Título Em Hematologia E Hemoterapia Practice Questions - Título De Especialista Em Hematologia E Hemoterapia (ABHH AMB) Exam

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A 34-year-old female presents with persistent fatigue, pica (pagophagia), and brittle spoon-shaped nails (koilonychia). Laboratory workup reveals: Hemoglobin 8.4 g/dL, MCV 68 fL, MCH 22 pg, Serum Iron 24 mcg/dL, Total Iron-Binding Capacity (TIBC) 450 mcg/dL, Transferrin Saturation 5.3%, and Serum Ferritin 6 ng/mL. Which laboratory finding most definitively confirms iron deficiency anemia (anemia ferropriva) over anemia of chronic disease / inflammation?

Severely decreased serum ferritin (< 15 ng/mL) combined with elevated TIBC. Elevated serum ferritin with normal transferrin saturation. Marked elevation of soluble transferrin receptor (sTfR) with a normal transferrin level. Decreased hemoglobin with an elevated reticulocyte production index (> 3.0).

Correct Answer:

Severely decreased serum ferritin (< 15 ng/mL) combined with elevated TIBC.

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