🔇 What is new in Hematology ??
The recent American Society of Hematology's 2026 guidelines on the diagnosis of iron deficiency is out!!
For years we've anchored to ferritin ≤12–15 ng/mL as the diagnostic line. The panel reviewed the evidence and concluded those thresholds were never evidence-based to begin with they were inherited. Here's what changes:
🔹 Children 9 months–4 years: ferritin ≤20 ng/mL (up from ≤12)
🔹 Adults: ≤30 ng/mL (up from ≤15) — and ≤50 ng/mL if there are symptoms or ongoing risk factors
🔹 Menstruating individuals: ≤30 ng/mL, with ≤50 ng/mL where there is heavy menstrual bleeding, planned surgery, or pregnancy being planned
🔹 Pregnancy: ≤30 ng/mL — and a strong recommendation against using ≤15 ng/mL, the only strong recommendation in the document
🔹 Anemia of inflammation: ferritin alone is not enough. Pair it with a fasting TSAT. Consider iron deficiency if TSAT <20% or ferritin <100 ng/mL
For India, where iron deficiency is near-endemic in women and young children, the practical implication is simple: a ferritin in the teens or twenties in a symptomatic menstruating woman is not reassurance. It is a diagnosis.
Worth a read, and worth a conversation with our lab colleagues about the reference ranges printed on our reports.
📄 Powers JM, et al. ASH 2026 guidelines for diagnosis of iron deficiency. Blood Advances. doi:10.1182/bloodadvances.2025015950
#Hematology #IronDeficiency #Anemia #WomensHealth #ASH2026 #EvidenceBasedMedicine
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اللهم يا مسهل الشديد، ويا ملين الحديد، ويا منجز الوعيد، ويا من هو كل يومٍ في أمرٍ جديد، أخرجني من حلق الضيق إلى أوسع الطريق، بك أدفع ما لا أطيق، ولا حول ولا قوة إلا بالله العليّ العظيم