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Iron deficiency anemia. When is parenteral therapy warranted?
R A Swain1, B Kaplan, E Montgomery
1West Virginia University-Charleston Division, USA.
Postgraduate Medicine
|November 1, 1996
Summary
Iron deficiency anemia requires iron replacement therapy. Intravenous iron dextran is an option for some patients, with manageable side effects and successful treatment outcomes.
Area of Science:
- Hematology
- Internal Medicine
- Primary Care
Background:
- Iron deficiency anemia (IDA) is a prevalent condition in primary care.
- Diagnosis requires confirmation and identification of underlying causes.
- Iron store replenishment is the primary treatment goal.
Observation:
- Oral iron preparations are effective for most patients.
- Intravenous iron dextran (InFeD) is indicated in specific cases.
- Side effects occur in approximately 25% of patients, often mild.
Findings:
- Test doses of undiluted iron dextran can rarely cause anaphylaxis.
- Prophylactic antihistamines, corticosteroids, and H2 blockers can enable successful IV iron treatment.
- Symptomatic improvement is consistently observed following IDA treatment.
Implications:
- Intravenous iron dextran offers a viable treatment alternative for IDA when oral iron is insufficient or not tolerated.
- Careful patient selection and premedication protocols can mitigate risks associated with IV iron dextran.
- Effective management of IDA leads to significant patient well-being.