Anemia

Paul K. Schick, MD

Professor of Medicine, Emeritus, Thomas Jefferson Medical College, Philadelphia
Research Professor, Drexel University College of Medicine, Philadelphia
Adjunct Clinical Professor, Lankenau Hospital (LIMR), Wynnewood, PA

This case was reviewed and updated in September 2012 by Dr. Peter Marks and members of the Teaching Cases Subcommittee.

Copyright of the American Society of Hematology, 2006. ISSN: 1931-6860.

VI. PROGNOSIS/CLINICAL COURSE

The prognosis for iron deficiency is excellent if it is treated correctly and the underlying source of bleeding can be managed. The patient is scheduled for GYN surgery to remove the fibroid that has caused her excessive menstrual bleeding.

Which of the following is appropriate for the initial management of the patient?

Transfusions
Trial course of oral iron for 4 to 6 weeks
Oral iron 320 mg three times daily until her hemoglobin is normal and then for an additional 6 months to replete iron stores
If Hgb is restored to normal levels, discontinue oral iron therapy
Parenteral iron sufficient to restore the Hgb level and replenish iron stores
Aggressive identification and management of the source of bleeding

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