Summary
Definition
History and exam
Other diagnostic factors
- impaired muscular performance
- glossitis and angular stomatitis
- gastric difficulties
- restless legs syndrome
- lesion on rectal examination
- growth impairment
- cognitive and behavioral impairment
- dyspnea
- recurrent infections
Risk factors
- black women
- pregnancy
- vegan diet
- menorrhagia
- hookworm infestation
- hemodialysis
- celiac disease
- gastrectomy/achlorhydria
- NSAID use
- low socioeconomic status postpartum
- obesity
- Helicobacter pylori infection
Diagnostic investigations
1st investigations to order
- hemoglobin and hematocrit
- platelet count
- MCV
- MCH
- MCHC
- red cell distribution width (RDW)
- peripheral blood smear
- reticulocyte count
- serum iron
- total iron-binding capacity (TIBC)
- transferrin saturation
- serum ferritin
- urinalysis
Investigations to consider
- celiac serology
- Helicobacter pylori IgG antibodies or fecal antigen
- urease breath test
- autoimmune gastritis testing
- upper GI endoscopy
- small-bowel biopsy
- lower GI endoscopy
- double contrast barium enema and sigmoidoscopy
- transferrin receptor-ferritin index
- bone marrow biopsy
- monitored trial of iron
Emerging tests
- urinary hepcidin
- percentage of hypochromic erythrocytes
- reticulocyte hemoglobin content
- erythrocyte protoporphyrin
Treatment algorithm
Contributors
AuthorsVIEW ALL
Consultant Haematologist
Lysosomal Storage Disorders Unit
Department of Haematology
Royal Free Hospital
London
UK
Disclosures
AM declares that he has no competing interests.
Dr Atul Metha would like to gratefully acknowledge Dr Martina Murphy, Dr Marc Zumberg, and Dr Rebecca Fischer Connor, the previous contributors to this monograph. MZ declares that he is medical director for NCF Diagnostics and DNA Technologies, as well as serving as a consultant for Alexion Pharmaceutics. MM and RFC declare that they have no competing interests.
Peer reviewersVIEW ALL
Internal Medicine Instructor
Member of Evidence Based Medicine Unit
Catholic University of Chile
Santiago
Chile
Disclosures
CA declares that he has no competing interests.
Consultant Haematologist
Clinical Haematology
University Hospital Birmingham NHS Trust
Birmingham
UK
Disclosures
JM declares that he has no competing interests.
Medical Director
Blood Management
Cleveland Clinic
Cleveland
OH
Disclosures
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.
Use of this content is subject to our disclaimer