Iron Deficiency Anemia: Evaluation and Management

Area of Science:

• Hematology
• Internal Medicine
• Gastroenterology

Background:

• Iron deficiency anemia (IDA) is a prevalent global health issue.
• Diagnosis in adults requires specific ferritin and transferrin saturation levels, varying with inflammation status.
• Risk factors include age, sex, socioeconomic status, and chronic inflammation.

Purpose of the Study:

• To summarize diagnostic criteria for iron deficiency anemia in adults.
• To outline recommended investigations for underlying causes.
• To review current treatment strategies, including oral and intravenous iron supplementation.

Main Methods:

• Review of diagnostic criteria based on ferritin and transferrin saturation.
• Discussion of risk factors and common etiologies like blood loss, H. pylori, and celiac disease.
• Evaluation of oral and intravenous iron replacement therapies and adherence considerations.

Main Results:

• Specific ferritin thresholds (<45 ng/mL or <100 ng/mL with inflammation) and transferrin saturation (<20%) define IDA.
• Recurrent blood loss accounts for the majority of cases (94%).
• Oral iron is first-line, with intravenous iron for specific conditions (heart failure) or intolerance/inadequate response.

Conclusions:

• Accurate diagnosis of IDA involves assessing iron biomarkers and investigating underlying causes.
• Treatment selection depends on patient factors, including inflammation, comorbidities, and tolerance.
• Intravenous iron offers an alternative with rare hypersensitivity reactions, improving adherence and efficacy in select populations.