From the Guidelines
Koilonchyia, also known as spoon nails, is primarily associated with iron deficiency anemia. This condition is characterized by thin, brittle nails that develop a concave shape, resembling a spoon. According to the British Society of Gastroenterology guidelines for the management of iron deficiency anaemia in adults 1, iron deficiency can cause various symptoms, including koilonychia. The guidelines highlight that iron deficiency anaemia can lead to specific symptoms such as angular stomatitis, glossitis, koilonychia, restless legs syndrome, pagophagia, and blue sclerae.
Some key points to consider about koilonchyia include:
- Iron deficiency is the most common cause of koilonchyia
- Other conditions, such as hemochromatosis, Raynaud's disease, lupus, protein deficiency, and certain occupational exposures, can also be associated with koilonchyia
- Treatment typically focuses on addressing the underlying cause, particularly iron supplementation for iron deficiency anemia
- Oral iron supplements, such as ferrous sulfate, ferrous gluconate, or ferrous fumarate, are commonly prescribed to restore iron levels 1.
The nail appearance typically improves gradually as the underlying condition is treated, and the spoon-shaped appearance occurs because iron deficiency affects keratin production, which is essential for proper nail formation, leading to the characteristic thinning and concavity of the nail plate.
From the Research
Koilonchyia (Spoon Nails) Association
- Koilonchyia, also known as spoon nails, is a nail abnormality characterized by thin, brittle, and spoon-shaped nails 2.
- It is frequently observed in chronic iron deficiency secondary to malnutrition, chronic blood loss, or malabsorption 2.
- The presence of koilonychia should prompt investigations for iron deficiency 2.
- Koilonychia is commonly associated with iron deficiency anemia 3.
Related Conditions
- Iron deficiency anemia (IDA) is a common extra-intestinal manifestation of celiac disease (CD) 4, 5.
- IDA can be caused by malabsorption of iron in patients with CD, and its prevalence can range from 12 to 82% in patients with new CD diagnosis 4.
- Iron replacement treatment is often necessary to manage IDA in patients with CD, and oral products containing ferrous sulphate are commonly used, although their absorption can be limited in patients with active CD 4.