Iron Deficiency Anemia Research Articles

Iron Treatment in Patients with Iron Deficiency Before and After Metabolic and Bariatric Surgery: A Narrative Review.

Iron is an essential nutrient in living organisms with multiple vital functions. Iron deficiency (ID) can cause long term health consequences beyond iron deficiency anemia (IDA). The high prevalence of ID and its long-term effects in patients with obesity and after metabolic and bariatric surgery (MBS) is recognized. Nevertheless, there is limited knowledge of the optimal route or dose for treatment of patients with obesity and post-MBS, and an evidence-based universal guideline for prevention and treatment of ID in short- and long-term post-MBS (PMBS) is not yet available. ID in the general population is currently treated with oral or parenteral iron, where oral iron treatment is considered the preferred option with parenteral iron as a second-line treatment in case there is intolerance or lack of response to oral iron. In patients with obesity with chronic low-grade inflammation and PMBS patients with altered gut anatomy and function, there are also alterations in the bioavailability and higher risks of side effects of available oral irons. The conclusions of current studies exploring effective treatment of iron deficiency in this population have been inconsistent and further well-planned randomized and prospective studies are needed. This is a narrative review of the literature on the available treatment options and strategies for treatment of ID in PMBS patients to recognize the knowledge gaps and provides topics of future research.

EVALUATING THE IRON DEFICIENCY ANEMIA IN TYPE-II DIABETIC PATIENTS TAKING METFORMIN AND ITS ASSOCIATION WITH OXIDATIVE STRESS

Iron deficiency anemia (IDA) is one of the most common nutritional disorders worldwide, affecting individuals across various demographic groups. Objective: The main objective of the study is to find iron deficiency anemia in type-II diabetic patients taking metformin and its association with oxidative stress. Methods: This cross-sectional observational study was conducted at the outpatient department (OPD) of the Medical Unit at Khawaja Muhammad Safdar Medical College, Sialkot, during the study period from 1st January 2024 to 31st June 2024. Data were collected from 285 patients diagnosed with type 2 diabetes mellitus (T2DM) who were receiving metformin therapy. Patients were divided into two groups—Group A (patients with IDA) and Group B (patients without IDA)—and the oxidative stress markers were compared between these two groups. Results: Data were collected from 285 patients with 92 in Group A (IDA) and 193 in Group B (Non-IDA). The mean age of participants was 57.6 ± 9.4 years, with no significant difference between Group A (58.2 ± 9.1) and Group B (57.3 ± 9.6) (p = 0.422). Gender distribution was similar between groups (p = 0.601). The mean duration of diabetes was also comparable between the groups (8.3 ± 3.4 years in Group A and 8.0 ± 3.1 years in Group B, p = 0.572). However, HbA1c levels were significantly higher in Group A (8.3 ± 1.6%) compared to Group B (7.5 ± 1.3%) (p = 0.012), indicating poorer glycemic control in the IDA group. Conclusion: This study concludes that iron deficiency anemia (IDA) is prevalent among type 2 diabetic patients on metformin therapy, affecting approximately one-third of the study population. Additionally, there is a significant association between IDA and increased oxidative stress, as evidenced by elevated levels of malondialdehyde (MDA) and reduced antioxidant enzymes (SOD and GPx) in patients with anemia.

Evaluating The Diagnostic Value Of Red Cell Distribution Width (RDW) In Identifying Iron Deficiency Anemia: A Retrospective Analysis

