Treatment of anemia and iron deficiency from the hematologist’s perspective

Summary

Iron deficiency anemia represents the most frequent hematological disorder worldwide. Basic mechanisms involved in iron metabolism regulation have been described over the past 20 years, e. g. the system of IRP/ IRP regulatory proteins or the discovery of hepcidin, a key regulatory peptide involved in the regulation of iron metabolism and synthesis. Increased iron loss from the body is the most common reason for iron deficiency, the combination of serum fer­ritin level and transferrin saturation represent the most effective laboratory tools for the dia­gnosis of iron deficiency. A combination of several parameters is usually necessary for an exact dia­gnosis of iron deficiency in conditions with a combined iron metabolism disorder (e. g. anemia of chronic diseases). Iron deficiency may be corrected with the administration of medications containing iron salts. Parenteral administration of iron is indicated in patients with altered iron absorption from the gut; new drugs with regular and gradual release of iron molecules, even in large amounts (e. g. ferric carboxymaltose), may effectively correct iron depletion in these patients. High bio­availability of these preparations could also be effective in the initial correction of severe sideropenic anemia in patients with poor toleration of oral iron medications.

Keywords:
iron deficiency anemia –  iron metabolism –  dia­gnosis –  treatment –  hepcidin –  parenteral iron drugs