John Libbey Eurotext

Hépato-Gastro & Oncologie Digestive


How to explore an iron deficiency? – Diagnostic management in 2018 Volume 25, issue 4, Avril 2018

Sorbonne Université, Hôpital Saint-Antoine, Service d’hépato-gastro-entérologie, 184, rue du faubourg Saint-Antoine, 75012 Paris, France
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Iron deficiency is the most frequent cause of anaemia worldwide. Iron deficiency anaemia occurs in 2-5 % of adult men and postmenopausal women in the developed world and is a common cause of referral to gastroenterologists. Gastrointestinal blood loss from colonic cancer or gastric cancer, and malabsorption in coeliac disease are the most important causes that need to be sought. It impairs quality of life, increases asthenia and can lead to clinical worsening of patients. The cause of iron deficiency should always be sought because the underlying condition can be serious. This review will summarize the current knowledge regarding diagnostic management for iron deficiency anaemia. The positive diagnosis of iron deficiency is well defined. Serum ferritin is the most powerful test for iron deficiency in the absence of inflammation. However, modalities of etiological exploration are less well codified and no consensus algorithm concerning the investigation of iron deficiency anemia is available, particularly in gastroenterology. The majority of aetiologies occur in the digestive tract, in men and postmenopausal women, and justify morphological examination of the gut. First line investigations are upper gastrointestinal endoscopy and colonoscopy, and when negative, the small bowel should be explored; with video capsule endoscopy has first tool assessment.

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