Background: Iron Deficiency Anemia (IDA) is the most prevalent form of anemia globally, with a significant impact on public health, especially in low-resource settings like Bangladesh. Accurate and early diagnosis of IDA is essential for effective treatment. Red Cell Distribution Width (RDW) has emerged as a promising, accessible diagnostic tool for IDA, yet its utility remains underexplored in this context. Methods: This retrospective cross-sectional study, conducted between July 2022 and July 2024 at Addin Barrister Rafique-ul Huq Hospital in Bangladesh, included 106 patients diagnosed with microcytic hypochromic anemia. Key hematological parameters, including hemoglobin, RBC count, MCV, and RDW, were analyzed. Correlation analyses were performed to assess the relationships between RDW and other parameters such as hemoglobin, MCV, RBC count, and Erythrocyte Sedimentation Rate (ESR). Results: RDW was elevated (>14.5%) in 92.45% of the participants, with a mean RDW of 17.59±3.33%. Significant negative correlations were observed between RDW and hemoglobin (r = -0.435, p < 0.001) and between RDW and MCV (r = -0.664, p < 0.001). RDW showed positive correlations with RBC count (r = 0.315, p = 0.001) and ESR (r = 0.225, p = 0.041). The study confirmed RDW’s strong diagnostic value in distinguishing IDA, particularly in resource-constrained settings. Conclusion: RDW, combined with other hematological parameters, is a sensitive and reliable marker for diagnosing IDA. Its incorporation into routine diagnostic protocols could significantly enhance IDA detection and management in low-resource settings like Bangladesh.

High internal phase Pickering emulsions co-loaded with astaxanthin and ferrous gluconate improve iron deficiency anemia in mice and their applications in 3D printing

Iron deficiency anemia (IDA) is a prevalent and serious nutritional health issue that can be mitigated through dietary iron supplementation. However, only ferrous ions, prone to oxidation, can be absorbed in the gastrointestinal tract. In the current work, the effects of high internal phase Pickering emulsions (HIPPEs) co-loaded with astaxanthin (ASTA) and ferrous gluconate on Fe2+ oxidation, IDA management, and their 3D printing performance were investigated. The results demonstrated that the HIPPEs co-loaded with ASTA and ferrous gluconate effectively reduced the oxidation rate of Fe2+ during storage. Animal studies also revealed that HIPPE co-loaded with ASTA and ferrous gluconate had a therapeutic effect on IDA symptoms in mice. HIPPE co-loaded with ASTA and 400 mg/L ferrous gluconate demonstrated superior efficacy in restoring hemoglobin (Hb) levels, organ coefficients, and histological parameters in mice with IDA. Moreover, the evaluation of the adaptability of HIPPEs co-loaded with ASTA and ferrous gluconate for food 3D printing indicated a slight reduction in printing resolution. Overall printing performance was found to be acceptable and satisfactory. Co-loading ASTA and ferrous gluconate in HIPPEs offers an efficient way to address the oxidation challenge of ferrous ion supplementation, enabling customization and flexibility in the production of iron-fortified foods to mitigate IDA.

Comparison of the Anaemia and Transfusion Rates of Pregnant Women Treated with Intravenous versus Oral Iron in the Third Trimester.

To evaluate and compare the blood transfusion requirements during delivery in third-trimester pregnant women with iron deficiency anaemia (IDA) who were treated with intravenous (IV) ferric carboxymaltose (FCM) versus those treated with oral iron supplementation. Comparative study. Place and Duration of the Study: Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkiye, from January 2017 to December 2022. Pregnant women with haemoglobin (Hb) levels <10 g/dL in their third trimester were included. One group (n = 50) received IV FCM, while the other group (n = 96) received oral iron therapy. Key outcome measures included Hb levels at delivery and the need for a postpartum blood transfusion. Inclusion criteria were third-trimester pregnancy with IDA, and exclusion criteria included haematological or chronic systemic diseases and high-risk pregnancies. The mean initial Hb levels in the third trimester of pregnancy in the FCM group and oral iron group were 8.31 ± 0.96 g/dL and 9.29 ± 1.20 g/dL, respectively (p <0.001). The mean Hb levels in the delivery room were 11.09 ± 1.38 and 9.44 ± 1.16 g/dL, respectively (p <0.001). The rates of postpartum erythrocyte transfusion requirement were 6% (n = 3) and 18.75% (n = 18), respectively (p = 0.037). IV FCM administration to pregnant patients with IDA during the third trimester was found to be more effective than oral iron treatment in reducing blood transfusion rates. Anaemia, Ferric carboxymaltose, Pregnancy, Iron deficiency, Intravenous iron.

