Длительная терапия железом у пациентов с риском редидива ЖД из-за мальабсорбции или потерь - варианты лечения/мониторинг анализами крови и др.
CHRONIC IRON NEED
There are many populations who will require ongoing iron supplementation beyond initial iron repletion as a maintenance iron therapy. Such populations include those with inflammatory bowel disease and malabsorption (e.g., bariatric surgery) or ongoing GI blood loss (e.g., abnormal uterine bleeding refractory to or awaiting gynecologic intervention).
Current guidelines recommend routinely rechecking complete blood count, reticulocytes, reticulated-Hb content, and iron parameters 3–6 months after initial iron repletion to determine whether ongoing iron supplementation is required and to establish the optimal route, dose, and frequency. For some patients (e.g., women with HBM), asymptomatic outpatients with mild ID/IDA in whom there is no inflammation and in whom oral iron is well tolerated, we are successful in maintaining normal iron stores and Hb levels using once-per-day or every-other-day oral iron. In other patients, a regimen of once per month, once every 3 months, or once every 6 months IV of iron is required, with the goal of maintaining normal iron status (ferritin >30 mg/L; TSAT >20%)
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из Iron deficiency anemia in women: pathophysiological, diagnosis, and practical management.
Cançado RD.
Rev Assoc Med Bras (1992). 2023 Aug 4;69(suppl 1):e2023S112.
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