In response to the recent article “Investigating microcytic anaemia”1, could I suggest that a management approach should be influenced by local factors?
There is a high prevalence of iron deficiency anaemia in Aboriginal children in the Northern Territory of Australia. We do not see thalassaemia trait in this population.
Regarding investigations, serum ferritin, serum iron and total iron binding capacity are not useful in our patients with mild to moderate anaemia, as they often have chronic infections: misleading results are commonly found due to the increased inflammatory load.
Regarding treatment, a tendency to extremely poor adherence to oral iron treatment in our population has led to the widespread use of iron by intramuscular injection2.
References
1. Uprichard WO., Uprichard J. Investigating iron deficiency anaemia. BMJ 2013;347:34-36
2. CARPA Standard Treatment Manual: a clinic manual for primary health care practitioners in remote and rural communities in Central and Northern Australia. 5th Edition, 2009
Rapid Response:
Re: Investigating microcytic anaemia
In response to the recent article “Investigating microcytic anaemia”1, could I suggest that a management approach should be influenced by local factors?
There is a high prevalence of iron deficiency anaemia in Aboriginal children in the Northern Territory of Australia. We do not see thalassaemia trait in this population.
Regarding investigations, serum ferritin, serum iron and total iron binding capacity are not useful in our patients with mild to moderate anaemia, as they often have chronic infections: misleading results are commonly found due to the increased inflammatory load.
Regarding treatment, a tendency to extremely poor adherence to oral iron treatment in our population has led to the widespread use of iron by intramuscular injection2.
References
1. Uprichard WO., Uprichard J. Investigating iron deficiency anaemia. BMJ 2013;347:34-36
2. CARPA Standard Treatment Manual: a clinic manual for primary health care practitioners in remote and rural communities in Central and Northern Australia. 5th Edition, 2009
Competing interests: No competing interests