Enhancing referral practices: A bariatric department's education initiative to reduce unnecessary referrals to hematology oncology.

82 Background: Bariatric surgery patients face an elevated risk of iron deficiency anemia. Referrals from the Bariatric department to Hematology Oncology for work up of these anemias strain clinic resources and delay timely care for cancer patients. We initiated a targeted education program to reduce unnecessary referrals from the Bariatric department to Hematology Oncology by raising awareness among staff about appropriate referral criteria. Methods: We developed a curriculum highlighting the differences between symptoms of bariatric surgery complications and hematologic malignancies. Interactive training sessions were held with Bariatric department staff, supplemented by informational materials. Case studies and real-world examples reinforced understanding and decision-making. Staff were also educated on managing iron deficiency anemia internally. Referral rates were tracked before and after the intervention. Results: Baseline data were collected from July 2023 to November 2023, showing an average of 17 referrals per month (85 total over 5 months). The educational initiative included three sessions in December 2023 on anemia management and referral criteria. These sessions highlighted the distinction between symptoms of bariatric complications and hematologic malignancies, as well as education to the bariatric surgery providers on management of hematologic diagnoses resulting from bariatric surgery. Post-intervention data from January 2024 to May 2024 showed a substantial reduction in referrals for bariatric-related iron deficiency anemias to an average of 4.4 referrals per month (22 total over 5 months), indicating a 74% reduction. Improved internal management of iron deficiency anemia contributed to this outcome. The percentage of cancer patients receiving a consult within 7 days of referral contemporaneously improved from 85.7% to 88.1%, indicating improved access to oncology care. Conclusions: The educational intervention significantly reduced unnecessary referrals from the Bariatric department to Hematology Oncology, improving access for cancer patients. Empowering staff with the knowledge to make informed referral decisions and manage common hematologic issues internally improved patient care and clinic efficiency, reducing healthcare costs and patient burden in both departments.

S1021 A Retrospective Review: The Use of Fecal Occult Blood Testing for Evaluation of Acute/Chronic Blood Loss and Iron Deficiency Anemia Despite Secondary Diagnoses

S1021 A Retrospective Review: The Use of Fecal Occult Blood Testing for Evaluation of Acute/Chronic Blood Loss and Iron Deficiency Anemia Despite Secondary Diagnoses

S2869 The Importance of Early Diagnosis in a Patient With Macrocephaly and Iron Deficiency Anemia: A Case of Cowden Syndrome

S2869 The Importance of Early Diagnosis in a Patient With Macrocephaly and Iron Deficiency Anemia: A Case of Cowden Syndrome

S2913 Chronic Left Lower Quadrant Pain and Iron Deficiency Anemia in a Young Lady Mimicking a Colonic Endometrioma: Consider Cavernous Hemangioma of the Sigmoid

S2913 Chronic Left Lower Quadrant Pain and Iron Deficiency Anemia in a Young Lady Mimicking a Colonic Endometrioma: Consider Cavernous Hemangioma of the Sigmoid

Iron deficiency anaemia: Managing symptoms and supporting self-care. 2024 - Part 1

Iron deficiency anaemia: Managing symptoms and supporting self-care. 2024 - Part 1

S2207 Perspectives From Black Individuals on Iron Deficiency Anemia and Development of a Patient-Directed Infographic to Reduce Disparities in Evaluation and Management

S2207 Perspectives From Black Individuals on Iron Deficiency Anemia and Development of a Patient-Directed Infographic to Reduce Disparities in Evaluation and Management

S5043 Gastric Metastasis From Renal Cell Carcinoma Presenting as Iron Deficiency Anemia: A Case Report

