Lord Kudolo 607. Bibliography Robbins & Cotran Pathologic Basis of Disease, 8e. Kumar, Abbas,...

Ir n Deficiency Anemia

Lord Kudolo607

Contents

• Introduction• Etiology• Clinical Features• Diagnosis• Risk Factors• Complications• Prevention • Management• Clinical Case

What is Iron Deficiency Anemia?Iron deficiency anemia is a common type of anemia — a condition in which blood lacks

adequate healthy red blood cells. This condition is due to insufficient iron in the

body.

It is the most common nutritional disorder in the world and mostly prevails in toddlers,

adolescent girls and women of childbearing age.

Etiology1. Dietary Lack

a) Infantsb) Elderly c) Junk Foodd) Less Privileged

2. Impaired Absorptiona) Sprueb) Chronic Diarrhea c) Inflammatory Bowel Diseased) Gastrectomy

Etiology3. Increased Requirement

a) Growing Infantsb) Childrenc) Adolescentsd) Premenopausal Women

4. Chronic Blood Loss *e) IDA in adults must always be attributed to GI blood

loss unless proven otherwise

Clinical Features• Pallor• Fatigue• Weakness• Koilonychia• Alopecia• Atrophic changes in the tongue and gastric mucosa • Intestinal malabsorption• Pica (depletion of iron in CNS)

Most Signs and Symptoms relate to the underlying cause.

DiagnosisLaboratory Studies.• Endoscopy, Colonoscopy, Ultrasound.• Moderately depressed hemoglobin (14-17gm/dL)

and hematocrit (35%-50%) due to hypochromia, microcytosis and modest poikilocytosis

• Serum Iron (65 – 177 μg/dL) and Ferritin levels (Male 20-250 μg/L) are low

• Total Plasma Iron Binding Capacity (250–370 μg/dL) is High reflecting elevated transferrin levels.

Risk Factors

• Women• Infants and Children• Vegetarians • Frequent Blood Donors

Complications

• Heart Problems• Problems During Pregnancy–Premature Births & Low Birth weights

• Growth Problems–Leads to delayed growth

developments

Prevention• Eat Food rich in Iron– Animal food such as meat*, fish and poultry.– Beans– Iron fortified Cereals, bread and pasta– Peas

• Choose food containing Vitamin C to enhance Iron Absorption. – Broccoli– Grapefruit – Kiwi– Oranges, etc.

• Adequate milk for infants.

Management• Iron Supplements– Better if taking with Ascorbic Acid

• Teat Underlying cause – Medications to lighten heavy menstrual flow– Antibiotics and other medications to treat peptic ulcers– Surgery to remove a bleeding polyp, a tumor or a

fibroid

Blood transfusion or iron given intravenously in severe cases

Clinical CaseA 16-year-old girl was referred by her pediatrician for evaluation of persistent microcytic anemia. Two years

previously, she presented to her local hospital complaining of fatigue and weakness. At that point, her hemoglobin level

was 46 g/L, with a low mean corpuscular volume and decreased iron and ferritin levels. Her TIBC level was at 575 μg/dL. She had no evidence of gastrointestinal bleeding and was otherwise healthy. Furthermore, she reported a regular

menstruation cycle without increase in blood loss. She received a blood transfusion and was started on iron

supplements, to which she had a good response as her hemoglobin level rose up to 129 g/L. Her clinical symptoms also resolved and iron supplementation was discontinued

one year later.

Bibliography

• Robbins & Cotran Pathologic Basis of Disease, 8e. Kumar, Abbas, Fausto, Aster.

• http://www.microscopyu.com/staticgallery/pathology/irondeficiencyanemia40x02.html

• http://www.medicinenet.com/hemoglobin/page2.htm#normal

• http://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/basics/complications/con-20019327