An iron insufficiency in the bone marrow can be detected very early by a rise in free erythrocyte protoporphyrin.Further testing may be necessary to differentiate iron-deficiency anemia from other disorders, such as thalassemia minor. It is very important not to treat people with thalassemia with an iron supplement, as this can lead to hemochromatosis. A hemoglobin electrophoresis provides useful evidence for distinguishing these two conditions, along with iron studies. Screening
It is unclear if screening pregnant women for iron-deficiency anemia during pregnancy improves outcomes in the United States. The same holds true for screening children who are 6 to 24 months old. Even so, screening is a Level B recommendation suggested by the US Preventative Services Task Force in pregnant women without symptoms and in infants considered high risk. Screening is done with either a hemoglobin or hematocrit lab test. Treatment
Treatment should take into account the cause and severity of the condition. If the iron-deficiency anemia is a result of blood loss or another underlying cause, treatment is geared toward addressing the underlying cause. Most cases of iron deficiency anemia are treated with oral iron supplements. In severe acute cases, treatment measures are taken for immediate management in the interim, such as blood transfusions or intravenous iron.For less severe cases, treatment of iron-deficiency anemia includes dietary changes to incorporate iron-rich foods into regular oral intake and oral iron supplementation. Foods rich in ascorbic acid (vitamin C) can also be beneficial, since ascorbic acid enhances iron absorption. Oral iron supplements are available in multiple forms.
Bacillary angiomatosis (BA) is a form of angiomatosis associated with bacteria of the genus Bartonella. Symptoms
Cutaneous BA is characterised by the presence of lesions on or under the skin. Appearing in numbers from one to hundreds, these lesions may take several forms:
papules or nodules which are red, globular and non-blanching, with a vascular appearance
purplish nodules sufficiently similar to Kaposis sarcoma that a biopsy may be required to verify which of the two it is
a purplish lichenoid plaque
a subcutaneous nodule which may have ulceration, similar to a bacterial abscessWhile cutaneous BA is the most common form, it can also affect several other parts of the body, such as the brain, bone, bone marrow, lymph nodes, gastrointestinal tract, respiratory tract, spleen, and liver. Symptoms vary depending on which parts of the body are affected; for example, those whose livers are affected may have an enlarged liver and fever, while those with osseous BA  experience intense pain in the affected area. Presentation
BA is characterised by the proliferation of blood vessels, resulting in them forming tumour-like masses in the skin and other organs. Causes
It is caused by either Bartonella henselae or B. quintana. B.  henselae is most often transmitted through a cat scratch or bite, though ticks and fleas may also act as vectors. B. quintana is usually transmitted by lice.It can manifest in people with AIDS and rarely appears in those who are immunocompetent. Diagnosis
Diagnosis is based on a combination of clinical features and biopsy. Neutrophilic infiltrate.