[Iron deficiency anemia in primary care - when the common turns uncommon]

A 52-year-old nurse with recurrent iron deficiency showed no adequate response to iron supplementation or a gluten-free diet after a diagnosis of celiac disease. Clinical evaluation, imaging, and endoscopy failed to identify a cause. Only further assessment at a university hospital, including push enteroscopy, revealed a completely resectable proximal jejunal adenocarcinoma. This case shows that a confirmed diagnosis does not exclude additional causes, highlighting malabsorption in iron deficiency anaemia and close follow-up in primary care.