Assessment of iron status in cases of anemia: A comparative analysis by Gale’s and Intensive method.

Abstract

Background: Nutritional anemia particularly iron deficiency anemia comprise a major public health problem in India. Precise diagnosis is necessary for the correct treatment as the multiple coexisting morbid chronic inflammatory conditions seen in these cases gives erroneous biochemical results. Microscopic assessment of bone marrow iron is considered to be the the gold standard. However, the conventional Gale's method cannot differentiate between the iron deficient cases and functional iron deficiency. This is made possible by the newer intensive method of iron assessment in the present study. Aim: To compare the assessment of iron status by Gale's and Intensive method on bone marrow aspirate smears in cases of anemia. Materials and Methods: A prospective study of 117 cases of all age groups and both sexes, having haemoglobin < 10mg/dl were included in the study. Bone marrow aspiration was done and iron assessment was done by both the Gale's and Intensive method. Serum ferritin was also done in 23 out of 117 cases to serve as a control. However, it was not a part of the study. Results: Gale's method revealed hypoferrimic state in 29.1% cases and normal iron stores in 70.9% cases. Iron deficient status was further reduced to 6.83% cases by the intensive method of iron assessment. Maximum number of cases had functional iron deficiency by the intensive method.

Post-mortem liver and bone marrow iron quantification in haemodialysis patients: A prospective cohort study

“… 8 , 51 , 52 Also semi-quantitative scales to grade iron deposition in liver and bone marrow are based upon seminal studies that have established the "normal" and "increased" iron content. 19 , 21 Hereditary haemochromatosis was not excluded by genetic test, as it is prevalent in Europeans and could explain iron overload on an individual basis. However, liver histology findings were not compatible with primary haemochromatosis in any patient.…”

“…Histological semi-quantitative analysis of bone marrow iron content (BMIC) was graded according to Gale's criteria 21 , 22 ranging from 0 to 6 (none to very heavy stainable iron). Bone marrow findings were classified as iron deficient (score of 0 or 1), normal (graded from 2-3) or iron overload (graded from 4-6).…”