General

Case study 08092016 - Iron deficiency anaemia

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8 Sep 2016 - General
 

A 61 years old gentleman, with background history of previous ischaemic heart disease, hypertension, hypercholesteroleamia, increased body mass index, smoker, on medications - aspirin, atorvastatin, ramipril, was initially referred by his general practitioner (GP), for endoscopy procedure, both gastroscopy and colonosocpy, due to new onset of iron deficieny anaemia, for the last 6 month. Patient has no specific upper or lower gastrointestinal symptoms. Both the gastroscopy and colonoscopy were normal (with the normal 2nd part of duodenum, terminal ileum ,and colonic biopsy) , no cause of his iron deficiency anaemia was identiifed. What will you do next ??? What will be your management plan ??

The Haemoglobin (Hb) was 8.5, with low MCV, and low ferritin level of 10, and low serum iron. With normal gastroscopy and colonoscopy, we are can rule out any blood loss from upper and lower gastrointestinal tract pathology. CT-Abdomen should done next if patient has persistent iron deficiency anaemia, to rule out other intra-abdominal pathology that can contribute to blood loss, like renal cell carcinoma (patients will usually have haematuria or possible just with microscopic haematuria that wo...
 (Total 113 words)