In a 23-year-old male with mild chest discomfort, fatigue, reduced exercise tolerance, normal hemoglobin and hematocrit, borderline low mean corpuscular volume, low mean corpuscular hemoglobin, normal red cell distribution width, normal reticulocyte count, low serum iron, low‑borderline transferrin saturation, normal‑to‑high ferritin, low C‑reactive protein, and normal echocardiogram, celiac serology, thyroid function tests, colonoscopy, and Helicobacter pylori testing, what is the most likely diagnosis and what work‑up and management should be pursued?

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Most Likely Diagnosis: Iron-Refractory Iron Deficiency Anemia (IRIDA)

The most likely diagnosis in this 23-year-old male is iron-refractory iron deficiency anemia (IRIDA), a genetic disorder caused by TMPRSS6 mutations that presents with remarkably low transferrin saturation, low-to-normal ferritin, microcytic hypochromic indices, and failure to respond to oral iron supplementation. 1

Rationale for IRIDA as Primary Diagnosis

Key Diagnostic Features Present

  • Remarkably low transferrin saturation (described as "low-borderline") combined with normal-to-high ferritin is the pathognomonic laboratory pattern of IRIDA, distinguishing it from typical iron deficiency anemia where both parameters are low. 1

  • Microcytic hypochromic indices (borderline low MCV, low MCH) with normal hemoglobin/hematocrit represent the early phase of IRIDA, where iron-restricted erythropoiesis causes red cell changes before overt anemia develops. 1

  • Low serum iron despite normal-to-high ferritin indicates functional iron deficiency—iron is sequestered in stores but unavailable for erythropoiesis due to elevated hepcidin from TMPRSS6 deficiency. 1, 2

  • Normal reticulocyte count confirms inadequate marrow response consistent with iron-restricted erythropoiesis rather than hemolysis or bleeding. 1

  • Low C-reactive protein excludes anemia of chronic disease, which requires elevated inflammatory markers and typically shows ferritin >100 µg/L with transferrin saturation <20%. 3, 2

Extensive Negative Workup Supports Genetic Etiology

  • Normal colonoscopy and negative H. pylori testing exclude gastrointestinal blood loss and malabsorption from atrophic gastritis. 1

  • Negative celiac serology rules out the most common malabsorption disorder causing iron deficiency (present in 2-3% of iron deficiency cases). 1

  • Normal thyroid function and normal echocardiogram eliminate secondary causes of fatigue and exercise intolerance. 1

  • The constellation of symptoms (chest discomfort, fatigue, reduced exercise tolerance) in a young male with iron-restricted erythropoiesis but extensive negative evaluation strongly points toward an inherited disorder. 1

Recommended Workup

Confirm IRIDA Diagnosis

  • Order genetic testing for TMPRSS6 mutations to definitively diagnose IRIDA, as this is the only genetic disorder that presents with low transferrin saturation and low-to-normal ferritin. 1

  • Measure soluble transferrin receptor (sTfR) if available—it will be elevated in IRIDA because tissue iron deficiency is present despite normal ferritin, and sTfR is not affected by inflammation. 3, 2

  • Calculate the ratio of serum iron to total iron-binding capacity to precisely quantify transferrin saturation; values <16% strongly confirm iron deficiency even with normal ferritin. 3, 1

Exclude Remaining Differential Diagnoses

  • Obtain hemoglobin electrophoresis to definitively rule out β-thalassemia trait, which can present with microcytosis and normal RDW (≤14%) but would show normal iron studies. 1

  • Check vitamin B12 and folate levels to exclude combined deficiencies, which can be suggested by elevated RDW despite normal values in this case. 1, 2

  • Consider bone marrow examination only if genetic testing is negative and the diagnosis remains unclear, as marrow iron staining can differentiate true iron deficiency from sideroblastic anemia. 1

Assess for Autoimmune Gastritis

  • Measure anti-parietal cell antibodies and anti-intrinsic factor antibodies to screen for autoimmune atrophic gastritis, which can cause oral iron refractoriness and must be excluded before attributing treatment failure to IRIDA. 1

  • Obtain serum gastrin level—elevated gastrin suggests atrophic gastritis even when H. pylori testing is negative. 1

Management Strategy

Initial Therapeutic Trial

  • Initiate oral ferrous sulfate 200 mg three times daily for 4 weeks as a diagnostic and therapeutic trial, even though IRIDA is suspected, because response patterns help confirm the diagnosis. 1

  • Recheck hemoglobin after 4 weeks—expect an increase of at least 2 g/dL if iron deficiency is responsive; failure to improve confirms iron refractoriness characteristic of IRIDA. 1

  • Monitor for gastrointestinal side effects and consider alternative oral formulations (ferrous gluconate or ferrous fumarate) if intolerance occurs, though this is less likely to improve absorption in IRIDA. 1

Definitive Treatment for IRIDA

  • Switch to intravenous iron (iron sucrose or ferric carboxymaltose) if oral iron fails to raise hemoglobin by ≥2 g/dL within 4 weeks, as IRIDA patients are refractory to oral iron but may respond partially to IV iron. 1

  • Administer IV iron in divided doses—a typical regimen is 500 mg initially, followed by 500 mg four weeks later, with monitoring of hemoglobin and ferritin. 2

  • Set realistic treatment goals—complete normalization of hemoglobin and ferritin is rarely achieved in IRIDA; aim for hemoglobin >11 g/dL and ferritin 50-100 µg/L to relieve symptoms. 1

  • Monitor ferritin closely during IV iron therapy—do not exceed 500 µg/L to avoid iron overload, especially in young patients requiring long-term treatment. 1

Long-Term Management

  • Repeat IV iron infusions every 3-6 months based on hemoglobin and ferritin trends, as IRIDA requires lifelong intermittent IV iron supplementation. 1

  • Avoid pyridoxine (vitamin B6) supplementation—this is effective only for X-linked sideroblastic anemia (ALAS2 defects), not IRIDA. 1

  • Do not pursue hematopoietic stem cell transplantation—this is reserved for severe congenital sideroblastic anemias (SLC25A38 defects) and is not indicated for IRIDA. 1

Critical Pitfalls to Avoid

  • Do not attribute normal-to-high ferritin to adequate iron stores—in IRIDA, ferritin is falsely reassuring because hepcidin elevation prevents iron mobilization from stores, creating functional iron deficiency. 1, 2

  • Do not delay genetic testing while pursuing additional GI investigations—the extensive negative workup (colonoscopy, celiac serology, H. pylori) already excludes common acquired causes, and further endoscopy is low-yield. 1

  • Do not assume treatment failure with oral iron indicates non-compliance—IRIDA is defined by oral iron refractoriness due to impaired duodenal iron absorption from elevated hepcidin. 1

  • Do not overlook the diagnosis in young males—IRIDA is autosomal recessive and affects both sexes equally, though it is often under-recognized in males because iron deficiency is typically attributed to menstrual blood loss in women. 1

  • Do not continue oral iron indefinitely without reassessment—if hemoglobin fails to rise after 4 weeks of adequate oral iron, switch to IV iron rather than prolonging ineffective therapy. 1

References

Guideline

Management of Microcytic Hypochromic Anemia

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Evaluation and Management of Anemia When Serum Ferritin Is ≥ 30 µg/L

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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