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==Overview==
[[Iron deficiency anemia]] causes can be broadly divided into physiological causes as that seen during [[growth]] and [[pregnancy]] and due to pathological process. The pathological process could be further divided based on blood loss and inadequate iron absorption.
 
== Causes  ==
 
===Life threatening causes===
* Severe blood loss such as traumatic [[Bleeding|haemorrhage]], haemetemesis, [[Hemoptysis|haemoptysis]] or uncontrolled bleeding from any body part can result in death from hypovolemic [[shock]]<ref name="urlRecommendations to Prevent and Control Iron Deficiency in the United States">{{cite web |url=http://www.cdc.gov/mmwr/preview/mmwrhtml/00051880.htm#top |title=Recommendations to Prevent and Control Iron Deficiency in the United States |format= |work= |accessdate=2012-09-18}}</ref><ref name="pmid21208814">{{cite journal| author=Price EA, Mehra R, Holmes TH, Schrier SL| title=Anemia in older persons: etiology and evaluation. | journal=Blood Cells Mol Dis | year= 2011 | volume= 46 | issue= 2 | pages= 159-65 | pmid=21208814 | doi=10.1016/j.bcmd.2010.11.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21208814  }} </ref><ref name="pmid26813849">{{cite journal| author=Mast AE, Bialkowski W, Bryant BJ, Wright DJ, Birch R, Kiss JE et al.| title=A randomized, blinded, placebo-controlled trial of education and iron supplementation for mitigation of iron deficiency in regular blood donors. | journal=Transfusion | year= 2016 | volume= 56 | issue= 6 Pt 2 | pages= 1588-97 | pmid=26813849 | doi=10.1111/trf.13469 | pmc=4905782 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26813849  }} </ref><ref name="pmid2681511">{{cite journal| author=Cook JD, Skikne BS| title=Iron deficiency: definition and diagnosis. | journal=J Intern Med | year= 1989 | volume= 226 | issue= 5 | pages= 349-55 | pmid=2681511 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2681511  }} </ref>
<ref name="pmid11690568">{{cite journal| author=Annibale B, Capurso G, Chistolini A, D'Ambra G, DiGiulio E, Monarca B et al.| title=Gastrointestinal causes of refractory iron deficiency anemia in patients without gastrointestinal symptoms. | journal=Am J Med | year= 2001 | volume= 111 | issue= 6 | pages= 439-45 | pmid=11690568 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11690568  }} </ref><ref name="pmid26314490">{{cite journal| author=Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L| title=Iron deficiency anaemia. | journal=Lancet | year= 2016 | volume= 387 | issue= 10021 | pages= 907-16 | pmid=26314490 | doi=10.1016/S0140-6736(15)60865-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26314490  }} </ref><ref name="pmid22288902">{{cite journal| author=Khadem G, Scott IA, Klein K| title=Evaluation of iron deficiency anaemia in tertiary hospital settings: room for improvement? | journal=Intern Med J | year= 2012 | volume= 42 | issue= 6 | pages= 658-64 | pmid=22288902 | doi=10.1111/j.1445-5994.2012.02724.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22288902  }} </ref><ref name="pmid12361812">{{cite journal| author=Ioannou GN, Rockey DC, Bryson CL, Weiss NS| title=Iron deficiency and gastrointestinal malignancy: a population-based cohort study. | journal=Am J Med | year= 2002 | volume= 113 | issue= 4 | pages= 276-80 | pmid=12361812 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12361812  }}  [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=&cmd=prlinks&id=12725635 Review in: ACP J Club. 2003 May-Jun;138(3):80] </ref><ref name="pmid26637694">{{cite journal| author=Camaschella C| title=Iron deficiency: new insights into diagnosis and treatment. | journal=Hematology Am Soc Hematol Educ Program | year= 2015 | volume= 2015 | issue=  | pages= 8-13 | pmid=26637694 | doi=10.1182/asheducation-2015.1.8 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26637694  }} </ref><ref name="pmid7732338">{{cite journal| author=Corazza GR, Valentini RA, Andreani ML, D'Anchino M, Leva MT, Ginaldi L et al.| title=Subclinical coeliac disease is a frequent cause of iron-deficiency anaemia. | journal=Scand J Gastroenterol | year= 1995 | volume= 30 | issue= 2 | pages= 153-6 | pmid=7732338 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7732338  }} </ref><ref name="pmid11122153">{{cite journal| author=Unsworth DJ, Lock RJ, Harvey RF| title=Improving the diagnosis of coeliac disease in anaemic women. | journal=Br J Haematol | year= 2000 | volume= 111 | issue= 3 | pages= 898-901 | pmid=11122153 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11122153  }} </ref><ref name="pmid15921373">{{cite journal| author=Hershko C, Hoffbrand AV, Keret D, Souroujon M, Maschler I, Monselise Y et al.| title=Role of autoimmune gastritis, Helicobacter pylori and celiac disease in refractory or unexplained iron deficiency anemia. | journal=Haematologica | year= 2005 | volume= 90 | issue= 5 | pages= 585-95 | pmid=15921373 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15921373  }} </ref><ref name="pmid931207">{{cite journal| author=Eschbach JW, Cook JD, Scribner BH, Finch CA| title=Iron balance in hemodialysis patients. | journal=Ann Intern Med | year= 1977 | volume= 87 | issue= 6 | pages= 710-3 | pmid=931207 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=931207  }} </ref> .
 
