How I treat unexplained refractory iron deficiency anemia

摘要: Endoscopic gastrointestinal workup fails to establish the cause of iron deficiency anemia(IDA) ina substantial proportionof patients. In patients referred for hematologic evaluation with unexplained or refractory IDA, screening celiac disease, autoimmune gastritis, Helicobacter pylori, and hereditary forms IDA is recommended. About 4% 6% obscure have gastritis encountered in 20% 27% Stratification by age cohorts implies a disease presenting as many years before establishment clinical cobalamin deficiency. Over 50% active Hp yloriinfection and, after excluding all other causes 64% 75% such are permanently cured ylorieradication. young history suggestive serum ferritin higher thanexpected mutations involving trafficking regulation should be considered. Recognition respective roles ylori, genetic defects pathogenesis strong impact on current diagnostic management unexplained, refractory, IDA. (Blood. 2014;123(3):326-333)