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Blood Transfus. 2017 Sep;15(5):422-437. doi: 10.2450/2017.0113-17.

Current misconceptions in diagnosis and management of iron deficiency.

Author information

Perioperative Transfusion Medicine, Department of Surgical Sciences, Biochemistry and Immunology, School of Medicine, University of Málaga, Málaga, Spain.
Department of Internal Medicine, University Hospital "Virgen de la Victoria", Málaga, Spain.
Department of Haematology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom.
Department of Pharmacology, School of Medicine, University of Málaga, Málaga, Spain.
Department of Gastroenterology, University Hospital "Lozano Blesa", IIS Aragón, CIBERehd, Zaragoza, Spain.
Italian National Blood Centre, National Institute of Health, Rome, Italy.
Metabolic Research Unit, Hull and East Yorkshire Hospitals NHS Trust; Hull York Medical School, Kingston upon Hull, United Kingdom.
Biomedical Research Institute, University Hospital Mar-Esperança, Barcelona, Spain.
Department of Anesthesiology, Critical Care Medicine, Pain Management and Hyperbaric Medicine, TeamHealth Research Institute, Englewood Hospital and Medical Centre, Englewood, NJ, United States of America.
Georgetown University School of Medicine, Washington, DC, United States of America.


The prevention and treatment of iron deficiency is a major public health goal. Challenges in the treatment of iron deficiency include finding and addressing the underlying cause and the selection of an iron replacement product which meets the needs of the patient. However, there are a number of non-evidence-based misconceptions regarding the diagnosis and management of iron deficiency, with or without anaemia, as well as inconsistency of terminology and lack of clear guidance on clinical pathways. In particular, the pathogenesis of iron deficiency is still frequently not addressed and iron not replaced, with indiscriminate red cell transfusion used as a default therapy. In our experience, this imprudent practice continues to be endorsed by non-evidence-based misconceptions. The intent of the authors is to provide a consensus that effectively challenges these misconceptions, and to highlight evidence-based alternatives for appropriate management (referred to as key points). We believe that this approach to the management of iron deficiency may be beneficial for both patients and healthcare systems. We stress that this paper solely presents the Authors' independent opinions. No pharmaceutical company funded or influenced the conception, development or writing of the manuscript.

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