In patients with pulmonary arteriovenous malformation, iron deficiency is a clinically significant comorbidity. Microcytic and/or hypochromic red cell indices point to iron deficiency even when standard markers appear normal — and in hypoxaemic patients, iron supplementation may be indicated regardless of haemoglobin level.
Iron deficiency is identified by microcytic and/or hypochromic red cell indices — findings that indicate iron deficiency not excluded by a normal serum ferritin. In hypoxaemic patients with pulmonary AVM, iron supplementation may be required even when haemoglobin is within the normal range.
When iron deficiency is confirmed, iron replacement is recommended. Oral iron supplementation is the preferred approach, with a specific choice of preparation favoured over higher-dose alternatives; intravenous iron is an established option in certain cases. The full protocol specifies which preparation to use and when.
DOI: 10.1136/thoraxjnl-2017-211217