Practice guidelines for the diagnosis and management of microcytic anemias due to genetic disorders of iron metabolism or heme synthesis

Blood. 2014 Jun 19;123(25):3873-86; quiz 4005. doi: 10.1182/blood-2014-01-548776. Epub 2014 Mar 24.

Abstract

During recent years, our understanding of the pathogenesis of inherited microcytic anemias has gained from the identification of several genes and proteins involved in systemic and cellular iron metabolism and heme syntheses. Numerous case reports illustrate that the implementation of these novel molecular discoveries in clinical practice has increased our understanding of the presentation, diagnosis, and management of these diseases. Integration of these insights into daily clinical practice will reduce delays in establishing a proper diagnosis, invasive and/or costly diagnostic tests, and unnecessary or even detrimental treatments. To assist the clinician, we developed evidence-based multidisciplinary guidelines on the management of rare microcytic anemias due to genetic disorders of iron metabolism and heme synthesis. These genetic disorders may present at all ages, and therefore these guidelines are relevant for pediatricians as well as clinicians who treat adults. This article summarizes these clinical practice guidelines and includes background on pathogenesis, conclusions, and recommendations and a diagnostic flowchart to facilitate using these guidelines in the clinical setting.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anemia, Hypochromic / diagnosis*
  • Anemia, Hypochromic / genetics
  • Anemia, Hypochromic / therapy*
  • Anemia, Iron-Deficiency / diagnosis
  • Anemia, Iron-Deficiency / genetics
  • Anemia, Iron-Deficiency / therapy
  • Anemia, Sideroblastic / diagnosis
  • Anemia, Sideroblastic / genetics
  • Anemia, Sideroblastic / therapy
  • Evidence-Based Medicine
  • Genetic Predisposition to Disease / genetics
  • Heme / biosynthesis*
  • Humans
  • Iron / metabolism*
  • Mutation
  • Practice Guidelines as Topic*

Substances

  • Heme
  • Iron

Supplementary concepts

  • Anemia, hypochromic microcytic
  • Iron-Refractory Iron Deficiency Anemia