Abstract
BACKGROUND: Iron deficiency anemia (IDA) affects approximately 2 billion individuals globally, yet optimal response to oral iron supplementation remains unpredictable. The oral iron absorption test (OIAT) represents a potentially valuable diagnostic tool for predicting therapeutic response and identifying underlying gastrointestinal malabsorption syndromes.
MATERIALS AND METHODS: This prospective study enrolled 190 IDA patients at a tertiary care center. After collecting baseline hematological parameters, participants underwent OIAT by receiving 60 mg of elemental iron, with serum iron levels measured at baseline and after 2 hours. Patients with abnormal OIAT results underwent additional investigations to identify underlying malabsorption syndromes.
RESULTS: Among the participants (mean age 32.34 ± 11.84 years, 90.5% female), 34.2% demonstrated abnormal OIAT results. Malabsorption was diagnosed in 19.5% of subjects, with Helicobacter pylori infection (54.1%), autoimmune gastritis (27.0%), and celiac disease (18.9%) as the predominant etiologies. OIAT showed excellent sensitivity (89.2%), good specificity (79.1%), and exceptional negative predictive value (97.6%) for identifying malabsorption syndromes.
CONCLUSIONS: OIAT demonstrates robust diagnostic performance for predicting response to oral iron therapy and identifying malabsorption syndromes in IDA. The high negative predictive value positions OIAT as an effective first-line screening tool, potentially reducing the need for invasive investigations in patients with normal test results.