Iron-deficiency anaemia (IDA) is a common clinical problem throughout the world and an enormous public health problem in developing countries. The cornerstone of the laboratory identification of IDA is a low haemoglobin and serum
ferritin concentration although a normal serum
ferritin does exclude IDA. When the serum
ferritin is normal in an anaemic patient with
iron-deficient erythropoiesis, it is common practise to perform a bone marrow examination to diagnose IDA. The recent introduction of serum
transferrin receptor measurements is a useful alternative for distinguishing IDA from the anaemia of
chronic disease because the serum receptor concentration is usually elevated in patients with IDA but normal in patients with anaemia due to
inflammation or
neoplasia. It is helpful for the clinican to be aware of the causes of physiological IDA. The most important are increased rate of body growth, excessive menstrual blood loss, pregnancy, regular blood donation, intensive
endurance training, chronic
aspirin use and a
vegetarian diet. Without these, a careful search for unsuspected gastrointestinal blood loss must be made and even when the suspicion of physiological IDA is high, it is prudent to screen for fecal occult blood. In most patients, IDA responds promptly to oral
iron therapy. Patients who experience troublesome side-effects with oral
iron might benefit from a gastric delivery system for oral
iron which eliminates
nausea and
vomiting and improves
iron absorption when given with food.(ABSTRACT TRUNCATED AT 250 WORDS)