Iron deficiency without anemia - a clinical challenge

Abstract

One should always consider iron deficiency (without anemia) as the cause of persisting, unexplained unspecific, often severe, symptoms, regardless of the primary underlying disease. The symptoms of iron deficiency may arise from the metabolic systems where many proteins are iron containing. Long-standing iron deficiency may be challenging to treat.

Keywords: Anemia; ferritin; hemoglobin; iron deficiency.

Figure 1

Hemoglobin, mean corpuscular volume (MCV) and ferritin of a patient, who received 1‐year oral iron and whose symptoms relapsed twice after discontinuation of oral iron at the same time when the ferritin concentration decreased to the <100 μg/L.

Figure 2

Hemoglobin, mean corpuscular volume (MCV) and ferritin of a patient who received oral iron for 1 year and thereafter intravenous iron three times after the first two infusions the patients' symptoms relapsed when her ferritin concentration decreased to the <100 μg/L.