Iron-Deficiency Anaemia (IDA)

The most common cause of this in children is dietary insufficiency. Other less common causes include:

• Inadequate absorption e.g. Crohn’s or Coeliac

• Blood loss e.g. in menstruation

Iron Absorption

Iron is absorbed in the duodenum and jejunum, therefore, conditions like Coeliac and Crohn’s can have an effect.

Acid in the stomach helps with iron absorption as it keeps the iron in its soluble form (Fe2+). Therefore, PPIs can have an effect.

Ferritin

N.B. Most useful test for Iron – When low, it’s highly suggestive of iron deficiency.

Ferritin is the form that Iron takes when its being stored. It's main storage organ is the Liver. It's released when there's inflammation, which is why it's also known as an acute phase reactant.

A high ferritin is difficult to interpret alone as it could be due to inflammation rather than a true iron overload. A normal ferritin can mask IDA if there's also inflammation, which is why it's important to measure it in the absence of infection/illness.

Management

• Treat underlying cause, which is usually by dietary supplementation e.g. more red meat and nuts

• Ferrous sulphate 200mg