S5043 Gastric Metastasis From Renal Cell Carcinoma Presenting as Iron Deficiency Anemia: A Case Report

Anaemia and selected micronutrient deficiencies among young women in rural North India – A community-based study

ABSTRACT Introduction: Anaemia is a major problem which affects half of young Indian women, impacting their health, education, and offspring. Despite ongoing efforts, a comprehensive understanding of anaemia remains limited. This study aims to assess the prevalence of anaemia among young women in rural Haryana and explore its causes comprehensively, which would help in tailoring targeted interventions for anaemia at a primary health care level. Methods: Young, non-pregnant women aged 15–24 years (n = 422) were assessed for socio-demographic details, menstrual/diet history, and anthropometry. Dietary diversity was assessed using Minimum Dietary Diversity for Women scale. Venous haemoglobin (Hb) was estimated using an auto-analyser. Serum ferritin, folate, and vitamin B12 were assessed for 260 participants. Anaemia was classified based on micronutrient deficiency. The morphology of anaemia was classified based on Red Blood Cell (RBC) indices. Multivariable analysis examined associations of anaemia with socio-demographic and clinical variables. Results: The prevalence of anaemia was 60.7%. Among those participants tested for micronutrient deficiency (n = 260), 170 (65.4%), 48 (18.5%), and 124 (47.7%) participants had deficiency of ferritin, folate, and vitamin B12, respectively. Iron deficiency anaemia (39.1%) and dimorphic anaemia (38.5%) were the two most common types of anaemia. The mixed morphology of RBCs was the most common morphology (41.8%). Almost all participants (98.2%) had inadequate dietary diversity. Being overweight was associated with lesser odds of having anaemia [OR = 0.41; 95% CI: 0.24 – 0.71 (P = 0.01)]. Conclusion: The high magnitude of anaemia is high, and there is a need for nutrition-based interventions for anaemia at a primary health care level among young women in rural India.

Factors Related To Compliance With The Consumption Of Iron Tablets In Adolescent Females

Background : Anemia is a condition characterized by decreased hemoglobin levels, red blood cell counts, and impaired oxygen requirements. One type of anemia that is often experienced by adolescents is iron deficiency anemia, due to the high iron requirements for adolescent growth which is inversely proportional to the amount of iron intake of adolescents. Many factors cause adolescent girls not to consume or still low consumption of Iron Supplement Tablets in Adolescent Girls. This study aims to determine the factors that influence compliance in taking iron tablets in adolescent girls at SMP Negeri 1 Kotabunan. Materials and Methods: This type of research uses quantitative observational analytic with a cross-sectional approach conducted on 74 female students taken from total sampling. Data collection was obtained from a research instrument in the form of a questionnaire. Data analysis was carried out by univariate analysis carried out on each variable and bivariate using the Charles Spearman Correlation Test or Spearman's Rank Correlation Coefficient with a confidence level (alpha) of 0.05. Results:of the study showed that respondents started menstruating at the age of 11-12 years by 35%, adolescent girls were obedient in consuming iron tablets by 57 people (77%), knowledge of adolescent girls by 67 people (90.5%) with a good category, Teacher Support 82.4%, Family 66.2% and Peers 77% supported adolescent girls consuming iron tablets, the correlation coefficient value with the Spearman's Rank test. for knowledge with compliance in consuming iron tablets 0.000, teacher support 0.003, family support 0.000 and peer support 0.007. There is a relationship between the level of knowledge, teacher support, family support and peer support with compliance in consuming iron tablets with a correlation coefficient value (sig.2-tailed) &lt;0.05. Conclusion: Adolescents in the growth and development period require adequate nutrient intake including the consumption of iron tablets to avoid anaemia. This study shows that factors associated with adherence to iron tablet consumption in adolescent girls are knowledge, attitude, parental support and teacher support.

