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Blood, Vol. 92 No. 5 (September 1), 1998:
pp. 1807-1813
An Assessment of Dried Blood-Spot Technology for Identifying Iron
Deficiency
James D. Cook,
Carol H. Flowers, and
Barry S. Skikne
From the Department of Medicine, University of Kansas Medical Center,
Kansas City, KS.
The present study was undertaken to assess the feasibility of using
ferritin and transferrin receptor measurements on dried capillary blood
spots to identify iron deficiency (ID) in public health surveys.
Measurements on serum and blood spots prepared from venous blood were
performed in 71 healthy subjects, 41 of whom were iron-replete and 30 who had ID, either without (n = 20) or with (n = 10) anemia.
Parallel measurements were performed on hemolyzed whole blood and
washed hemolyzed red blood cells to assess the erythrocyte contribution
of ferritin and transferrin receptor to dried blood samples. The
concentration of ferritin in dried blood samples was threefold higher
than serum assays due to the release of ferritin from hemolyzed
erythrocytes, which diminished the usefulness of ferritin measurements
for detecting ID. On the other hand, there was negligible erythrocyte
contribution to the measurement of transferrin receptor in dried blood
spots. The most sensitive parameter in dried blood spots was the ratio of receptor/ferritin, which was suitable for identifying
iron-deficiency anemia (IDA), but less reliable than serum assays for
detecting milder ID without anemia. We conclude that tandem
measurements of serum ferritin and transferrin receptor in dried blood
spots can be used to facilitate the identification of IDA in
epidemiologic studies.
© 1998 by The American Society of Hematology.
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