Chronic Severe Iron Deficiency Anemia in Hospitalized Indian Patients: Laboratory Profile and Treatment Outcomes

Introduction: Iron deficiency anemia is a common finding which adds to the morbidity and mortality burden in hospitalized patients. This study was done to evaluate the laboratory parameters and different treatment options for chronic severe iron deficiency anemia. Methods: A cross-sectional study was done on patients with chronic, untreated, severe anemia with hemoglobin (Hb) less than 8g% and a hypochromic microcytic peripheral smear. Blood indices, reticulocyte count, iron studies and bone marrow examination were done.All patients were treated either with oral or parenteral iron and the outcome was evaluated a day before discharge and 28 days post-treatment by repeating the hemogram and a six-minute walk test. Results: 148 anemic patients were initially enrolled. 73 patients were excluded as their peripheral smear did not show hypochromic, microcytic picture. The remaining 75 were included. Average Hb on admission was 6.9 ± 1.74g/dL. Average serum ferritin levels of 17.0 ± 3.50 ng/ml. Depleted bone marrow iron stores were found in 69.45% cases. Rise in hemoglobin and improvement in functional capacity of patients at 28 days post treatment with parenteral iron was statistically significantly higher than that after oral iron therapy. Conclusion: Serum ferritin and bone marrow iron stores were sensitive indicators of IDA. Hemoglobin and functional capacityof patients treated with parenteral iron improved rapidly compared to oral iron.