Interpretation of iron profile

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iron deficiency anemia diagnosis serum iron TIBC transferrin saturation

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Here is a detailed interpretation of Mrs. Ankita's iron profile:

Patient Summary

Mrs. Ankita | 26 years | Female | Collected: 02/05/2026

Results at a Glance

Test	Result	Reference Range	Flag	Interpretation
Serum Iron	15.24 μg/dL	37–145 μg/dL	🔴 LOW	Markedly low
UIBC	409.00 μg/dL	110–370 μg/dL	🔴 HIGH	Elevated
TIBC	424.24 μg/dL	228–428 μg/dL	✅ Normal (upper limit)	Borderline high
% Transferrin Saturation	3.59%	20–50%	🔴 LOW	Critically low

Interpretation

This iron profile is classic for Iron Deficiency Anemia (IDA), showing all four hallmark features:

1. Very Low Serum Iron (15.24 μg/dL)

Serum iron is only ~41% of the lower normal limit. This reflects a severely depleted circulating iron pool available for hemoglobin synthesis. — Harrison's Principles of Internal Medicine 22E

2. Elevated UIBC (409 μg/dL)

UIBC (Unsaturated Iron Binding Capacity) represents the unfilled iron-binding sites on transferrin. When iron stores are depleted, transferrin remains largely unoccupied, driving UIBC up. This is a direct marker of iron deficiency. — Quick Compendium of Clinical Pathology, 5th ed.

3. TIBC at Upper Normal Limit (424.24 μg/dL)

TIBC reflects the total transferrin concentration. In iron deficiency, the liver upregulates transferrin synthesis as a compensatory response, pushing TIBC toward the upper limit or above the reference range. Here it sits at the very top of the normal range — consistent with developing IDA. — Tietz Textbook of Laboratory Medicine, 7th ed.

4. Critically Low Transferrin Saturation (3.59%)

This is the most sensitive indicator. Normal saturation is 20–50%; a saturation < 15% confirms iron deficiency, and 3.59% is profoundly low. The formula:

% Saturation = (Serum Iron / TIBC) × 100 = (15.24 / 424.24) × 100 = 3.59%

Quick Compendium of Clinical Pathology, 5th ed. states that % saturation < 15% is diagnostic of iron deficiency; Tietz Textbook sets the cutoff at < 15% as well.

Clinical Significance

This pattern — ↓ serum iron + ↑ UIBC + ↑/normal TIBC + ↓↓ transferrin saturation — is the textbook picture of iron deficiency. In a 26-year-old premenopausal woman, the most common causes are:

Chronic menstrual blood loss (most likely) — menstruating women lose ~30 mg iron per cycle and are at high risk. — Harrison's 22E
Poor dietary intake — vegetarian/vegan diet lacking heme iron
Malabsorption — e.g., celiac disease, post-gastrectomy
Occult gastrointestinal blood loss (less common in this age group but must be excluded if no menstrual cause)

What to Do Next

Since this is only the iron profile (page 1 of 3), the full workup likely includes or should include:

Complete Blood Count (CBC) — to check for microcytic hypochromic anemia (low MCV, low MCH, high RDW)
Serum Ferritin — the most sensitive single test for iron stores (low ferritin < 30 μg/L confirms iron deficiency)
Peripheral blood smear — may show hypochromic microcytes and pencil/elliptocyte cells
Reticulocyte count

Summary

Mrs. Ankita's iron profile is strongly consistent with iron deficiency, almost certainly iron deficiency anemia (IDA) given the severity of transferrin saturation at 3.59%. She should be evaluated by her physician for the underlying cause and started on oral iron supplementation (e.g., ferrous sulfate 150–200 mg elemental iron/day) with dietary counseling. A follow-up iron profile and CBC in 4–8 weeks will confirm treatment response.

⚠️ This interpretation is for informational purposes. Clinical correlation and physician consultation are essential before any treatment decisions.

Interpret

Finding Sources

I have all the information I need from the 4-page report. Here is a comprehensive interpretation:

Whole Body PET-CECT Scan — Interpretation

Mrs. Satya Wanti | 78 years | Female | Action Cancer Hospital | Report Date: 05/05/2026 Clinical Context: Metastatic Carcinoma Right Breast — Restaging scan

Background & Treatment History

This patient has a long-standing metastatic right breast cancer being managed since at least 2022 with multiple lines of therapy:

2022: Oral chemotherapy + hormonal therapy + Denosumab → partial response
2022–2023: Palbociclib (CDK4/6 inhibitor) + Anastrozole + Denosumab → residual disease
2023–2024: Altraz (Anastrozole) + Palbociclib + Denosumab → residual disease
Nov 2024: Right breast lesion with nodules
Aug 2025: Residual disease on Denosumab + Palbociclib + Fulvestrant + Altraz
Current scan (May 2026): Restaging

