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Swiss Med Wkly. 2019 Jul 3;149:w20097. doi: 10.4414/smw.2019.20097. eCollection 2019 Jul 1.

Swiss Delphi study on iron deficiency.

Author information

1
Department of Endocrinology and Clinical Nutrition, University Hospital Zurich, Switzerland / Department of Internal Medicine, Psychiatry University Hospital Zurich, Switzerland.
2
Department of Haematology and Central Haematology Laboratory, Bern University Hospital, Inselspital, University of Bern, Switzerland.
3
Clinics of Medical Oncology, HFR Fribourg Cantonal Hospital, Switzerland.
4
Clinic for Transplantation Immunology and Nephrology, University Hospital Basel, Switzerland.
5
Division of Primary Care Medicine, Department of Primary Care Medicine, Geneva University Hospitals, Switzerland.
6
Department of Gastroenterology, Clinic for Visceral Surgery and Medicine, Bern University Hospital, Switzerland.
7
Centre for Laboratory Medicine, and Haemostasis and Haemophilia Centre, St Gallen, Switzerland.
8
Institute of Primary Care, University and University Hospital Zurich, Switzerland.
9
Division of Cardiology, University Hospital Basel, Switzerland.
10
Department of Obstetrics and Gynaecology, Bern University Hospital, University of Bern, Switzerland.
11
Department and Outpatient Clinic for Internal Medicine, University Hospital Zurich, Switzerland.
12
Horten Centre for Patient Oriented Research and Knowledge Transfer, University Hospital Zurich, Switzerland.

Abstract

AIMS OF THE STUDY:

Iron deficiency (ID) and iron deficiency anaemia (IDA) are important conditions affecting a large proportion of the general population, causing the patients physical and psychosomatic symptoms, particularly fatigue, and significantly affecting their quality of life. General practitioners (GPs) are frequently consulted with nonspecific symptoms due to the ID. However, little evidence is available to guide iron treatment. The aim of the Swiss Delphi study was to generate a broad consensual Swiss expert opinion in various therapeutic areas on diagnosis and treatment of ID/IDA and their practical implications.

METHODS:

Specific statements regarding clinical relevance, practical diagnostic and therapeutic approaches, and treatment were evaluated by Swiss experts in various therapeutic areas using the Delphi method. “Consensus” was defined as ≥80% agreement; the agreement of 50–79% was defined as “critical”, of <50% as “disagreement”.

RESULTS:

Consensus was reached for most statements. In patients without systemic inflammation, the threshold of 30 μg/l provide a good accuracy for the diagnosis of ID without anaemia. Ferritin levels within the range 30–50 μg/l with TSAT <20% can indicate ID without anaemia. Iron replacement therapy is accepted for treatment, not only of IDA, but also of symptomatic ID without anaemia. GPs play a central role in diagnosis and management of ID.

CONCLUSIONS:

This consensus study provides potential therapeutic strategies for management of iron deficiency and is based on opinions of a high number of contributing specialists, providing their views from a wide range of clinical perspectives. &nbsp.

PMID:
31269223
DOI:
10.4414/smw.2019.20097
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