Iron Deficiency Anemia

Pictures of iron deficiency anemia and disease information have been excerpted from the VisualDx® clinical decision support system as a public health service. Additional information, including symptoms, diagnostic pearls, differential diagnosis, best tests, and management pearls, is available in VisualDx.

Full Clinical Write-up


This anemia results from deficient levels of iron. The deficiency is caused by inadequate iron intake (especially during periods of rapid growth or pregnancy), blood loss (including menorrhagia and internal bleeding), or decreased iron absorption in the gastrointestinal (GI) tract. In early stages, hemolysis may present as an iron deficiency anemia.

Common findings include fatigue, dyspnea, weakness, pallor, and coarse skin and hair. Less common findings include pica (a craving to eat nonfood items, particularly ice or metal), brittle nails, tongue edema, and headache.

Within the general population, there are subsets at increased risk for iron deficiency anemia. These include children younger than 5 years, due to decreased GI absorption and increased metabolism; menstruating individuals; and pregnant individuals. Some chronic diseases result in an iron deficiency anemia. These include inflammatory bowel disease (IBD), in which excess loss but also impaired iron absorption can contribute to deficiency; chronic kidney disease; and congestive heart failure. Medications can cause changes in iron absorption and metabolism and lead to iron deficiency anemia

Iron deficiency anemia is easy to diagnose, but often subtle symptoms lead to delays in diagnosis. Once confirmed, many patients will improve within weeks with iron repletion and recognition with treatment of the underlying etiology.

Look For

Many cases of iron deficiency anemia are asymptomatic and detected via routine screening.

Observable visual findings: Pallor (skin and conjunctiva), dry skin, and brittle hair. Patients with severe deficiency can have painful tongue swelling and concave fingernails.

Physical examination: Cardiac systolic flow murmur and tachycardia may be present.

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