- For iron deficiency screening in very young children, serum ferritin measures at 15 or 18 months can be useful in primary care.
- Adding C-reactive protein (CRP) measurement in children at low acute inflammation risk may not be needed.
Why this matters
- The current American Academy of Pediatrics recommendation is to screen for anemia at age 12 months, using hemoglobin.
- Sensitivity and specificity of hemoglobin for iron deficiency are low, and optimal screening age is unclear.
- Editorial entitled “ Looking behind the iron curtain ” asks, “are we ready to replace the hemoglobin test?” and answers: “Not yet.”
- Serum ferritin values stayed low and changed very little from ages 15 to 24 months.
- They increased by an average 2% for each month from 24 to 38 months; by contrast, hemoglobin increased by 20%.
- When comparing hemoglobin , hemoglobin sensitivity was 25% (95% CI, 19%-32%) and specificity was 89% (95% CI, 87%-91%).
- Only 3.3% had CRP ≥10 mg/L.
- Cross-sectional, children ages 1-3 years (1735 for ferritin analysis).
- Funding: Canadian Institutes of Health Research.
- No information on other causes of anemia.