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Volume 338:1926-1927 June 25, 1998 Number 26
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Clinical Problem-Solving: A Square Peg in a Round Hole

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 by Saint, S.
To the Editor: The Clinical Problem-Solving exercise by Saint et al. (Feb. 5 issue)1 was a useful discussion of several important topics. However, the statement that "the diagnosis of iron deficiency is virtually ruled out by the normal ferritin concentration" requires modification, since this misconception can easily lead to delay and misdiagnosis in the management of anemia.

It is well established2 that the serum ferritin concentration can be used as a reliable marker to predict iron stores in bone marrow only when an acute-phase reaction is absent. This is an important point in clinical situations such as the one described. . . . [Full Text of this Article]

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