Physician's Assistant

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Refined clinic supervision (15 weeks ago 14:57)

Refined clinic supervision Mon 22 December 2025 14:57

Last Modified: 15 weeks ago

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Pamela Noon, 74, 1116510.
Follow up
Main issue was persistent iron deficiency with recent development of microcytosis.

This 74-year-old lady was recently admitted with giant cell arteritis and is currently on high-dose steroids. She has had persistent iron deficiency for some time but has recently developed microcytosis with Hb 120. FIT and TTG are negative. She denies weight loss and has no GI symptoms apart from long-standing IBS. She is fit for upper and lower GI investigations. Previous iron supplementation has been poorly tolerated due to worsening of her IBS symptoms. The clinical challenge here is determining whether this represents iron deficiency anaemia requiring investigation versus iron deficiency without anaemia in the context of her inflammatory state. Given her giant cell arteritis, she may also have anaemia of chronic disease contributing to her presentation, making this a complex diagnostic scenario.

Plan was blood test today to reassess. If she develops anaemia, proceed with investigations for iron deficiency anaemia. If not anaemic, consider the iron deficiency secondary to her chronic inflammatory condition and avoid further investigation.

Point to discuss in supervision: Management approach for iron deficiency without anaemia in the context of chronic inflammatory disease.

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Refined clinic supervision (104 days ago 06:38)

Refined clinic supervision Tue 23 December 2025 06:38

Last Modified: 104 days ago