Fehr J, Favrat B, Schleiffenbaum B, Krayenbühl P A, Kapanci C, von Orelli F
Vormals Klinik für Hämatologie.
Praxis (Bern 1994). 2009 Dec 2;98(24):1445-51. doi: 10.1024/1661-8157.98.24.1445.
Iron deficiency (ID) without anaemia frequently remains undiagnosed when symptoms are attributed to ID with anaemia. Serum ferritin is the primary diagnostic parameter, whereas <10 microg/l represent depleted iron stores, 10-30 microg/l can confirm ID without anaemia and 30-50 microg/l might indicate functional ID. In case of increased CRP or ALT, normal/elevated ferritin should be interpreted with caution. Intravenous iron is indicated if oral iron is not effective or tolerated. At ferritin <10 microg/l, a cumulative dose of 1000 mg iron and at ferritin 10-30 microg/l, a cumulative dose of 500 mg is advised. At ferritin 30-50 microg/l a first dose of 200 mg might be considered. Ferritin shall be reassessed not sooner than 2 weeks after the last oral or 8-12 weeks after the last iv iron administration.
当症状归因于伴有贫血的缺铁时，无贫血的缺铁（ID）常常仍未被诊断出来。血清铁蛋白是主要的诊断参数，<10微克/升表示铁储存耗竭，10 - 30微克/升可确诊无贫血的ID，30 - 50微克/升可能提示功能性ID。在CRP或ALT升高的情况下，应谨慎解读正常/升高的铁蛋白。如果口服铁剂无效或无法耐受，则需使用静脉铁剂。铁蛋白<10微克/升时，建议累积剂量为1000毫克铁；铁蛋白在10 - 30微克/升时，累积剂量为500毫克。铁蛋白在30 - 50微克/升时，可考虑首剂200毫克。末次口服铁剂后至少2周或末次静脉注射铁剂后8 - 12周后，才应重新评估铁蛋白。
