Elakeya Elumalai Saraswathy, Shivaashankari Dharmalingam, Anusha Chelladurai
1. Assistant Professor, Department of Paediatrics, Srinivasan Medical College and Hospital, Tiruchirapalli, Tamil Nadu, India.
2. Associate Professor, Department of Paediatrics, Srinivasan Medical College and Hospital, Tiruchirapalli, Tamil Nadu, India.
3. Assistant Professor, Department of Paediatrics, Srinivasan Medical College and Hospital, Tiruchirapalli, Tamil Nadu, India.
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Correspondence
Address :
Dr. Elakeya Elumalai Saraswathy,
Assistant Professor, Department of Paediatrics, Srinivasan Medical College and
Hospital, NH 45, Trichy Chennai Trunk Road, Near Samayapuram Toll Plaza,
Samayapuram, Tiruchirapalli-621112, Tamil Nadu, India.
E-mail: elak.yadav@gmail.com
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: Iron Deficiency Anaemia (IDA) is the most common nutritional deficiency among children and remains a major public health concern in developing countries. Although serum ferritin is considered the gold standard marker for diagnosing IDA, its levels may be falsely elevated during infections and inflammatory conditions. Hence, additional haematological and biochemical markers are required for accurate diagnosis, especially in children with microcytic hypochromic anaemia.
Aim: To compare the diagnostic utility of serum iron, Total Iron Binding Capacity (TIBC), Transferrin Saturation (TSAT) and serum ferritin in identifying IDA among children.
Materials and Methods: This hospital-based prospective observational study was conducted at the Paediatric Outpatient and Inpatient Departments of Srinivasan Medical College and Hospital, Samayapuram, Tiruchirappalli, Tamil Nadu, India, from July 2025 to November 2025. A total of 120 children with microcytic hypochromic anaemia and normal or low red blood cell counts were included. Blood samples were analysed for serum iron, serum ferritin, TIBC, TSAT, Red cell Distribution Width (RDW), and the Mentzer index. The diagnostic utility of these parameters in identifying IDA was compared. Data were analysed using Spearman’s rank correlation test to assess correlations. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated. A p-value <0.05 was considered statistically significant.
Results: The mean age of the study population was five years four months. Of the 120 children, 63 (52.5%) were males, and 57 (47.5%) were females. Low serum iron was observed in 107 (89.2%) of children, while abnormal TSAT and elevated TIBC were seen in 84 (70.0%) and 76 (63.3%), respectively. TSAT showed the highest diagnostic accuracy (71.7%), whereas serum iron demonstrated the highest sensitivity (88.9%). RDW >13% was present in 111 (92.5%) of children, and Mentzer index >13, was observed in all 120 (100%) cases.
Conclusion: Serum iron and TSAT are valuable diagnostic markers for IDA and should be interpreted along with serum ferritin, particularly in hospital-based settings where inflammatory conditions may alter serum ferritin levels. An elevated Mentzer index may also prompt evaluation for possible co-existing haemoglobinopathies in children presenting with microcytic anaemia.
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