Clinical management of iron deficiency anemia in adults: Systemic review on advances in diagnosis and treatment

Global burden disease studies point out that one of the top cause-specific anemias is iron deficiency (ID). Recent advances in knowledge of iron homeostasis have shown that fragile patients are a newtarget population inwhich the correction of IDmight impact theirmorbidity, mortality and quality of life. We did a systematic review using specific search strategy, carried out the review of PubMed database, Cochrane Database of systemic reviews and international guidelines on diagnosis and clinicalmanagement of ID from2010 to 2016. The International guidelineswere limited to thosewith peer-reviewprocess and published in journal present in citation index database. The eligible studies showthat serumferritin and transferrin saturation are the key tests in early decision-making process to identify iron deficiency anemia (IDA). The clinician has to carefully consider fragile and high-risk subset of patients such as elders or individualswith chronic diseases (i. e chronic kidney disease, inflammatory bowel disease, chronic heart failure). Treatment is based on iron supplementation. Infusion route should be preferentially considered in frail patients especially in the view of new iron available formulations. The available evidences indicate that (i) recurrent IDA should always be investigated, considering uncommon causes; (ii) IDA might worse the performance and the clinical outcome of fragile and high-risk patients and require an intensive treatment. (C) 2017 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.