TY - JOUR T1 - New concepts in iron deficiency anaemia JF - British Journal of General Practice JO - Br J Gen Pract SP - 10 LP - 11 DO - 10.3399/bjgp17X688465 VL - 67 IS - 654 AU - Satish Keshav AU - Richard Stevens Y1 - 2017/01/01 UR - http://bjgp.org/content/67/654/10.abstract N2 - Iron deficiency continues to be a major health issue worldwide — and iron deficiency anaemia is associated with well-documented adverse health outcomes.1 Many studies have shown that iron deficiency is associated with a longer length of stay in hospital,2 cognitive dysfunction,3 increased risk of falls,4 and reduced life expectancy.5 Paradoxically, iron is one of the most abundant minerals on earth and is plentiful in all but the most restricted diets.The discovery of a new peptide hormone, hepcidin, in 2001, which is made in the liver, is one key advance in this area. The discovery provides a critical insight into how iron deficiency arises in patients with inflammatory disease, despite an adequate intake of iron and no overt loss from bleeding. And, although previously parenteral iron therapy was hazardous and inefficient, modern formulations of intravenous iron overcome the perils of anaphylactic and anaphylactoid reactions6 caused by the dextran component used previously. Now, complete body iron replenishment can be administered feasibly in an ambulant day-case unit. With the advent of such powerful pharmaceutical tools, we have also begun to understand the more subtle aspects of iron deficiency, such as the remarkable effects of even sub-clinical iron deficiency, prior to the onset of anaemia, on cardiac and respiratory function.7–8It has long been recognised that anaemia arises in many chronic diseases, including chronic renal failure and inflammatory diseases such as rheumatoid arthritis, … ER -