Recommendations for diagnosis, treatment, and prevention of iron deficiency and iron deficiency anemia

Author:

Iolascon Achille12,Andolfo Immacolata12ORCID,Russo Roberta12ORCID,Sanchez Mayka3,Busti Fabiana4,Swinkels Dorine5,Aguilar Martinez Patricia6,Bou‐Fakhredin Rayan7,Muckenthaler Martina U.8910ORCID,Unal Sule11,Porto Graça12,Ganz Tomas13,Kattamis Antonis14,De Franceschi Lucia15,Cappellini Maria Domenica16,Munro Malcolm G.17,Taher Ali18,

Affiliation:

1. Dipartimento di Medicina Molecolare e Biotecnologie Mediche Università degli Studi di Napoli Federico II Napoli Italy

2. CEINGE Biotecnologie Avanzate Franco Salvatore Napoli Italy

3. Department of Basic Sciences, Iron metabolism: Regulation and Diseases Universitat Internacional de Catalunya (UIC) Barcelona Spain

4. Department of Medicine, Section of Internal Medicine and Azienda Ospedaliera Universitaria Integrata of Verona, EuroBloodNEt Referral Center for Iron Disorders, Policlinico G.B. Rossi University of Verona Verona Italy

5. Department of Laboratory Medicine, Translational Metabolic Laboratory (TML 830) Radboud University Medical Center Nijmegen The Netherlands

6. Department of Hematological Biology, Reference Center on Rare Red Cell Disorders Montpellier University Hospital Montpellier France

7. Department of Clinical Sciences and Community Health University of Milan Milan Italy

8. Molecular Medicine Partnership Unit European Molecular Biology Laboratory Heidelberg Germany

9. Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), University of Heidelberg Heidelberg Germany

10. German Centre for Cardiovascular Research, Partner Site Heidelberg Germany

11. Department of Pediatric Hematology Hacettepe University Ankara Turkey

12. HematologyServiço de Imuno‐hemoterapia, CHUdSA‐Centro Hospitalar Universitário de Santo António Porto Portugal

13. Department of Medicine David Geffen School of Medicine at UCLA Los Angeles California USA

14. Division of Pediatric Hematology‐Oncology, First Department of Pediatrics, National & Kapodistrian University of Athens “Aghia Sophia” Children's Hospital Athens Greece

15. Department of Medicine University of Verona & AOUI Verona, Policlinico GB Rossi Verona Italy

16. Department of Clinical Sciences and Community University of Milan, Cà Granda Foundation IRCCS Maggiore Policlinico Hospital Milan Italy

17. Department of Obstetrics and Gynecology David Geffen School of Medicine Los Angeles California USA

18. Division of Hematology‐Oncology, Department of Internal Medicine American University of Beirut Medical Center Beirut Lebanon

Abstract

AbstractIron is an essential nutrient and a constituent of ferroproteins and enzymes crucial for human life. Generally, nonmenstruating individuals preserve iron very efficiently, losing less than 0.1% of their body iron content each day, an amount that is replaced through dietary iron absorption. Most of the iron is in the hemoglobin (Hb) of red blood cells (RBCs); thus, blood loss is the most common cause of acute iron depletion and anemia worldwide, and reduced hemoglobin synthesis and anemia are the most common consequences of low plasma iron concentrations. The term iron deficiency (ID) refers to the reduction of total body iron stores due to impaired nutrition, reduced absorption secondary to gastrointestinal conditions, increased blood loss, and increased needs as in pregnancy. Iron deficiency anemia (IDA) is defined as low Hb or hematocrit associated with microcytic and hypochromic erythrocytes and low RBC count due to iron deficiency. IDA most commonly affects women of reproductive age, the developing fetus, children, patients with chronic and inflammatory diseases, and the elderly. IDA is the most frequent hematological disorder in children, with an incidence in industrialized countries of 20.1% between 0 and 4 years of age and 5.9% between 5 and 14 years (39% and 48.1% in developing countries). The diagnosis, management, and treatment of patients with ID and IDA change depending on age and gender and during pregnancy. We herein summarize what is known about the diagnosis, treatment, and prevention of ID and IDA and formulate a specific set of recommendations on this topic.

Publisher

Wiley

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