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Iron deficiency: new insights into diagnosis and treatment
Abstract
Iron deficiency and iron deficiency anemia are common conditions worldwide affecting especially children and young women. In developing countries, iron deficiency is caused by poor iron intake and/or parasitic infection, whereas vegetarian dietary choices, poor iron absorption, and chronic blood loss are common causes in high-income countries. Erythropoiesis stimulating agents can result in functional iron deficiency for erythropoiesis even when stores are iron-replete. Diagnosis of iron deficiency is straightforward, except when it occurs in the context of inflammatory disorders. Oral iron salts correct absolute iron deficiency in most patients, because low hepcidin levels facilitate iron absorption. Unfortunately frequent side effects limit oral iron efficacy. Intravenous iron is increasingly utilized, because currently available preparations allow rapid normalization of total body iron even with a single infusion and are effective also in functional iron deficiency and in iron deficiency associated with inflammatory disorders. The evidence is accumulating that these preparations are safe and effective. However, long-term safety issues of high doses of iron need to be further explored.
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“Although many laboratory indexes may be helpful for the ID differential diagnostic workup, such as the mean corpuscular volume (MCV), the reticulocyte count and reticulocyte Hb content, the soluble transferrin receptor and its correlation with SF, and hepcidin measurement, based on the real-life evidence, the determination of iron status by using SF and TSAT is the most commonly deployed strategy”
From Defining Global Thresholds for Serum Ferritin: A Challenging Mission in Establishing the Iron Deficiency Diagnosis in This Era of Striving for Health Equity (2025) · cites this paper as [19]
In the citing paper
“It is a usual practice in many specialties and guidelines to assume that, regardless of the lower normality value of the ferritin test used, SF <30 ng/mL (irrespective of the TSAT value) or SF <100 ng/mL and TSAT <20% are the hallmarks of absolute ID; while SF >100 ng/mL and TSAT <20% usually indicate AI in the context of infection or inflammation [1,2,15,16,17,18,19,20].”
From Defining Global Thresholds for Serum Ferritin: A Challenging Mission in Establishing the Iron Deficiency Diagnosis in This Era of Striving for Health Equity (2025) · cites this paper as [19]
In the citing paper
“Iron deficiency is the most common pathology of iron homeostasis, eventually resulting in iron deficiency anemia, the most frequent anemia worldwide (Camaschella, 2015).”
From The Role of Iron Regulation in Immunometabolism and Immune-Related Disease (2019) · cites this paper as Camaschella, 2015
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Metadata
- Authors
- Camaschella, C.
- Affiliations
- Vita-Salute San Raffaele University (IT)
- Corresponding author
- Camaschella, Clara
- ORCID
- Camaschella, Clara
- Venue
- Hematology
- Publisher
- American Society of Hematology
- Published
- 2015-12-05
- Volume
- 2015
- Issue
- 1
- Pages
- 8-13
- ISSN
- 1520-4383 (ISSN-L)
- 1520-4391
- OpenAlex
- W2220231666
- Cited by
- 201
- References
- 42
- Citations by year
- 2026: 17 · 2025: 16 · 2024: 22 · 2023: 19 · 2022: 32 · 2021: 18 · 2020: 24 · 2019: 23 · 2018: 21 · 2017: 7 · 2016: 2
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hematology (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Topics
- Health Sciences › Medicine › Hematology › Iron Metabolism and Disorders
- Health Sciences › Medicine › Hematology › Erythropoietin and Anemia Treatment
- Health Sciences › Medicine › Genetics (clinical) › Hemoglobinopathies and Related Disorders
- Keywords
- iron deficiency, iron deficiency anemia, diagnosis, treatment, oral iron supplementation, intravenous iron, hepcidin, functional iron deficiency, erythropoiesis-stimulating agents, inflammation, iron absorption, parasitic infection, vegetarian diet, chronic blood loss, iron toxicity
- MeSH terms
- Iron Deficiencies, Administration, Oral, Animals, Disease Models, Animal, Female, Ferritins, Hematologic Tests, Hematology, Humans, Inflammation, Infusions, Intravenous, Infusions, Parenteral, Iron, Male, Transferrin, Anemia, Iron-Deficiency, Dietary Supplements, Genetic Predisposition to Disease
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