Summary
Definition
History and exam
Key diagnostic factors
- fadiga
- dispneia ao esforço
- pica
- síndrome das pernas inquietas
- alterações ungueais
- disfagia
Other diagnostic factors
- desempenho muscular comprometido
- glossite e estomatite angular
- dispepsia
- palidez
- queda de cabelos
- lesão retal no exame físico
- retardo de crescimento
- comprometimento cognitivo e de comportamento
- insuficiência cardíaca
- infecções recorrentes
Risk factors
- gestação
- dieta vegana e vegetariana
- menorragia
- infestação por ancilostomídeo
- doença renal crônica
- doença celíaca
- gastrectomia/acloridria
- uso de anti-inflamatórios não esteroidais (AINEs)
- insuficiência cardíaca crônica
- prematuro ou baixo peso ao nascer
- alimentação de lactentes com leite de vaca
- mulheres negras e mexicanas
- condição socioeconômica baixa
- obesidade
- infecção por Helicobacter pylori
Diagnostic investigations
1st investigations to order
- hemoglobina e hematócrito
- contagem plaquetária
- volume corpuscular médio (VCM)
- hemoglobina corpuscular média (HCM)
- CHCM
- amplitude de distribuição do volume eritrocitário
- esfregaço de sangue periférico
- contagem de reticulócitos
- ferro sérico
- capacidade total de ligação do ferro
- saturação de transferrina
- ferritina sérica
- sorologia celíaca
- urinálise
- Teste para Helicobacter pylori
Investigations to consider
- eletroforese da hemoglobina
- teste respiratório de urease
- teste de gastrite autoimune
- endoscopia digestiva alta
- biópsia do intestino delgado
- endoscopia digestiva baixa (colonoscopia)
- colonografia por TC
- índice receptor de transferrina-ferritina
- biópsia da medula óssea
- teste terapêutico monitorado com ferro
- exames de sangue oculto nas fezes
Emerging tests
- hepcidina urinária
- porcentagem de eritrócitos hipocrômicos
- conteúdo de hemoglobina dos reticulócitos
- protoporfirina eritrocitária
Treatment algorithm
todos os pacientes
Contributors
Authors
Atul Mehta, MD
Consultant Haematologist
Lysosomal Storage Disorders Unit
Department of Haematology
Royal Free Hospital
London
UK
Disclosures
AM declares that he has no competing interests.
Acknowledgements
Dr Atul Mehta would like to gratefully acknowledge Dr Martina Murphy, Dr Marc Zumberg, and Dr Rebecca Fischer Connor, previous contributors to this topic.
Disclosures
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.
Peer reviewers
Carlos Aravena, MD
Internal Medicine Instructor
Member of Evidence Based Medicine Unit
Catholic University of Chile
Santiago
Chile
Disclosures
CA declares that he has no competing interests.
Jim Murray, MBBS
Consultant Haematologist
Clinical Haematology
University Hospital Birmingham NHS Trust
Birmingham
UK
Disclosures
JM declares that he has no competing interests.
Ajay Kumar, MD, FACP
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
US Preventive Services Task Force. Iron deficiency and iron deficiency anemia during pregnancy: screening and supplementation. Aug 2024 [internet publication].Full text
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.Full text Abstract
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.Full text Abstract
US Preventive Services Task Force. Iron deficiency anemia in young children: screening. Sep 2015 [internet publication].Full text
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Anemia de doença crônica
- Distúrbios da síntese de globina (talassemias, hemoglobina E, hemoglobina C, hemoglobinas instáveis)
- Anemias sideroblásticas
More DifferentialsGuidelines
- Guideline for the laboratory diagnosis of iron deficiency in adults (excluding pregnancy) and children
- Chronic kidney disease: assessment and management
More GuidelinesPatient information
Deficiência de ferro, anemia por
More Patient information
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