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CPE-004 · Safety
ID-GI-02: Premenopausal women: blood-loss assessment
Premenopausal women: blood-loss assessment. Evaluates iron-deficiency anemia pattern (ID-11).
Condition
- iron-deficiency anemia pattern (ID-11)
- premenopausal woman
What it reports
- Menstrual blood loss should be quantified; gastrointestinal causes remain possible
Recommended next steps (for physician review)
- Assess menstrual history and heavy menstrual bleeding
- Consider noninvasive celiac and H. pylori testing or endoscopy when there is no explanation, GI symptoms or poor response
Diagnostic boundary
- Heavy menstrual bleeding does not exclude a gastrointestinal source.
Evidence
- EV-AGA-2020Ko CW, Siddique SM, Patel A, et al. AGA Clinical Practice Guidelines on the Gastrointestinal Evaluation of Iron Deficiency Anemia. Gastroenterology. 2020;159(3):1085-1094.Supports: A ferritin cutoff of 45 ng/mL is suggested to diagnose iron deficiency Bidirectional endoscopy is suggested for asymptomatic men and postmenopausal women with iron-deficiency anemia Celiac serology and H. pylori testing have a role in evaluation
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
IRON-FX-01
Classic iron-deficiency anemia in a premenopausal woman
A 34-year-old with heavy periods, Hb 9.8, MCV 72 and a ferritin of 6.
IRON-FX-06
Inflammation with ferritin 48 and TSAT 9
Ferritin looks near normal but sits under the WHO inflammation cutoff of 70.
IRON-FX-13
Severe anemia
Hemoglobin 6.4 g/dL with a ferritin of 4.
IRON-FX-18
Four months of oral iron without response
Adherent for four months, ferritin still 12.
IRON-FX-20
IV iron considered during a urinary infection
Ferritin 14 and an active infection.
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