===Most common causes===
* [[Growth]]
* [[Pregnancy]]
* [[Malnutrition]]
* [[Malabsorption]]
* Blood loss
* [[Chronic renal disease|Chronic Kidney disease]]
* Anemia of [[Chronic (medical)|chronic disease]]
* [[Myeloproliferative neoplasm|Myeloproliferative]] disorders
 
=== Less common causes ===
* Erythrpoetin/eryhtropoetin stimulating drugs
* [[Leflunomide]]
* [[Pramipexole]]
* [[Trientine]]
 
=== Genetic cause ===
* IRIDA- iron referactory iron deficiency anemia due to TMPRSS6 mutation
* SLC11A-2 mutation
* Iron-refractory iron deficiency anaemia  •
* Divalent metal transporter deficiency anaemia,  •
* Fanconianaemia 
* Pyruvate kinase deficiency
 
====Pathological====


==Overview==
=====Blood Loss=====
* [[Menstruation]]
* Gastrointestinal tract (Bleeding from the [[gastrointestinal tract]] ([[ulcers]], [[hemorrhoid]]s, [[Esophageal varices]], The use of [[aspirin]], [[ibuprofen]], or [[Arthritis (patient information)|arthritis]] medicines for a long time, Cancer in the esophagus, stomach, or colon)
** Food sensitivity
** [[Hookworm]]s
* [[Genitourinary tract]]
* [[Respiratory tract]] (Rarely [[laryngological]] bleeding or from the [[respiratory tract]])
* Blood donation
 
===Inadequate Iron Absorption===
* Dietary deficiency
* Impaired absorption ([[Celiac disease]], [[Crohn's disease]])
** Intestinal [[malabsorption]]
** [[Gastric surgery]]
** [[Hypochorhydria]]
*Taking too many antacids that contain [[calcium]]


==Causes==
* Chronic bleeding ([[hemoglobin]] contains iron)
** Excessive [[menstrual bleeding]]
** Non-menstrual [[bleeding]]
** Bleeding from the [[gastrointestinal tract]] ([[ulcers]], [[hemorrhoid]]s, [[Esophageal varices]], The use of [[aspirin]], [[ibuprofen]], or [[Arthritis (patient information)|arthritis]] medicines for a long time, Cancer in the esophagus, stomach, or colon etc.)
** Rarely [[laryngological]] bleeding or from the [[respiratory tract]]
* Inadequate intake (special diets low in dietary iron)
* Substances (in diet or drugs) interfering with iron absorption
* [[Malabsorption]] syndromes
:*[[Celiac disease]]
:*[[Crohn's disease]]
:*[[Gastric bypass surgery]]
:*Taking too many antacids that contain [[calcium]]
*You may not get enough iron in the diet if:
:*You are a strict vegetarian
:*You are an older adult and do not eat a full diet


