ABSTRACT

Aim: To evaluate the utility of hematological and biochemical markers in diagnosing iron deficiency anemia (IDA) and differentiating it from anemia of chronic disease (ACD).

Material and Methods: This prospective observational study was conducted on 100 adult patients (aged 18–70 years) presenting with anemia (hemoglobin<12 g/dL for females and <13 g/dL for males). Patients were divided into two groups of 50 each: IDA, diagnosed by low serum ferritin (<15 ng/mL) and/or transferrin saturation (<20%) with microcytic hypochromic red cells, and ACD, identified by normocytic or microcytic anemia, elevated inflammatory markers (CRP, ESR), and normal or high serum ferritin (≥100 ng/mL). Hematological indices, iron studies, and inflammatory markers were analyzed, and diagnostic performance was assessed using receiver operating characteristic (ROC) curves.

Results: The IDA group had significantly lower hemoglobin (8.2 ± 1.5 g/dL), MCV (65 ± 5 fL), and MCHC (29 ± 2 g/dL) compared to the ACD group (9.5 ± 1.3 g/dL, 80 ± 7 fL, and 32 ± 2 g/dL, respectively; p < 0.001). Serum ferritin (8 ± 4 ng/mL vs. 150 ± 30 ng/mL, p < 0.001) and transferrin saturation (10 ± 2% vs. 20 ± 5%, p < 0.001) showed the most significant differences between the groups. Inflammatory markers, including CRP and IL-6, were elevated in ACD. Serum ferritin had the highest diagnostic accuracy (AUC: 0.95), followed by transferrin saturation (AUC: 0.93), RDW (AUC: 0.91), and IL-6 (AUC: 0.92).

Conclusion: Hematological and biochemical markers, particularly serum ferritin, transferrin saturation, and RDW, effectively differentiate IDA from ACD. Inflammatory markers such as CRP and IL-6 provide additional diagnostic value for ACD. An integrated approach combining these markers can guide precise diagnosis and tailored treatment.