Patient
Referral letter: 36-year-old female referred for persistent iron-deficiency anemia
Address
Dear Gastroenterology Colleague,
Reason for Referral
I would appreciate your assessment of persistent iron-deficiency anemia despite three months of oral iron therapy.
Clinical Context
Ms. R. reports fatigue but no weight loss, abdominal pain, change in bowel habit, or visible gastrointestinal bleeding. Menstrual bleeding is moderate and unchanged. She has no family history of colorectal cancer. Examination today was unremarkable, including a soft, non-tender abdomen.
Investigations to Date
Hemoglobin 98 g/L, MCV 76 fL, ferritin 7 µg/L, and transferrin saturation 9%. Coeliac serology is negative. Repeat hemoglobin after three months of ferrous fumarate increased from 91 to 98 g/L. Renal and liver function are normal.
Requested Action
Please assess for an occult gastrointestinal source and advise on further investigation and iron replacement. I have attached the recent blood results and medication list. Please contact me if additional information is required.
Sign-off
Thank you for seeing her.
Yours sincerely,
Dr. Elena Rossi
General Practice