Ferritin is a key laboratory test used to measure iron status. Findings from a recent questionnaire on ferritin testing was presented by Anna Johnston at the Ontario Society of Clinical Chemists Annual Scientific Meeting on Thursday, October 27.

Anna, who is a Consultant Technologist at IQMH Proficiency Testing presented the results of the questionnaire on behalf of the IQMH Endocrinology and Immunology Scientific committee. A total of 97 laboratories responded to questions related to how they manage reference intervals and reporting of ferritin levels.

The presentation prompted meaningful discussions among the attendees regarding the variation in the assay and interpretive parameters that determine one’s iron status based on the committee’s findings, which suggest that some patients with iron deficiency anemia (IDA) may not be appropriately  diagnosed or treated  because:

• Standardization of the ferritin assay has yet to be achieved by manufacturers.
• There are available reference materials that most manufacturers use however, results are not directly comparable.
• There is variation in lower and upper reference intervals both within and between methods and variation in interpretative guidance provided to physicians.
• Few laboratories apply clinical cutoffs to alert for iron deficiency or excess.
• Various sources are used to develop ferritin reference intervals or clinical cutoffs.

Why is this important for patient safety?
IDA is the most common nutritional deficiency worldwide and can give rise to symptoms such as fatigue, lethargy, and reduced child development. According to the World Health Organization (WHO), approximately 25% of the world’s population experience IDA. Two of the biggest risk groups for developing IDA are women of childbearing years and young children. As well, iron overload can result in liver disease, heart problems, and hormonal diseases such as diabetes. IQMH’s initiative highlights the need for further studies to develop appropriate ferritin reporting in Ontario.