Hematology 1
Iron Kinetics and Laboratory Assessment
Iron Chemistry
- Metabolic functions of iron depend on its ability
to change its valence states from reduced
ferrous (Fe2+) iron to the oxidized ferric (Fe3+)
state
- Fe2+ + H2O2 = Fe3+ + HO- + OH Iron Transport in the Blood
- The resulting hydroxyl radical (OH) also known - Iron exported from the enterocyte into the
as free radical, is especially reactive as a short blood is ferrous and must be converted to the
lived but potent oxidizing agent able to ferric form for transport in the blood
damage proteins, lipids and nuclei acids. - Once oxidized, the iron is ready for plasma
transport, carried by a specific, apotransferrin
Iron Kinetics (ApoTf)
Cellular Iron Storage
- Ferric iron is stored in a cage-liked protein
Absorption of Iron in the Intestines called apoferritin
- Iron can be absorbed in the intestines as heme - Once iron binds, it is known as ferritin
from animal food sources or as ionic iron - Partially degraded ferritin is known as
- Heme is absorbed by enterocytes hemosiderim.
- Iron is freed from protoporphyrin by heme
oxygenase
- Iron is transported from the endosome and
enters enterocyte cytoplasm
- Approx. daily iron absorbed in the body
o 2g – male
o 1.5g - female
- Most dietary iron is non-heme ionic iron in the
ferric form and must be reduced by duodenal
cytochrome b (or Dcytb) before it can enter the
enterocyte
- Carried across by DMT1 – Integral 12
transmembrane protein that has the ability to
transport a number of divalent cation, including
ferrous.
- Ferric iron can be stored as ferritin
MA. PATRICIA VILLANUEVA 1
Hematology 1
assessment of with the reagent
Iron Recycling tissue iron store forming the
- Largest percentage of recycled iron: comes Prussian blue
from RBC compound (seen
- Hgb is degraded: Iron held by macrophages microscopically:
(ferritin)—macrophage contains ferroportin in dark blue
their membrane allowing them to export granules
salvage irons binding with plasma - Gold standard
apotransferrin for it to be used eventually by for assessment
other cells. of body iron
stores
Laboratory Test Specimen:
Bone marrow/ Liver
Serum Iron Reagent: ferrozine biopsies
- Iron is released Ferritin Test - Iron-storage
- Used as an from transferrin protein
indicator of by acid, then the - Indicator for iron - Acute phase
available reagent is store reaction/
transport iron allowed to react reactant –
- Represent the with the freed released during
number bound iron forming a inflammation/
in iron colored complex infection
- Increases after o Can cause
recent ingestion false
of iron elevation
containing foods Thomas Plot - Plotting the ratio
Collection: fasting ; of soluble
early morning - Useful in transferrin
TIBC/ Total Iron - Transferrin is recognition of receptor to lag
Binding Capacity maximally Iron deficiency transferrin
saturated by when the other against the Hgb
- Used as indirect addition of test result content of
indicator of iron excess ferric reticulocytes
stores iron to the produced a
- Also represents specimen graph with four
the total number - Any unbound quadrants.
of site in iron iron is removed
binding by precipitation
with Magnesium
Carbonate
Powder
Amount of iron
detected:
All binding sites
available on transferrin
(TIBC)
Ref Interval:
250-400 g/dL
Percent Transferrin
Saturation
SI/TIBC X 100% = %
- Used as an transferrin saturation
indirect indicator
of iron stores Ref Interval:
with transport 20%-55%
iron
Prussian Blue Staining Reagent: Acidic
potassium
- Used for visual ferrocyanide
qualitative - The ferric iron in
the tissue reacts
MA. PATRICIA VILLANUEVA 2