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Iron deficiency anemia

Última revisão: 12 Jul 2025
Última atualização: 29 Apr 2025

Resumo

Definição

História e exame físico

Principais fatores diagnósticos

  • fatigue
  • dyspnea on exertion
  • pica
  • restless legs syndrome
  • nail changes
  • dysphagia
Detalhes completos

Outros fatores diagnósticos

  • impaired muscular performance
  • glossitis and angular stomatitis
  • dyspepsia
  • pallor
  • hair loss
  • rectal lesion on examination
  • growth impairment
  • cognitive and behavioral impairment
  • heart failure
  • recurrent infections
Detalhes completos

Fatores de risco

  • pregnancy
  • vegetarian and vegan diet
  • menorrhagia
  • hookworm infestation
  • chronic kidney disease
  • celiac disease
  • gastrectomy/achlorhydria
  • nonsteroidal anti-inflammatory drugs (NSAID) use
  • chronic heart failure
  • preterm or low birth weight
  • infant feeding with cows' milk
  • black women and Mexican women
  • low socioeconomic status
  • obesity
  • Helicobacter pylori infection
Detalhes completos

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • hemoglobin and hematocrit
  • platelet count
  • MCV
  • MCH
  • MCHC
  • red cell distribution width
  • peripheral blood smear
  • reticulocyte count
  • serum iron
  • total iron-binding capacity
  • transferrin saturation
  • serum ferritin
  • celiac serology
  • urinalysis
  • Helicobacter pylori testing
Detalhes completos

Investigações a serem consideradas

  • hemoglobin electrophoresis
  • urease breath test
  • autoimmune gastritis testing
  • upper gastrointestinal endoscopy (esophagogastroduodenoscopy)
  • small-bowel biopsy
  • lower gastrointestinal endoscopy (colonoscopy)
  • CT colonography
  • transferrin receptor-ferritin index
  • bone marrow biopsy
  • monitored trial of iron
  • fecal occult blood tests
Detalhes completos

Novos exames

  • urinary hepcidin
  • percentage of hypochromic erythrocytes
  • reticulocyte hemoglobin content
  • erythrocyte protoporphyrin

Algoritmo de tratamento

AGUDA

all patients

Colaboradores

Autores

Atul Mehta, MD

Consultant Haematologist

Lysosomal Storage Disorders Unit

Department of Haematology

Royal Free Hospital

London

UK

Declarações

AM declares that he has no competing interests.

Agradecimentos

Dr Atul Mehta would like to gratefully acknowledge Dr Martina Murphy, Dr Marc Zumberg, and Dr Rebecca Fischer Connor, previous contributors to this topic.

Declarações

MZ declares that he is medical director for NCF Diagnostics and DNA Technologies, and a consultant for Alexion Pharmaceuticals. MM and RFC declare that they have no competing interests.

Revisores

Carlos Aravena, MD

Internal Medicine Instructor

Member of Evidence Based Medicine Unit

Catholic University of Chile

Santiago

Chile

Declarações

CA declares that he has no competing interests.

Jim Murray, MBBS

Consultant Haematologist

Clinical Haematology

University Hospital Birmingham NHS Trust

Birmingham

UK

Declarações

JM declares that he has no competing interests.

Ajay Kumar, MD, FACP

Medical Director

Blood Management

Cleveland Clinic

Cleveland

OH

Declarações

AK has received a fee for speaking about perioperative blood management from Ortho-Biotech, and has also received reimbursement from medscape.com for the education webcast of the same presentation.

Referências

Nossas equipes internas de editoria e de evidências trabalham em conjunto com colaboradores internacionais especializados e pares revisores para garantir que forneçamos acesso às informações o mais clinicamente relevantes possível.

Principais artigos

US Preventive Services Task Force. Iron deficiency and iron deficiency anemia during pregnancy: screening and supplementation. Aug 2024 [internet publication].Texto completo

Pavord S, Daru J, Prasannan N, et al. UK guidelines on the management of iron deficiency in pregnancy. Br J Haematol. 2020 Mar;188(6):819-30.Texto completo  Resumo

Snook J, Bhala N, Beales ILP, et al. British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults. Gut. 2021 Nov;70(11):2030-51.Texto completo  Resumo

US Preventive Services Task Force. Iron deficiency anemia in young children: screening. Sep 2015 [internet publication].Texto completo

Artigos de referência

Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
  • Iron deficiency anemia images
  • Diagnósticos diferenciais

    • Anemia of chronic disease
    • Disorders of globin synthesis (thalassemias, hemoglobin E, hemoglobin C, unstable hemoglobins)
    • Sideroblastic anemias
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Guideline for the laboratory diagnosis of iron deficiency in adults (excluding pregnancy) and children
    • Guidelines for the management of iron deficiency anaemia in adults
    Mais Diretrizes
  • Folhetos informativos para os pacientes

    Anemia, iron deficiency

    Mais Folhetos informativos para os pacientes
  • Videos

    Venepuncture and phlebotomy: animated demonstration

    Mais vídeos
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