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Iron Deficiency Anemia
Transcript of Iron Deficiency Anemia
"Mind Mapping" Method
Iron transport & storage by 3 proteins :
2- Transferrin receptor.
Body iron distribution & transport
Body iron distribution & transport.
Iron required each day to compensate for losses from body & growth
;it is highest in pregnancy ,adolescent and menstruating females .
cause of anemia.?
Body has limited ability to absorb iron
Excess loss of iron
(hemorrhage is frequent)
Most important cause of
microcytic hypo chromic anemia .
defect in Hb synthesis .
Transferrin & Transferrin receptor
Transferrin delivers iron to tissues with transferrin
(erythroblasts) in BM which incorporate iron into Hb.
RBC broken down in
and iron released form Hb enters plasma and provides most of iron on transferrin .
Small plasma transferrin iron comes from dietary iron ,absorbed through duodenum & jejunum .
Ferritin & haemosiderin (store)
Some iron stored in RES cells as ferritin & haemosiderin , amount varying.
water –soluble protein, contains
of its weight as iron and
water – insoluble protein, varying composition containing
iron by weight,
in MQ & other cells by light microscopy after staining by perls`
(Prussian blue )
Iron in food as
. Both iron content Proportion of iron absorbed differ from food to food ;
meat & liver
is better source than vegetables ,egg or dairy foods.
of iron from which only
is normally absorbed . Proportion
but, even in these situations ,most dietary iron remains
Factors Increase Absorption
Heam iron .
Ferrous (fe ++) .
Acids ( Hcl ,vitamin c ) .
Solubilizing agents (e.g. sugars, amino acids ) .
Iron deficiency .
Hereditary haemochromatosis .
Factors Decrease Absorption
inorganic iron .
Ferric (fe +++) .
Alkalis –antacids, pancreatic secretion .
Precipitation agents – phytates ,phosphates .
Iron excess .
Causes of iron deficiency
Chronic blood loss:
Uterine , gastrointestinal ,e.g. peptic ulcer ,, Oesophageal varices , aspirin (or other non steroid anti –inflammatory drugs) partial gastrectomy ,carcinoma of stomach ,caecum, colon or rectum ,colitis ,etc.
Prematurity , growth , pregnancy , erythropoietin therapy.
Poor diet .
symptoms & signs of anemia and show painless glossitis , angular stomatitis brittle, ridged or spoon nails (
), dysphagia as a result of pharyngeal webs (paterson – kelly or plummer - vinson syndrom) unusual dietary cravings
IDA cause irritability , poor cognitive function and decline in psychomotor deveopment .
1. Red blood cell
If IDA associated
anemia 'dimorphic ' film (dual population of RBC “macrocytic + microcytic” and “hypo chromic; indices may be normal .
IDA patients received recent
population of new wel- filled normal- size RBC
Earliest change of IDA is
& red cell distribution width (
Mild ovalocytosis ,target cells .
Elongated hypo chromic elliptocytes (
Progressive hypochromia ( MCH) & microcytosis ( MCV), MCHC variable .
Reticulocytes: normal or .
RBC count ,Hb level, Hct: proportionately .
(300 - 4400/Ml ) is found in small number of patients.
Differential count is normal .
: 33 %
N: 33 %
: 33 %
: 33 %
: not essential to assess iron stores except in complicated cases.
4. Bone marrow iron
TIBC: TIBC < 10% saturated .
This contrasts both with anemia of
when serum iron & TIBC are both reduced and with other hypo chromic anemia's where serum iron is normal or even raised .
5. Serum iron & TIBC
6. Serum transferrin receptor (sTfR)
receptor is shed from cells into plasma .
in anemia of
if erythropoiesis is
7. Serum ferritin
10 - 20
May be with
inflammatory diseases (e.g. rheumatoid arthritis) ,gaucher disease , chronic renal disease , malignancy ,hepatitis , or iron administration .
in rheumatoid arthritis if ferritin level is
mg /liter .
8. Free Erythrocyte protoporphyrin
Usually in IDA .
for diagnosis of IDA & suitable for large –scale
of children, detecting both IDA & lead poisoning .
Lab diagnosis of hypochromic Anemia
MCV & MCH
BM iron stores
a severity of anemia
Thalassaemia trait ( or )
MCV : congenital but in acquired
Thank you ...