iron deficiency anemia in biochemically defined moderate to severe anemic patients in tertiary care center. METHODS: A descriptive cross-sectional study was done in 43 patients who underwent bone marrow aspiration for evaluation of any cause and had moderate to severe anemia at the same time over a period of one year from Nov 2015 to 2016. Ethical clearance was obtained from Institutional Review Committee. The bone marrow iron stores were assessed by the “intensive method” apart from the routinely used Gale’s method. Data was collected and entry were done in Statistical Package for Social Sciences version 24. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. RESULTS: The intensive grading system demonstrated normal marrow iron store in 13 (30.2%), depleted iron stores in 3 (7%), functional iron deficiency in 14 (32.6%), and combined deficiency in 13 (30.2%) patients. Mean log ferritin concentration was lower in patients with depleted iron stores (2.2µg/l) than in those with normal (2.7µg/l), and functional iron deficiency (2.4µg/l). The mean log ferritin in combined deficiency was lower than the mean log ferritin concentration in iron store defficiency (1.9µg/l). CONCLUSIONS: The prevalence of functional iron deficiency anemia was greatest when the intensive method for assessment of bone marrow iron was used, thus differentiating four different iron status categories, including functional iron deficiency, from actual iron store deficiency, avoiding unnecessary iron supplementation in the former group.