Department of Clinical Sciences and Community, IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital, University of Milan, Milan, Italy.
International Network of Hematology, London, UK.
J Intern Med. 2020 Feb;287(2):153-170. doi: 10.1111/joim.13004. Epub 2019 Nov 12.
Iron deficiency anaemia is a global health concern affecting children, women and the elderly, whilst also being a common comorbidity in multiple medical conditions. The aetiology is variable and attributed to several risk factors decreasing iron intake and absorption or increasing demand and loss, with multiple aetiologies often coexisting in an individual patient. Although presenting symptoms may be nonspecific, there is emerging evidence on the detrimental effects of iron deficiency anaemia on clinical outcomes across several medical conditions. Increased awareness about the consequences and prevalence of iron deficiency anaemia can aid early detection and management. Diagnosis can be easily made by measurement of haemoglobin and serum ferritin levels, whilst in chronic inflammatory conditions, diagnosis may be more challenging and necessitates consideration of higher serum ferritin thresholds and evaluation of transferrin saturation. Oral and intravenous formulations of iron supplementation are available, and several patient and disease-related factors need to be considered before management decisions are made. This review provides recent updates and guidance on the diagnosis and management of iron deficiency anaemia in multiple clinical settings.
缺铁性贫血是一个全球性的健康问题,影响儿童、妇女和老年人,同时也是多种医学病症的常见合并症。病因多种多样,归因于多种降低铁摄入和吸收或增加需求和损失的风险因素,多种病因在个体患者中常同时存在。虽然表现症状可能是非特异性的,但越来越多的证据表明缺铁性贫血对多种医学病症的临床结局有不良影响。提高对缺铁性贫血的后果和流行率的认识有助于早期发现和管理。通过测量血红蛋白和血清铁蛋白水平可以很容易地做出诊断,而在慢性炎症性疾病中,诊断可能更具挑战性,需要考虑更高的血清铁蛋白阈值,并评估转铁蛋白饱和度。口服和静脉铁补充剂都有,在做出管理决策之前,需要考虑几个与患者和疾病相关的因素。这篇综述提供了关于在多种临床环境中缺铁性贫血的诊断和管理的最新更新和指导。