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CPE-004 · Safety
ID-REF-01: Iron deficiency not responding to oral iron
Iron deficiency not responding to oral iron. Evaluates oral iron taken for at least 3 months with adherence documented.
Condition
- oral iron taken for at least 3 months with adherence documented
- iron deficiency still present
What it reports
- Refractory pattern: reconsider adherence, ongoing loss, malabsorption and the diagnosis
Recommended next steps (for physician review)
- Review ongoing blood loss and malabsorption (celiac disease, H. pylori, atrophic gastritis, surgery, long-term acid suppression)
- Physician to consider whether another route is appropriate
Diagnostic boundary
- No route or dose is recommended.
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
- EV-CAMASCHELLA-2015Camaschella C. Iron-deficiency anemia. N Engl J Med. 2015;372(19):1832-1843.Supports: Stages of iron deficiency, causes and differential diagnosis of microcytic anemia
Cases where this rule fires
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