Post-transplant renal anemia: a call to action from a national study in routine clinical practice.

Post-transplant anemia is a prevalent yet often overlooked condition that poses significant risks. Current guidelines consider the same treatment recommendations and goals for these patients as for chronic kidney disease patients not on dialysis. Previous reports demonstrated a lack of awareness and suboptimal management, indicating a pressing need for improvement. We therefore wanted to update the information on post-transplant anemia. We aimed to describe the present state of anemia management, goals and adherence to guidelines within a representative sample of the kidney transplant (KTx) population. We designed a retrospective nationwide multicenter study including outpatients from eight KTx hospitals. Nephrologists gathered data from electronic medical records encompassing demographics, comorbidities, KTx characteristics and immunosuppressive therapy, and information pertaining to anemia management (laboratory values, previously prescribed treatments and subsequent adjustments). The European statement on the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines was the reference for definitions, drug prescriptions and targets. Anemia occurring within the initial 6 months post-transplantation was classified as early onset. We included 297 patients with post-transplant anemia aged 62.8 years (standard deviation 13.6), 60% of whom were male. They had received a graft from cardiac death or brain death donors (61.6% and 31.1%, respectively) a median of 2.5 years (0.5-8.7) before. Among them 77% (n=228) were classified as having late post-transplant anemia, characterized by a higher prevalence of microcytic and iron deficiency anemia. A total of 158 patients were on erythropoietic-stimulating agents (ESAs) treatment, yet surprisingly 110 of them lacked iron supplementation. Notably, 44 patients had an indication for iron supplementation and among them, 30 exhibited absolute iron deficiency. Out of the 158 patients receiving ESAs, only 39 surpassed the limit for the ESA resistance index, indicating poor response. This resistance was more frequent among patients with early post-transplant anemia (26.1% vs 9.2%). We have identified iron profile, early post-transplant anemia and estimated glomerular filtration rate as factors associated with the highest risk of resistance. We found that hemoglobin targets are individualized upwards in post-transplant anemia. In this setting, iron therapy continues to be underutilized, especially intravenous, and iron deficiency and prior events (blood transfusion or hospital admission) explain most of the hyporesponsiveness to ESA. This highlights missed opportunities for precise prescription targeting and adherence to established guidelines, suggesting a need for improved management strategies in post-transplant anemia patients.

Pil-Pintar Intervention Reduce Anemia among Young Teen Girls: A Pilot Study

Background: Iron deficiency anemia and low adherence to take iron tablets are prevalent issues among teenage school girls in Indonesia. To address this concern and encourage regular iron supplementation, the public health office of Sukoharjo Central Java Indonesia introduced a pil-pintar program, colloquially known as the “smart pill.” Aims: This study aimed to measure the increase in hemoglobin (Hb) levels and its correlation with nutrient intake related to Hb synthesis following the pil-pintar intervention. Methods: A quasi-experimental design with a one-group pre-posttest approach was performed involving 49 school teenage girls aged 12-15 years in a public school in Sukoharjo, Indonesia. Each student was given an iron sugar coat tablet containing 182 mg of ferrous-fumarate (equivalent to 60 mg elemental iron) and 0.400 mg of folic acid per tablet, called pil-pintar, once a week for 12 weeks. Results: A decrease in anemia prevalence by 24.4% and a notable increase in Hb levels by 1.0 mg/dL (p = 0.001) were observed in the 12 weeks of intervention. However, the study found no association between the nutrient intakes related to Hb production and the resulting Hb levels. Conclusion: The pil-pintar program effectively improved the hemoglobin levels of anemic teenage girls in the Sukoharjo district, Indonesia.

Iron deficiency anemia in post-bariatric surgery patients: A retrospective study at Baghdad teaching hospital, 2024

Iron deficiency anemia in post-bariatric surgery patients: A retrospective study at Baghdad teaching hospital, 2024

Standardizing the evaluation and management of iron deficiency anemia secondary to heavy menstrual bleeding in the emergency department.

