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Diagnosis and management of iron deficiency anaemia: A clinical update

Pasricha, S-A, Flecknoe-Brown, S.C., Allen, K.J., Gibson, P.R., McMahon, L.P., Olynyk, J.K., Roger, S.D., Savoia, H.F., Tampi, R., Thomson, A.R., Wood, E.M. and Robinson, K.L. (2010) Diagnosis and management of iron deficiency anaemia: A clinical update. Medical Journal of Australia, 193 (9). pp. 525-532.

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• 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.

Publication Type: Journal Article
Publisher: Australasian Medical Publishing Company
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