==References==
===Causes by Organ System===
{{Reflist|2}}
{| style="width:80%; height:100px" border="1"
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
| style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
|-
| bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dental'''
| bgcolor="Beige" | Gum bleeding
|-
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| bgcolor="Beige" | [[Leflunomide]], [[Pramipexole]], [[trientine]], antacids
|-
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| bgcolor="Beige" | Epistaxis
|-
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| bgcolor="Beige" | Erythropoetin deficiency
|-
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| bgcolor="Beige" | Haemetemesis, Celiac disease, bariatric surgery, Gatsritis, esophageal varices, [[Tropical sprue]], [[Whipple's disease]], [[Small intestinal bacterial overgrowth syndrome]], Giardia, Malabsorption
{| class="wikitable"
| colspan="2" |[[Blind loop syndrome]]
|-
| colspan="2" |[[Fistula]]
|-
| colspan="2" |[[Diverticular|Diverticula]]
|-
| colspan="2" |[[Stenosis|Stricture]]
|}
[[Cystic fibrosis]], 
{| class="wikitable"
| colspan="2" |[[Zollinger-Ellison syndrome|Zollinger–Ellison syndrome]]
|-
| colspan="2" |[[VIPoma]]
|-
| colspan="2" |[[Carcinoid syndrome]]
|-
| colspan="2" |[[Bile acid malabsorption]]
|}
{| class="wikitable"
|[[Crohn's disease]]
|-
|[[Ulcerative colitis]]
|}
|-
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| bgcolor="Beige" | '''''SLC11A2'' mutation, IRIDA'''
|-
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| bgcolor="Beige" | Myeloproliferative disorder
|-
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| bgcolor="Beige" | Erythrpoetin administartion
|-
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| bgcolor="Beige" | H.pylori, Giardia, Hookworms, Entamoeba histolytica
|-
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| bgcolor="Beige" | Mennorhagia, Fibroids, Post partum bleeding, Pregnancy, Endometriosis
|-
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| bgcolor="Beige" | Colon cancer, esophageal cancer, gastric cancer, pancreatic cancer, lung cancer
|-
|- bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| bgcolor="Beige" | Haemoptysis
|-
|- bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| bgcolor="Beige" | Chronic kidney disease, haemodialysis
|-
|- bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| bgcolor="Beige" | Anemia of chronic disease
|-
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| bgcolor="Beige" | Bleeding
|-
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| bgcolor="Beige" | Haematuria
|-
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| bgcolor="Beige" | Decreased iron intake, increased body requirements
|-
|}


[[Category:Needs content]]
===Causes in alphabetical order===
<div style="-moz-column-count:3; column-count:3;">
* [[Anemia of chronic disease]]
* [[Antacid|Antacids]]
* [[Bariatric surgery]]
* Blood donation
* [[Bleeding|Blood loss]]
* [[Carcinoid syndrome]]
* [[Celiac disease]]
* [[Chronic renal failure|Chronic kidney disease]]
* [[Crohn's disease]]
* [[Colorectal cancer|Colon cancer]]
* Decreased iron intake
* [[Diverticulosis]]
* [[Endometriosis]]
* [[Entamoeba histolytica]]
* [[Epistaxis]]
* Erythropoetin deficiency
* [[Esophageal cancer]]
* [[Esophageal varices]]
* [[Leiomyoma|Fibroids]]
* [[Gastritis]]
* GI fistula
* [[Stomach cancer|Gastric cancer]]
* [[Giardia lamblia|Giardia]]
* [[Helicobacter pylori|H. Pylori]]
* [[Hookworm]]
* [[Hemoptysis|Haemoptysis]]
* Haemetemesis
* [[Hematuria|Haematuria]]
* [[Hemorrhoids|Haemorrhoids]]
* [[Myeloproliferative neoplasm|Myeloproliferative disorders]]
* [[Malnutrition]]
* [[Malabsorption]]
* [[Peptic ulcer|Peptic ulcer disease]]
* [[Pregnancy]]
* Post partum bleeding
* [[Pancreatic cancer]]
* [[Tropical sprue|Stricture]]
* [[Tropical sprue]]
* [[Ulcerative colitis]]
* [[Whipple's disease|Whipple disease]]
* [[Zollinger Ellison syndrome]]
</div>
[http://www.cdc.gov/mmwr/preview/mmwrhtml/00051880.htm Center for disease control and prevention]


==References==
{{reflist|2}}
{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[Category:Hematology]]
[[Category:Gastroenterology]]
[[Category:Endocrinology]]

Latest revision as of 22:25, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

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Overview

Iron deficiency anemia causes can be broadly divided into physiological causes as that seen during growth and pregnancy and due to pathological process. The pathological process could be further divided based on blood loss and inadequate iron absorption.

Causes

Life threatening causes

[5][6][7][8][9][10][11][12][13] .

Most common causes

Less common causes

Genetic cause

  • IRIDA- iron referactory iron deficiency anemia due to TMPRSS6 mutation
  • SLC11A-2 mutation
  • Iron-refractory iron deficiency anaemia •
  • Divalent metal transporter deficiency anaemia, •
  • Fanconianaemia
  • Pyruvate kinase deficiency

Pathological

Blood Loss

Inadequate Iron Absorption


Causes by Organ System

Cardiovascular No underlying causes
Chemical/Poisoning No underlying causes
Dental Gum bleeding
Dermatologic No underlying causes
Drug Side Effect Leflunomide, Pramipexole, trientine, antacids
Ear Nose Throat Epistaxis
Endocrine Erythropoetin deficiency
Environmental No underlying causes
Gastroenterologic Haemetemesis, Celiac disease, bariatric surgery, Gatsritis, esophageal varices, Tropical sprue, Whipple's disease, Small intestinal bacterial overgrowth syndrome, Giardia, Malabsorption
Blind loop syndrome
Fistula
Diverticula
Stricture

