Iron dificiency is the most common cause of anemia worldwide. The goal of therapy for iron deficiency anemia (IDA) is to supply sufficient iron to repair the hemoglobin deficit and replenish storage iron, combined with correction of underlying
conditions. The majority of patients with IDA respond well to oral or parenteral iron replacement therapy if appropriately prescribed, but some rare cases of IDA refractory to both oral and parenteral iron replacement therapy due to in-born error
of
iron metabolism have been reported previously. We report here a mysterious case of IDA refractory to both oral and parenteral iron therapy and even to red cell transfusions. A 21-year-old male patient was admitted to our hospital due to general
weakness
and dizziness. His hemogram, iron profiles and bone marrow study showed the findings compatible with IDA. We could not find any conditions that cause acute or chronic blood loss, or any evidence of in-born error of iron metabolism. In spite of
adequate
iron relplacement therapy via both oral and parenteral routes, and even with red cell transfusions, his hemogram and iron profiles were not improved.

Keywords: Iron deficiency anemia, Refractory,