Comprehensive guidelines for the management of iron deficiency anemia (IDA) in adolescents with heavy menstrual bleeding (HMB) presenting to the emergency department (ED) are lacking, leading to variability in care. We aimed to standardize the evaluation and management of these patients through the development and implementation of an evidence-based algorithm using quality improvement methodology. Baseline data of the target population identified variability across four key measures of clinical management: therapy choice and administration, laboratory evaluation, hematology service consultation, and patient disposition. Literature review and consensus from pediatric hematology and gynecology providers informed a draft algorithm that was refined in an iterative multidisciplinary process. From December 2022 to July 2023, we aimed to achieve a 25% relative increase in patients to receive optimal management per the algorithm, while using sequential Plan-Do-Study-Act (PDSA) cycles. Process measures focusing on provider documentation and balancing measures, such as ED length of stay, were assessed concurrently. Forty-nine patients were evaluated during four PDSA cycles. Improvement of ≥40% above baseline regarding recommended therapy administration was achieved across four PDSA cycles. Adherence to recommended therapy choice improved from 57% (baseline) to 100%, minimal laboratory evaluation from 14% to 83%, hematology consultation from 36% to 100%, and appropriate disposition from 71% to 100%. ED length of stay remained stable. Implementation of a standardized algorithm for management of IDA secondary to HMB in adolescents in the ED increased adherence to evidence-based patient care.

Vitamin C-rich guava consumed with mungbean dal reduces anemia and increases hemoglobin but not iron stores: a randomized controlled trial of food-to-food fortification in Indian children.

BackgroundAdding vitamin C-rich fruit to staples containing iron could be an effective strategy to improve iron bioavailability and thereby reduce iron-deficiency anemia in children. ObjectiveWe aimed to assess the effect of consuming a mungbean-based meal with or without guava fruit on body iron stores, hemoglobin concentration, and anemia of children as part of a school feeding program. MethodsWe conducted a 7-month randomized, controlled trial with 6 to 10-year-old school children (n=200; 46% anemic, 71% iron-deficient) from a rural community in Haryana, North India. Children were assigned to two treatment groups to daily receive either a meal of mungbean dal only (3.0 mg of iron; vitamin C:iron molar ratio ∼0.5:1), or mungbean dal with fresh guava (3.2 mg of iron; ∼170 mg of vitamin C; molar ratio ∼18:1). Meals were served every school day under supervision. The primary outcome was body iron stores, while concentrations of hemoglobin and other iron indicators were secondary outcomes. ResultsDaily consumption of mungbean dal along with guava did not result in an overall improvement of body iron stores (mean treatment effect: 0.65 mg/kg body weight; 95% CI: −0.34, 1.63; P=0.197). However, compared to children who consumed mungbean dal only, children in the guava group showed a larger increase in hemoglobin concentration (3.7 g/L; 95% CI: 1.6, 5.6; P=0.001), and a larger drop in the prevalence of anemia (−51%; 95% CIs: −74, −10; P= 0.022) and iron-deficiency anemia (−56%, 95% CI: −83, 13; P=0.087). These effects were more pronounced in children who were iron-deficient at study start. ConclusionsAddition of guava to a mungbean-based meal containing a moderate amount of iron increased hemoglobin and reduced anemia but did not provide enough additional absorbed iron to also increase body iron stores. Food-to-food fortification by inclusion of vitamin C rich fruits in iron-containing school meals may help alleviate the burden of anemia in children.This trial was registered at https://clinicaltrials.gov/ct2/show/NCT01191463.

S1017 Diagnosis of GI Tract Cancers in New Onset Iron Deficiency Anemia in a National Retrospective Cohort (2005-2019)

S1017 Diagnosis of GI Tract Cancers in New Onset Iron Deficiency Anemia in a National Retrospective Cohort (2005-2019)