Cystic fibrosis,

Zollinger–Ellison syndrome
VIPoma
Carcinoid syndrome
Bile acid malabsorption
Crohn's disease
Ulcerative colitis
Genetic SLC11A2 mutation, IRIDA
Hematologic Myeloproliferative disorder
Iatrogenic Erythrpoetin administartion
Infectious Disease H.pylori, Giardia, Hookworms, Entamoeba histolytica
Musculoskeletal/Orthopedic No underlying causes
Neurologic No underlying causes
Nutritional/Metabolic No underlying causes
Obstetric/Gynecologic Mennorhagia, Fibroids, Post partum bleeding, Pregnancy, Endometriosis
Oncologic Colon cancer, esophageal cancer, gastric cancer, pancreatic cancer, lung cancer
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary Haemoptysis
Renal/Electrolyte Chronic kidney disease, haemodialysis
Rheumatology/Immunology/Allergy Anemia of chronic disease
Sexual No underlying causes
Trauma Bleeding
Urologic Haematuria
Miscellaneous Decreased iron intake, increased body requirements

Causes in alphabetical order

Center for disease control and prevention

References

  1. ↑ "Recommendations to Prevent and Control Iron Deficiency in the United States". Retrieved 2012-09-18.
  2. ↑ Price EA, Mehra R, Holmes TH, Schrier SL (2011). "Anemia in older persons: etiology and evaluation". Blood Cells Mol Dis. 46 (2): 159–65. doi:10.1016/j.bcmd.2010.11.004. PMID 21208814.
  3. ↑ Mast AE, Bialkowski W, Bryant BJ, Wright DJ, Birch R, Kiss JE; et al. (2016). "A randomized, blinded, placebo-controlled trial of education and iron supplementation for mitigation of iron deficiency in regular blood donors". Transfusion. 56 (6 Pt 2): 1588–97. doi:10.1111/trf.13469. PMC 4905782. PMID 26813849.
  4. ↑ Cook JD, Skikne BS (1989). "Iron deficiency: definition and diagnosis". J Intern Med. 226 (5): 349–55. PMID 2681511.
  5. ↑ Annibale B, Capurso G, Chistolini A, D'Ambra G, DiGiulio E, Monarca B; et al. (2001). "Gastrointestinal causes of refractory iron deficiency anemia in patients without gastrointestinal symptoms". Am J Med. 111 (6): 439–45. PMID 11690568.
  6. ↑ Lopez A, Cacoub P, Macdougall IC, Peyrin-Biroulet L (2016). "Iron deficiency anaemia". Lancet. 387 (10021): 907–16. doi:10.1016/S0140-6736(15)60865-0. PMID 26314490.
  7. ↑ Khadem G, Scott IA, Klein K (2012). "Evaluation of iron deficiency anaemia in tertiary hospital settings: room for improvement?". Intern Med J. 42 (6): 658–64. doi:10.1111/j.1445-5994.2012.02724.x. PMID 22288902.
  8. ↑ Ioannou GN, Rockey DC, Bryson CL, Weiss NS (2002). "Iron deficiency and gastrointestinal malignancy: a population-based cohort study". Am J Med. 113 (4): 276–80. PMID 12361812. Review in: ACP J Club. 2003 May-Jun;138(3):80
  9. ↑ Camaschella C (2015). "Iron deficiency: new insights into diagnosis and treatment". Hematology Am Soc Hematol Educ Program. 2015: 8–13. doi:10.1182/asheducation-2015.1.8. PMID 26637694.
  10. ↑ Corazza GR, Valentini RA, Andreani ML, D'Anchino M, Leva MT, Ginaldi L; et al. (1995). "Subclinical coeliac disease is a frequent cause of iron-deficiency anaemia". Scand J Gastroenterol. 30 (2): 153–6. PMID 7732338.
  11. ↑ Unsworth DJ, Lock RJ, Harvey RF (2000). "Improving the diagnosis of coeliac disease in anaemic women". Br J Haematol. 111 (3): 898–901. PMID 11122153.
  12. ↑ Hershko C, Hoffbrand AV, Keret D, Souroujon M, Maschler I, Monselise Y; et al. (2005). "Role of autoimmune gastritis, Helicobacter pylori and celiac disease in refractory or unexplained iron deficiency anemia". Haematologica. 90 (5): 585–95. PMID 15921373.
  13. ↑ Eschbach JW, Cook JD, Scribner BH, Finch CA (1977). "Iron balance in hemodialysis patients". Ann Intern Med. 87 (6): 710–3. PMID 931207.

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