Region-by-Region Findings

🧠 Brain / Head

No focal brain metastasis detected on FDG PET-CT
Sella turcica (pituitary region): Increased FDG uptake — likely pituitary adenoma, noted as unchanged from prior scans
⚠️ Note: MRI brain recommended if brain metastasis is clinically suspected, as small lesions may be missed on PET-CT

🦋 Thyroid

Both lobes enlarged with heterogeneous attenuation
Multiple hypodensities with increased FDG uptake in both lobes, predominantly in the left lobe
Likely multinodular goiter — an incidental finding, not related to breast cancer

🎗️ Right Breast (Primary Disease Site — Active)

Two metabolically active lesions identified:

Lesion	Location	Size	SULmax	Significance
Lesion 1	Lower outer quadrant	3.0 × 2.8 cm	6.0	Irregular margins, skin tethering
Lesion 2 (nodule)	Lower inner quadrant	2.2 × 1.8 cm	8.0	Contiguous nodule, involves overlying skin

Both lesions are metabolically active (FDG avid), with skin involvement. The left breast and axilla are normal.

🔵 Right Axillary Lymph Node (Metastatic)

One small right axillary lymph node with mild FDG uptake (SULmax 2.9) — likely metastatic
A few other subcentimeter right axillary nodes with no significant FDG uptake (may be reactive)

🫁 Chest / Mediastinum

Multiple subcentimeter lymph nodes with increased FDG uptake in prevascular, precarinal, AP window, subcarinal, and bilateral hilar regions (R-SULmax 8.4) — described as possibly inflammatory (not definitively metastatic)
Small right supraclavicular lymph nodes — non-FDG avid (less likely metastatic)
Few tiny bilateral lung infiltrates — unchanged from prior
No pleural effusion; no focal pulmonary parenchymal lesion

🫀 Abdomen / Pelvis

Liver: Normal size but shows diffuse fatty infiltration (incidental finding); no focal lesion or abnormal FDG accumulation
Spleen, pancreas, adrenals: Normal with physiological FDG uptake
Kidneys: Normal; no calculus or hydronephrosis
Bowel: Normal caliber; physiological FDG uptake
Subcentimeter periportal lymph node with mild FDG uptake — likely inflammatory
No retroperitoneal or pelvic lymphadenopathy
Uterus not visualized — post-hysterectomy status (known)

🦴 Bones (NEW Metastasis Identified)

Right femoral head: Sclerotic lesion with increased FDG uptake — METASTATIC (new development since Aug 2025 scan)
D6 vertebra: Sclerotic changes with no abnormal FDG uptake — inactive/treated/sclerotic metastasis
Degenerative changes in vertebrae (age-related); no other focal abnormal bone uptake

Impression (as stated in report)

IN A CASE OF METASTATIC CA RIGHT BREAST:

✅ Metabolically active right breast lesions — primary disease site, active
✅ Right axillary lymph node — likely metastatic
✅ Right femoral head lesion — METASTATIC (NEW)

Comparison with Previous Scan (02 August 2025)

The report explicitly states this is PROGRESSIVE DISEASE:

Change	Details
⬆️ Right breast lesions	Increased in size + mild increase in metabolic activity
⬆️ Right axillary node	Mild increase in metabolic activity
🆕 Right femoral lesion	NEW bone metastasis — not present in Aug 2025 scan
➡️ Rest of body	No other significant interval change

Overall conclusion by radiologist: PROGRESSIVE DISEASE

Clinical Significance

This scan confirms that the current regimen (Denosumab + Palbociclib + Fulvestrant + Anastrozole) has failed to control disease progression. Key implications:

New bone metastasis in the right femoral head is a critical finding — the femoral head is a weight-bearing site and carries a risk of pathological fracture. Orthopedic evaluation and assessment for prophylactic intervention (surgical fixation or radiation) should be considered urgently.
Growing breast lesions with skin involvement suggest locally aggressive disease requiring reassessment of local and systemic management.
The overall metabolic progression indicates a need for change in systemic therapy — the oncology team will likely consider switching to a new line of treatment (e.g., different CDK inhibitor, antibody-drug conjugate such as T-DM1 or sacituzumab govitecan, or chemotherapy depending on tumor biology).
Denosumab (bone-targeted agent) may need dose optimization or replacement given new bone metastasis.

⚠️ This interpretation is for informational and educational purposes only. All treatment decisions must be made by the treating oncologist in full clinical context.

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