What is the role of bone marrow aspiration (BMA) in the diagnosis of iron deficiency anemia?

Updated: Aug 04, 2019
  • Author: James L Harper, MD; Chief Editor: Emmanuel C Besa, MD  more...
  • Print
Answer

A bone marrow aspirate can be diagnostic of iron deficiency. The absence of stainable iron in a bone marrow aspirate that contains spicules and a simultaneous control specimen containing stainable iron permit establishment of a diagnosis of iron deficiency without other laboratory tests.

A bone marrow aspirate stained for iron (Perls stain) can be diagnostic of iron deficiency, provided that spicules are present in the smear and that a control specimen containing iron is performed at the same time. Although this test has largely been displaced in the diagnosis of iron deficiency by serum iron, TIBC, and serum ferritin testing, the absence of stainable iron in a bone marrow aspirate is the criterion standard for the diagnosis of iron deficiency.

This test is diagnostic in identifying the sideroblastic anemias by showing ringed sideroblasts in the aspirate stained with Perls stain. Occasionally, it is useful in separating patients with the anemia of chronic disorders or alpha-thalassemia from patients with iron deficiency, and it is useful in identifying patients with both iron deficiency and the anemia of chronic disorders.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!