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Gregory et al recently discussed (Gut 2007;56:1319) the importance of appropriately investigating iron deficiency anaemia (IDA) in accordance with updated British Society of Gastroenterology (BSG) guidelines published in May 2005.1 As part of an audit they found that 41% of their patients with a microcytic anaemia had ferritin levels measured. Those with a low ferritin level had subsequent gastro-intestinal investigations. We feel it is important to clarify that whilst serum ferritin has an important role in the evaluation of patients with anaemia, it should be remembered that it may be elevated as part of an acute phase response or in malignancy and hence is not always an accurate marker of iron deficiency in patients with a microcytic anaemia. Iron studies …
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