Iron-Deficiency Anaemia

Haematology

Microcytic hypochromic anaemia from depleted iron stores.

Causes

  • GI blood loss (occult cancer, peptic ulcer, NSAIDs)
  • Menorrhagia
  • Pregnancy
  • Malabsorption (coeliac, post-gastrectomy)
  • Hookworm (endemic)

Investigations

  • FBC: ↓ Hb, ↓ MCV, ↑ RDW
  • Ferritin <30 µg/L diagnostic (acute phase: also low transferrin saturation, ↑ TIBC)
  • Coeliac screen
  • OGD/colonoscopy in men + post-menopausal women

Management

  • Ferrous sulphate 200 mg OD or alt days × 3 months after Hb normalises
  • IV iron (ferric carboxymaltose) if intolerant / malabsorption / CKD

Clinical pearls

  • Alternate-day dosing improves absorption by avoiding hepcidin block

References

  • BSG iron deficiency 2021

Educational — verify locally.

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