Guidelines for the management of iron deficiency anaemia

Background < Iron deficiency anaemia (IDA) occurs in 2e5% of adult men and postmenopausal women in the developed world and is a common cause of referral to gastroenterologists. Gastrointestinal (GI) blood loss from colonic cancer or gastric cancer, and malabsorption in coeliac disease are the most important causes that need to be sought. Defining iron deficiency anaemia < The lower limit of the normal range for the laboratory performing the test should be used to define anaemia (B). < Any level of anaemia should be investigated in the presence of iron deficiency (B). < The lower the haemoglobin the more likely there is to be serious underlying pathology and the more urgent is the need for investigation (B). < Red cell indices provide a sensitive indication of iron deficiency in the absence of chronic disease or haemoglobinopathy (A). < Haemoglobin electrophoresis is recommended when microcytosis and hypochromia are present in patients of appropriate ethnic background to prevent unnecessary GI investigation (C). < Serum ferritin is the most powerful test for iron