A 65-year-old woman with a history of joint pain and under treatment with anti-inflammatory drugs is referred for anemia. In the complementary studies she presented red blood cells 3,164,000, Hto. 32%, Hb 11g/dl, MCV 69 fl, Leukocytes 7800, Platelets 370,000, CRP 0.29 mg/dl, Fe 20ng/ml, Ferritin 18 ng/ml, Glucose 105 mg/dl, GOT, GPT, GGT, Alkaline F, total Bilirubin, Cholesterol, Creatinine, Calcium and Phosphorus normal. Negative antitransglutaminase and antigliadin antibodies. Gastroscopy: hiatus hernia of 3 cm, the rest without alterations. Colonoscopy: up to cecum, isolated diverticula in sigma. Intestinal transit without alterations. Ultrasound of the abdomen without alterations. Which of the following examinations do you consider most appropriate to complete the study?
It is a study of iron deficiency anemia with normal gastroscopy and colonoscopy, having ruled out possible celiac disease. We have yet to see jejunum and ileum, so we will have to perform a capsule endoscopy. In iron deficiency anemia, a digestive cause must always be ruled out.
Jejunum biopsy.
Arteriography.
Endoscopic capsule.
Radioisotopes.
Pelvic MRI.
It is a study of iron deficiency anemia with normal gastroscopy and colonoscopy, having ruled out possible celiac disease. We have yet to see jejunum and ileum, so we will have to perform a capsule endoscopy.