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BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7462.370 (Published 12 August 2004) Cite this as: BMJ 2004;329:370
  1. Harvey Marcovitch (h.marcovitch@btinternet.com), BMJ syndication editor

    Iron deficient patients are underinvestigated and diagnosis is delayed

    General practitioners investigated fewer than half the 603 patients presenting to them with iron deficiency anaemia, and a fifth were unwilling or unfit for further testing, a community based study has found. Of the 217 offered investigation within three months, 33 refused and 55 had a major disease, including 27 with gastrointestinal malignancy, 10 with active peptic ulcer and five with coeliac disease. After one year, 263 still had no diagnosis; of these, 40% were still anaemic. The eventual prevalence of malignancy was 11%, similar to that found in hospital studies, and diagnosis was delayed in a third of cases. Many of the patients had not been prescribed iron. The authors advise a full course of iron therapy and retesting for all, as recommended by the …

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