Albertine Donker

Chapter 8 292 which endoscopic evaluation of the gastrointestinal tract is not necessary to exclude malignancy as possible cause of IDA, as is mainly the case when it concerns children, TMPRSS6- related IRIDA should be considered when a ratio ≤5.9%/nM has been found before performing invasive gastrocolonoscopy as this procedure carries a higher risk in children than in adults (1.1 % versus 0.3%), predominantly related to the use of general anesthesia and sedation. 44 Further studies are required to i) assess the performance of the TSAT/hepcidin ratio in IDA controls with comorbid inflammatory conditions and patients who received recent iron therapy (<3 months) and in IDA patients < 18 years and ii) evaluate the value of the TSAT/hepcidin ratio as screening tool for detecting TMPRSS6- related IRIDA from multi-causal IDA in a prospective cohort study. Acknowledgments We thank the gastro-enterologists, gynecologists and emergency room physicians of the Máxima MC for their assistance in including IDA control patients. Author Contributions AED, DLB, and DWS designed the research. HS, AED, and DLB coordinated the data collection. JS, LM and MB coordinated the inclusion of the subjects at the Department of Gastro-Enterology, the Emergency Room Department and the Department of Gynecology of the Máxima Medical Center respectively. SM and CML performed the hepcidin analyses. AED, HS, JPD, DLB and DWS analyzed the data and interpreted the results. HS and AED wrote the manuscript. Conflicts of Interest SMK, CML and DWS are employees of Radboudumc, which offers hepcidin assays and hepcidin reference material to the research, clinical, and pharmaceutical community at a fee for service via the Hepcidinanalysis initiative (www.hepcidinanalysis.com ). 33 All other authors have no conflict of interest to declare. Data Sharing Statement For original data, please contact DorineW. Swinkels (dorine. swinkels@radboudumc.nl) .