Current misconceptions in diagnosis and management of iron deficiency

• Published in: Blood transfusion = Trasfusione del sangue 2017-09, Vol.15 (5), p.422-437
• Main Authors: Muñoz, Manuel, Gómez-Ramírez, Susana, Besser, Martin, Pavía, José, Gomollón, Fernando, Liumbruno, Giancarlo M, Bhandari, Sunil, Cladellas, Mercé, Shander, Aryeh, Auerbach, Michael
• Format: Article
• Language: English
• Subjects: Anemia, Iron-Deficiency - diagnosis; Anemia, Iron-Deficiency - therapy; Diagnostic Errors; Evidence-Based Practice; Humans; Iron - blood; Iron - deficiency; Iron - therapeutic use; Review
• ISSN: 1723-2007
• DOI: 10.2450/2017.0113-17

The prevention and treatment of iron deficiency is a major public health goal. Challenges in the treatment of iron deficiency include finding and addressing the underlying cause and the selection of an iron replacement product which meets the needs of the patient. However, there are a number of non-evidence-based misconceptions regarding the diagnosis and management of iron deficiency, with or without anaemia, as well as inconsistency of terminology and lack of clear guidance on clinical pathways. In particular, the pathogenesis of iron deficiency is still frequently not addressed and iron not replaced, with indiscriminate red cell transfusion used as a default therapy. In our experience, this imprudent practice continues to be endorsed by non-evidence-based misconceptions. The intent of the authors is to provide a consensus that effectively challenges these misconceptions, and to highlight evidence-based alternatives for appropriate management (referred to as key points). We believe that this approach to the management of iron deficiency may be beneficial for both patients and healthcare systems. We stress that this paper solely presents the Authors' independent opinions. No pharmaceutical company funded or influenced the conception, development or writing of the manuscript.