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D50.9 - Iron Deficiency Anaemia: Causes & Treatment
D50.9 is the ICD-10 code for iron deficiency anaemia, unspecified. It occurs when the body lacks enough iron to produce sufficient red blood cells.
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D50.9 is the ICD-10 code for iron deficiency anaemia, unspecified. It occurs when the body lacks enough iron to produce sufficient red blood cells.
What is D50.9?
D50.9 is an ICD-10 diagnosis code that refers to iron deficiency anaemia, unspecified. Anaemia is defined as a reduction in the concentration of haemoglobin in the blood below the normal level. In iron deficiency anaemia, a lack of iron is the root cause, since iron is an essential component for the production of haemoglobin. The term “unspecified” indicates that the exact underlying cause of the iron deficiency has not been further identified.
Causes
Iron deficiency anaemia can arise from a variety of factors:
- Insufficient dietary iron intake: A diet low in iron, for example in individuals following a vegan or vegetarian diet without appropriate supplementation.
- Increased iron requirements: Pregnancy, breastfeeding, and growth phases in children and adolescents.
- Reduced iron absorption: Gastrointestinal conditions such as coeliac disease, Crohn's disease, or states following gastric surgery.
- Chronic blood loss: Heavy menstrual bleeding, gastric ulcers, intestinal polyps or tumours, or frequent blood donation.
- Medications: Long-term use of aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs), which can cause gastric bleeding.
Symptoms
The symptoms associated with D50.9 may develop gradually and vary in severity:
- Persistent fatigue and exhaustion
- Pale skin and mucous membranes
- Shortness of breath and palpitations, particularly during physical exertion
- Headaches and dizziness
- Brittle nails and hair loss
- Cracked corners of the mouth (angular cheilitis)
- Burning tongue or difficulty swallowing
- Difficulty concentrating and reduced performance
Diagnosis
The diagnosis of iron deficiency anaemia is typically established through blood tests. The following laboratory values are measured:
- Haemoglobin (Hb): The primary marker for detecting anaemia.
- Serum ferritin: Reflects the body's iron stores; a low value is an early indicator of iron deficiency.
- Serum iron and transferrin saturation: Provide information on current iron transport in the blood.
- Full blood count (MCV, MCH): In iron deficiency, red blood cells are often smaller (microcytic) and paler (hypochromic) than normal.
To identify the underlying cause, further investigations may be required, such as gastroscopy or colonoscopy.
Treatment
Treatment depends on the underlying cause and the severity of the anaemia:
Iron Supplementation
The most common therapeutic measure is targeted iron replacement:
- Oral iron preparations: Iron tablets or capsules (e.g. ferrous sulphate, ferrous fumarate) are typically taken over several weeks to months to replenish the body's iron stores.
- Intravenous iron administration: In severe cases, intolerance to oral preparations, or significantly impaired intestinal absorption, iron can be administered directly into a vein.
Dietary Adjustments
An iron-rich diet can support treatment. Good dietary sources of iron include red meat, legumes, dark leafy vegetables, and whole grain products. Taking vitamin C alongside iron-rich foods improves iron absorption.
Treatment of the Underlying Condition
If a specific cause is identified (e.g. a source of bleeding or an intestinal disorder), this must also be addressed to prevent recurrence.
References
- World Health Organization (WHO): Nutritional anaemias: tools for effective prevention and control. Geneva, 2017. Available at: https://www.who.int/publications/i/item/9789241513067
- Kasper DL et al.: Harrison's Principles of Internal Medicine, 20th edition. McGraw-Hill Education, 2018.
- National Institute for Health and Care Excellence (NICE): Iron deficiency anaemia. Clinical Knowledge Summary. Available at: https://cks.nice.org.uk/topics/anaemia-iron-deficiency/
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