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BMJ 2004; 329 doi: (Published 12 August 2004) Cite this as: BMJ 2004;329:370
  1. Harvey Marcovitch (, 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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