Dilip Kumar Pandey, Subhash Chandra Jha


Background: Iron deficiency anaemia is most common anemia worldwide. It is most common in female. In male IDA occurs most commonly due to gastrointestinal disease. Diagnosis of IDA on clinical suspicion is easy with CBC report and iron profile .Few dimorphic anemias and anemias in complex clinical settings pose difficulty in diagnosis, thus other investigations are also needed. Materials and Methods: we prospectively collected clinical data, CBC findings and iron profile results of patients of IDA in tertiary teaching institutes of Bihar. EDTA peripheral blood samples were run on Sysmex XT-1800i and CBC findings were noted, whenever needed peripheral blood smears were made to know morphology of red blood cells; serum samples of all cases were run for serum iron profile (iron, ferritin and transferritin saturation) and values noted and tabulated.Result:  All patients have both decreased serum iron and ferritin. They revealed classical microcytic hypochromic picture with raised RDW. Female outnumbered male. Male female ratio was 1:1.4. In this study CBC findings (MCV, MCH and RDW) were well correlated with iron profile findings. Minimum hemoglobin level was 5.4gm/dl.  Conclusion: Iron deficiency anemia is major public health problem worldwide .In majority of cases, CBC and iron profile study can clinch the diagnosis, however few cases need further investigations and clinical correlation.


IDA, Ferritin, Iron, CBC, Peripheral Blood smear, Hemoglobin

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Sayer JM, Long RG. A perspective on iron deficiency anaemia. Gut. 1993;34:1297–1299. [PMC free article] [PubMed] [Google Scholar]

McIntyre AS, Long RG. Prospective survey of investigations in outpatients referred with iron deficiency anaemia. Gut. 1993;34:1102–1107. [PMC free article] [PubMed] [Google Scholar]

Beutler E, Hoffbrand AV, Cook JD. Iron deficiency and overload. Hematology Am Soc Hematol Educ Program. 2003;34:40–61. [PubMed] [Google Scholar]

Yates JM, Logan EC, Stewart RM. Iron deficiency anaemia in general practice: clinical outcomes over three years and factors influencing diagnostic investigations. Postgrad Med J. 2004;80:405–410. [PMC free article] [PubMed] [Google Scholar]

Kepczyk T, Kadakia SC. Prospective evaluation of gastrointestinal tract in patients with iron-deficiency anemia. Dig Dis Sci. 1995;40:1283–1289. [PubMed] [Google Scholar]

Ioannou GN, Rockey DC, Bryson CL, Weiss NS. Iron deficiency and gastrointestinal malignancy: a population-based cohort study. Am J Med. 2002;113:276–280. [PubMed] [Google Scholar]

Hershko C, Hoffbrand AV, Keret D, Souroujon M, Maschler I, Monselise Y, Lahad A. Role of autoimmune gastritis, Helicobacter pylori and celiac disease in refractory or unexplained iron deficiency anemia. Haematologica. 2005;90:585–595. [PubMed] [Google Scholar]

Barabino A. Helicobacter pylori-related iron deficiency anemia: a review. Helicobacter. 2002;7:71–75. [PubMed] [Google Scholar]

Sarker SA, Mahmud H, Davidsson L, Alam NH, Ahmed T, Alam N, Salam MA, Beglinger C, Gyr N, Fuchs GJ. Causal relationship of Helicobacter pylori with iron-deficiency anemia or failure of iron supplementation in children. Gastroenterology. 2008;135:1534–1542. [PubMed] [Google Scholar]

Rector WG Jr. Pica: its frequency and significance in patients with iron-deficiency anemia due to chronic gastrointestinal blood loss. J Gen Intern Med. 1989;4:512–513. [PubMed] [Google Scholar]

Skikne BS. Serum transferrin receptor. Am J Hematol. 2008;83:872–875. [PubMed] [Google Scholar]

Rockey DC, Cello JP. Evaluation of the gastrointestinal tract in patients with iron-deficiency anemia. N Engl J Med. 1993;329:1691–1695. [PubMed] [Google Scholar]

Sawhney MS, Lipato T, Nelson DB, Lederle FA, Rector TS, Bond JH. Should patients with anemia and low normal or normal serum ferritin undergo colonoscopy? Am J Gastroenterol. 2007;102:82–88. [PubMed] [Google Scholar]

Kautz L, Nemeth E. . Molecular liaisons between erythropoiesis and iron metabolism. Blood 2014;124(4):479-482

Young MF, Glahn RP, Ariza-Nieto M, et al. Serum hepcidin is significantly associated with iron absorption from food and supplemental sources in healthy young women. Am J Clin Nutr 2009;89(2):533-538.

Roe MA, Collings R, Dainty JR, Swinkels DW, Fairweather-Tait SJ. Plasma hepcidin concentrations significantly predict interindividual variation in iron absorption in healthy men. Am J Clin Nutr 2009;89(4):1088-1091

Prentice AM, Doherty CP, Abrams SA, et al. Hepcidin is the major predictor of erythrocyte iron incorporation in anemic African children. Blood 2012;119(8):1922-1928.

Donker AE, Raymakers RA, Vlasveld LT, et al Practice guidelines for the diagnosis and management of microcytic anemias due to genetic disorders of iron metabolism or heme synthesis. Blood 2014;123(25):3873-3886

Aue Macdougall I, Macdougall I, Mast A Iron deficiency: what are the future trends in diagnostics and therapeutics? Clin Chem 2013;59(5):740-745.

L. A. Cohen, L. Gutierrez, A. Weiss et al., “Serum ferritin is derived primarily from macrophages through a nonclassical secretory pathway,” Blood, vol. 116, no. 9, pp. 1574–1584, 2010.

F. M. Torti and S. V. Torti, “Regulation of ferritin genes and protein,” Blood, vol. 99, no. 10, pp. 3505–3516, 2002.


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