[Latent and manifest iron deficiency conditions. Diagnostic and therapeutic developments]

The developments of the last 15 years rendered possible more exact clinical evidences on stages (cross section diagnoses of the iron state within the body), developmental forms (longitudinal section diagnoses with estimation of the iron balance) and substitution of the iron deficiency. In the stages I (storage iron deficiency with increased intestinal iron absorption) and II (additional decrease of the serum iron) haemoglobin lies within the normal. Iron deficiency anaemias without (III) and with (IV) tissue damage show much decreased serum ferritin values. In the pre-treatment or in complications by infections or tumours the dispersion areas of serum ferritin intersect with the lower dispersion area of the norm of control persons with normal reserves of iron. - The most frequent cause of the non-haemorrhagic iron deficiency developing by an absolute or relatively too small iron supply are pregnancies without an effective iron prophylaxis. The chronic haemorrhagic iron deficiency relapsing without iron supply is caused by hypermenorrhoeas (blood losses per year 1-6 l) and in older patients by blood losses from the gastro-intestinal canal (blood losses per year 1 to more than 30 l). The posthaemorrhagic or postpartal iron deficiency remaining after removal of the causes remits spontaneously with sufficient nutrition. A more exact knowledge about the bioavailability of oral ferroiron preparation and the biotransformation of parenterally administered colloidal iron preparation render possible a better adaptation of the iron substitution to the demand of iron to the limits of tolerability and metabolisability of the remedies administered.