Iron Consultation
Date: 1 November 2024
Reason for Consultation
- Patient referred for evaluation of iron deficiency and consideration of intravenous iron infusion.
History of Presenting Illness
- Patient presents with fatigue, weakness, and shortness of breath for the past three months.
- Patient reports experiencing fatigue/weakness, shortness of breath, and pale skin.
Iron Related Medical History:
- Patient has a history of iron deficiency anemia diagnosed two years ago, treated with oral iron supplements.
- Patient reports heavy menstrual bleeding.
Past Medical History:
- Hypertension, well-controlled with medication.
Allergies: No known allergies.
Medications: Lisinopril 10mg daily, Ferrous Sulfate 325mg daily (discontinued).
Family History:
- Mother with a history of iron deficiency anemia.
Dietary and Lifestyle Factors:
- Patient reports a vegetarian diet.
Supplements:
- Patient previously taking Ferrous Sulfate 325mg daily, but discontinued due to side effects.
Social History
- Non-smoker.
- Drinks alcohol occasionally.
Physical examination:
- Patient appears well and in reasonably good health.
- Pale conjunctiva noted.
Initial Investigation results
- Labs: CBC: Hemoglobin 10.2 g/dL, Ferritin 10 ng/mL, Transferrin Saturation 8%, TIBC elevated.
Assessment:
- Iron deficiency anemia.
Goals for Management:
- Patient goals: To improve energy levels and resolve symptoms of iron deficiency.
Management Plan:
- Discussed the patient's iron status and the need for iron replacement.
- Patient will be started on an iron infusion.
Iron Infusion:
- Patient will receive an iron infusion of 1000mg of iron sucrose.
- Follow-up labs (CBC, ferritin, TSAT) in six weeks.
- Follow up with results.
- Will send the patient home with a repeat lab requisition including CBC, ferritin, and TSAT six weeks post-infusion and will follow up on the results.