Dear Healthcare Practitioner,
Please be advised that effective September 9, 2024, there will be changes to the ferritin test reports. Instead of reference intervals, clinical decision limits for iron deficiency of < 30 ug/L for adults and < 20 ug/L for children will be applied to patient results. The detailed changes are outlined in Table 1 below. This update is in accordance with the recent update to the Ontario Association of Medical Laboratories (OAML) guideline “Guidelines for the Use of Laboratory tests for Iron Deficiency” 1 and aligns with the most recent recommendations of the Ontario Laboratory Medicine Program.2 A summary of the changes is listed below.
Table 1: Change in ferritin interpretive comments:
|
Patient Age |
Ferritin concentration (µg/L) |
Interpretative comment |
|
<18 years of age |
<20 |
Result consistent with iron deficiency
For guidance, see www.hemequity.com/raise-the-bar |
|
≥20 |
In absence of concomitant inflammation, Ferritin levels can be interpreted as follows: · 20 – 50 µg/L: Probable iron deficiency · 51 – 100 µg/L: Possible iron deficiency, if risk factors are present · 101 – 300 µg/L: Iron deficiency unlikely · ≥600 µg/L: Consider test for iron overload
In patients with concomitant inflammation, use iron studies, including TIBC and Transferrin Saturation, to assess iron deficiency status. For guidance, see www.hemequity.com/raise-the-bar |
|
|
≥18 years of age |
<30 |
Result consistent with iron deficiency. For guidance, see www.hemequity.com/raise-the-bar |
|
≥30 |
In absence of concomitant inflammation, Ferritin levels can be interpreted as follows: · 30 – 50 µg/L: Probable iron deficiency · 51 – 100 µg/L: Possible iron deficiency, if risk factors are present · 101 – 300 µg/L: Iron deficiency unlikely · ≥600 µg/L: Consider test for iron overload
In patients with concomitant inflammation, use iron studies, including TIBC and Transferrin Saturation, to assess iron deficiency status. For guidance, see www.hemequity.com/raise-the-bar |
Summary of changes:
- Reference intervals will be removed from the test reports and will be replaced with clinical decision limits.
- Results less than 30 µg/L for adults (≥18 years of age) will be flagged as low.
- Results less than 20 µg/L for children (<18 years of age) will be flagged as low.
- Results greater than or equal to 600 µg/L will be flagged as high for all ages.
For any clinical or technical questions regarding this change please contact the LifeLabs biochemist:
|
Dr. Kika Veljkovic, PhD FCACB Discipline Head, High Volume Chemistry T 416-675-4530 Ext. 42832
|
Thank you
References
- Guidelines for the Use of Laboratory Tests for Iron Deficiency (2024) Ontario Association of Medical Laboratories (OAML). https://oaml.com/guidelines/ (accessed Sep 4th 2024).
- Ontario Health – Ontario Laboratory Medicine Program (OLMP) Info Bulletin: Change in clinical decision limit for serum ferritin testing. Received by laboratory director September 4th, 2024.
