title: Iron deficiency: from diagnosis to treatment.
abstract: Iron deficiency is the most frequent cause of anaemia worldwide. It impairs quality of life, increases asthenia and can lead to clinical worsening of patients. In addition, iron deficiency has a complex mechanism whose pathologic pathway is recently becoming better understood. The discovery of hepcidin has allowed a better clarification of iron metabolism regulation. Furthermore, the ratio of concentration of soluble transferrin receptor to the log of the ferritin level, has been developed as a tool to detect iron deficiency in most situations. 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 algorithms for iron deficiency anaemia. 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; newer tools such as video capsule endoscopy have also been developed. The treatment of iron deficiency is aetiological if possible and iron supplementation whether in oral or in parenteral form. New parenteral formulations are available and seem to have promising results in terms of efficacy and safety.
authors.affiliation: Department of Gastroenterology, Cochin Teaching Hospital, AP-HP, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France. Electronic address: vanessa.polin@cch.aphp.fr.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Polin
authors.forename: Romain
authors.initials: R
authors.lastname: Coriat
authors.forename: Géraldine
authors.initials: G
authors.lastname: Perkins
authors.forename: Marion
authors.initials: M
authors.lastname: Dhooge
authors.forename: Vered
authors.initials: V
authors.lastname: Abitbol
authors.forename: Sarah
authors.initials: S
authors.lastname: Leblanc
authors.forename: Frédéric
authors.initials: F
authors.lastname: Prat
authors.forename: Stanislas
authors.initials: S
authors.lastname: Chaussade
mesh_terms: D018798:Anemia, Iron-Deficiency / Q000175:diagnosis* / Q000209:etiology*; D016099:Endoscopy, Gastrointestinal; D005767:Gastrointestinal Diseases / Q000150:complications / Q000628:therapy; D006801:Humans; D007501:Iron / Q000378:metabolism / Q000627:therapeutic use*; D000090463:Iron Deficiencies; D014131:Trace Elements / Q000627:therapeutic use*
chemical_list: D014131:Trace Elements; D007501:Iron
keywords: Anaemia; Colonoscopy; Ferric carboxymaltose; Hepcidin; Iron deficiency; Upper gastrointestinal endoscopy; Videocapsule endoscopy