Persistent iron deficiency

Persistent iron deficiency — referral criteria for Gastroenterology services.

Full SRC reference

Eligibility

At least one must be met for the patient to be eligible for referral.

Clinically suspected or confirmed persistent iron deficiency with initial primary-care work-up completed

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Shortness of breath or chest pain, syncope or pre-syncope with iron deficiency (ferritin below the lower limit of normal)

Routine referral criteria

Determine Category 2 or 3 urgency.

Persistent iron deficiency in men and post-menopausal women with either — ferritin less than 30 micrograms per litre

Persistent iron deficiency in men and post-menopausal women with either — ferritin 30-100 micrograms per litre in the presence of inflammation (e.g. C-reactive protein (CRP) greater than or equal to 5 milligrams per litre)

Iron deficiency that persists despite correction of potential causative factors

Iron deficiency in pre-menopausal women — with positive coeliac serology

Iron deficiency in pre-menopausal women — with positive faecal occult blood test

Iron deficiency in pre-menopausal women — that persists despite treatment of menorrhagia, with good cycle control

Usually managed in primary care

Iron deficiency in pre-menopausal women with — no positive coeliac serology
Iron deficiency in pre-menopausal women with — negative faecal occult blood test
Iron deficiency in pre-menopausal women with — managed menorrhagia and with good cycle control
Isolated low serum iron
Non-iron deficiency anaemia without evidence of blood loss
Vegetarian diet without iron supplementation