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Iron deficiency anemia.
Am Fam Physician 2007; 75(5):671-8AF

Abstract

The prevalence of iron deficiency anemia is 2 percent in adult men, 9 to 12 percent in non-Hispanic white women, and nearly 20 percent in black and Mexican-American women. Nine percent of patients older than 65 years with iron deficiency anemia have a gastrointestinal cancer when evaluated. The U.S. Preventive Services Task Force currently recommends screening for iron deficiency anemia in pregnant women but not in other groups. Routine iron supplementation is recommended for high-risk infants six to 12 months of age. Iron deficiency anemia is classically described as a microcytic anemia. The differential diagnosis includes thalassemia, sideroblastic anemias, some types of anemia of chronic disease, and lead poisoning. Serum ferritin is the preferred initial diagnostic test. Total iron-binding capacity, transferrin saturation, serum iron, and serum transferrin receptor levels may be helpful if the ferritin level is between 46 and 99 ng per mL (46 and 99 mcg per L); bone marrow biopsy may be necessary in these patients for a definitive diagnosis. In children, adolescents, and women of reproductive age, a trial of iron is a reasonable approach if the review of symptoms, history, and physical examination are negative; however, the hemoglobin should be checked at one month. If there is not a 1 to 2 g per dL (10 to 20 g per L) increase in the hemoglobin level in that time, possibilities include malabsorption of oral iron, continued bleeding, or unknown lesion. For other patients, an endoscopic evaluation is recommended beginning with colonoscopy if the patient is older than 50.

Authors+Show Affiliations

Department of Family and Community Medicine, University of Kentucky, Lexington, Kentucky, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

17375513

Citation

Killip, Shersten, et al. "Iron Deficiency Anemia." American Family Physician, vol. 75, no. 5, 2007, pp. 671-8.
Killip S, Bennett JM, Chambers MD. Iron deficiency anemia. Am Fam Physician. 2007;75(5):671-8.
Killip, S., Bennett, J. M., & Chambers, M. D. (2007). Iron deficiency anemia. American Family Physician, 75(5), pp. 671-8.
Killip S, Bennett JM, Chambers MD. Iron Deficiency Anemia. Am Fam Physician. 2007 Mar 1;75(5):671-8. PubMed PMID: 17375513.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Iron deficiency anemia. AU - Killip,Shersten, AU - Bennett,John M, AU - Chambers,Mara D, PY - 2007/3/23/pubmed PY - 2007/4/14/medline PY - 2007/3/23/entrez SP - 671 EP - 8 JF - American family physician JO - Am Fam Physician VL - 75 IS - 5 N2 - The prevalence of iron deficiency anemia is 2 percent in adult men, 9 to 12 percent in non-Hispanic white women, and nearly 20 percent in black and Mexican-American women. Nine percent of patients older than 65 years with iron deficiency anemia have a gastrointestinal cancer when evaluated. The U.S. Preventive Services Task Force currently recommends screening for iron deficiency anemia in pregnant women but not in other groups. Routine iron supplementation is recommended for high-risk infants six to 12 months of age. Iron deficiency anemia is classically described as a microcytic anemia. The differential diagnosis includes thalassemia, sideroblastic anemias, some types of anemia of chronic disease, and lead poisoning. Serum ferritin is the preferred initial diagnostic test. Total iron-binding capacity, transferrin saturation, serum iron, and serum transferrin receptor levels may be helpful if the ferritin level is between 46 and 99 ng per mL (46 and 99 mcg per L); bone marrow biopsy may be necessary in these patients for a definitive diagnosis. In children, adolescents, and women of reproductive age, a trial of iron is a reasonable approach if the review of symptoms, history, and physical examination are negative; however, the hemoglobin should be checked at one month. If there is not a 1 to 2 g per dL (10 to 20 g per L) increase in the hemoglobin level in that time, possibilities include malabsorption of oral iron, continued bleeding, or unknown lesion. For other patients, an endoscopic evaluation is recommended beginning with colonoscopy if the patient is older than 50. SN - 0002-838X UR - https://www.unboundmedicine.com/medline/citation/17375513/Iron_deficiency_anemia_ L2 - http://www.aafp.org/link_out?pmid=17375513 DB - PRIME DP - Unbound Medicine ER -