Iron deficiency
Last updated: Wednesday, 15, December, 2010
| Causes | Appropriate Tests |
|---|---|
Review clinical findings, FBC, blood film; see Anaemia - hypochromic, microcytic. Iron deficiency can be present before the development of anaemia; the red cell indices and blood film are more sensitive indicators than is the Hb. Ferritin provides the most sensitive measure of iron stores; low ferritin is diagnostic of iron deficiency, however normal levels may occur when iron deficiency is associated with inflammation or neoplasia. Iron/iron binding capacity and transferrin saturation may distinguish iron deficiency from the anaemia of chronic disease, but as they may co-exist, a more specific test for iron deficiency is the ratio of plasma soluble transferrin receptor to serum ferritin. See Table 3 Interpretation of the results of iron studies Alternatively, a trial of oral iron therapy offers a more practical approach. | |
Chronic blood loss, especially | This is the commonest cause of iron deficiency anaemia and may be occult; uterine and gastrointestinal blood loss, in particular, should be considered. |
Menorrhagia | See under Vaginal bleeding |
Gastrointestinal malignancy | |
Parasitic infection, especially
| See Worm infection |
Intravascular haemolysis e.g. mechanical heart valves | |
Increased iron requirements, especially | |
Pregnancy | |
Neonate | |
Growth | |
Malabsorption, especially | |
| |
Dietary deficiency | An uncommon cause in developed countries, but may be seen in the elderly and may be a contributing factor in pregnancy, debilitating illness and alcoholism. |