In developed countries the physician is only allowed to even consider treatment of iron deficiency if its cause is diagnosed, or proper further evaluation is initiated. Treatment of iron deficiency anaemia is rather simple and inexpensive in most subjects and entails oral treatment with ferrous salts. Despite lower absorption of iron, there is renewed interest in therapeutic use of ferric maltose, suggesting that a large influx of Fe(II) from therapeutic doses may cause oxidative damage (Fodor and Marx, 1988; Geisser, 1998). Although treatment failure mostly results from an inadequate dose, persistent blood loss which exceeds iron absorption and poor compliance, failure may also be the result of malabsorption. The cause may be bowel inflammation in the duodenal region, coeliac disease or a genetic defect of one of the proteins involved in intestinal iron absorption. In these patients, parenteral treatment is needed with iron-sucrose or iron-dextran complexes (the latter is not available now in many countries because of severe side effects). If the iron transport defect is (also) localized in the erythron, any form of iron therapy will remain ineffective.
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