Document Detail


Diagnosis and management of iron deficiency anaemia: a clinical update.
MedLine Citation:
PMID:  21034387     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Iron deficiency anaemia (IDA) remains prevalent in Australia and worldwide, especially among high-risk groups. IDA may be effectively diagnosed in most cases by full blood examination and serum ferritin level. Serum iron levels should not be used to diagnose iron deficiency. Although iron deficiency may be due to physiological demands in growing children, adolescents and pregnant women, the underlying cause(s) should be sought. Patients without a clear physiological explanation for iron deficiency (especially men and postmenopausal women) should be evaluated by gastroscopy/colonoscopy to exclude a source of gastrointestinal bleeding, particularly a malignant lesion. Patients with IDA should be assessed for coeliac disease. Oral iron therapy, in appropriate doses and for a sufficient duration, is an effective first-line strategy for most patients. In selected patients for whom intravenous (IV) iron therapy is indicated, current formulations can be safely administered in outpatient treatment centres and are relatively inexpensive. Red cell transfusion is inappropriate therapy for IDA unless an immediate increase in oxygen delivery is required, such as when the patient is experiencing end-organ compromise (eg, angina pectoris or cardiac failure), or IDA is complicated by serious, acute ongoing bleeding. Consensus methods for administration of available IV iron products are needed to improve the utilisation of these formulations in Australia and reduce inappropriate transfusion. New-generation IV products, supported by high-quality evidence of safety and efficacy, may facilitate rapid administration of higher doses of iron, and may make it easier to integrate IV iron replacement into routine care.
Authors:
Sant-Rayn S Pasricha; Stephen C Flecknoe-Brown; Katrina J Allen; Peter R Gibson; Lawrence P McMahon; John K Olynyk; Simon D Roger; Helen F Savoia; Ramdas Tampi; Amanda R Thomson; Erica M Wood; Kathryn L Robinson
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  The Medical journal of Australia     Volume:  193     ISSN:  0025-729X     ISO Abbreviation:  Med. J. Aust.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-01     Completed Date:  2010-12-23     Revised Date:  2011-06-06    
Medline Journal Info:
Nlm Unique ID:  0400714     Medline TA:  Med J Aust     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  525-32     Citation Subset:  IM    
Affiliation:
Royal Melbourne Hospital, Melbourne, VIC, Australia.
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MeSH Terms
Descriptor/Qualifier:
Anemia, Iron-Deficiency / complications,  diagnosis*,  etiology,  therapy*
Biological Markers / blood
Bone Marrow / metabolism
Erythrocyte Transfusion
Ferritins / blood
Humans
Iron / metabolism
Iron Compounds / administration & dosage
Nutritional Requirements
Receptors, Transferrin / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Iron Compounds; 0/Receptors, Transferrin; 7439-89-6/Iron; 9007-73-2/Ferritins
Comments/Corrections
Comment In:
Med J Aust. 2011 Apr 18;194(8):429   [PMID:  21495954 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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