[Significance of laboratory examinations in the diagnosis of iron-deficiency anemia in older persons].

In order to assess the effectiveness of selected laboratory examinations in the differential diagnosis of anaemias in elderly patients the authors examined 170 patients aged 65-93 years. Depending on the cause of anaemia, they divided the group into five sub-groups. Analysis revealed that for the diagnosis of iron-deficiency anaemia the mean corpuscular volume and red cell haemoglobin level have a relatively low sensitivity (63 and 65.6%) and specificity (76.7 and 72.4%), serum iron has a very low specificity (37%) and the total iron binding capacity has a low sensitivity (31.3%). Serum ferritin (sF) has at the lower borderline of the reference interval 30 micrograms/l a 48% sensitivity and 100% specificity; when the value is 65 micrograms/l the respective values are 80 and 99%. Using routine parameters, it is not possible differentiate reliably in this group iron deficiency anaemia during chronic inflammations, infectious diseases and malignant diseases. Examination of SF when the lower borderline of the reference is raised improves the effectiveness of laboratory diagnosis in elderly patient.