Iron deficiency anaemia in a young woman: a plea for early investigation
Following a tragic case of late diagnosis of colorectal cancer, a father calls for an overhaul of current guidelines for the investigation of iron deficiency anaemia in premenopausal women
At 22 years of age, she was lacking in energy and generally feeling unwell. She presented early to her local medical clinic where she was found to have severe iron deficiency anaemia (IDA) (haemoglobin, 61 g/L). Supplemental iron tablets were prescribed over a period of 6 months, with some improvement, although her iron reserves remained depleted. She was referred to a gastroenterologist, who examined her and performed a gastroscopy to test for coeliac disease. Nothing untoward was discovered; a colonoscopy was not performed, and she was returned to her general practitioner for continuation of iron supplementation. Eleven months later (at 24 years of age), she felt a lump in her lower abdomen and was referred to a gastrointestinal surgeon for investigation. He performed a colonoscopy and colectomy, which revealed a caecal cancer that had spread to her lymph glands and liver.