Criteria for iron deficiency anaemia of unknown cause should allow for confounding effect of inflammation

Abstract

Iron deficiency anaemia (IDA) of unknown cause was the final diagnosis in seven of the 26 IDA patients who were the subjects of a recent study [ [1] Joosten E. Lioen P. Brusselmans C. Indevuyst C. Boeckx N. Is analysis of reticulocyte haemoglobin equivalent a useful test for the diagnosis of iron deficiency anaemia in geriatric patients?. Eur J Intern Med. 2012; https://doi.org/10.1016/j.ejim.2012.09.001 Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar ]. Such patients are best identified by a strategy which includes a search for gastrointestinal as well as non-gastrointestinal sources of chronic blood loss [ [2] Jolobe O.M.P. Does this elderly patient have iron deficiency anaemia, and what is the underlying cause?. Postgrad Med J. 2000; 76: 195-198 Crossref PubMed Scopus (13) Google Scholar ] as well as dietary deficiencies [ [3] Cook I.J. Pavli P. Riley J.W. Goulston K.J. Dent O.F. Gastrointestinal investigation of iron deficiency anaemia. BMJ. 1986; 292: 1380-1382 Crossref PubMed Scopus (110) Google Scholar ], optimisation of the diagnostic accuracy of red blood cell indices [ [1] Joosten E. Lioen P. Brusselmans C. Indevuyst C. Boeckx N. Is analysis of reticulocyte haemoglobin equivalent a useful test for the diagnosis of iron deficiency anaemia in geriatric patients?. Eur J Intern Med. 2012; https://doi.org/10.1016/j.ejim.2012.09.001 Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar ], and an interpretation of diagnostic cut-off levels which encompasses the entire range of serum ferritin levels [ [4] Guyatt G.H. Oxman A.D. Ali M. Willan A. McIlroy W. Patterson C. Laboratory diagnosis of iron-deficiency anemia. An overview. J Gen Intern Med. 1992; 7: 145-153 Crossref PubMed Scopus (420) Google Scholar ] so as to take full account of the confounding effect of co-existing neoplastic as well as non-neoplastic inflammatory disorders.