Hematology and Oncology Q24

A 28-year-old woman is evaluated for decreased exercise tolerance and ice cravings for the past several weeks. Medical history is notable for Crohn colitis diagnosed 6 years ago. Her symptoms flared 3 months ago with increased abdominal pain and diarrhea, and she began therapy with azathioprine and infliximab. Her only other medication is ferrous sulfate tablets, 325 mg once daily, which she has been taking for 6 weeks after being diagnosed with iron deficiency anemia; her hemoglobin level at that time was 8.2 g/dL (82 g/L).

On physical examination, vital signs are normal. She is thin, with pale conjunctivae and nail beds. Cardiac examination reveals a grade 2/6 systolic flow murmur. The remainder of the examination is unremarkable.

Laboratory studies show a hemoglobin level of 7.5 g/dL (75 g/L) and a serum ferritin level of 1 ng/mL (1 µg/L).

Which of the following is the most appropriate treatment?


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