Iron-Deficiency Anemia

Iron-Deficiency Anemia

“What is iron-deficiency anemia and its causes?”

Iron deficiency anemia is caused by a deficiency of iron in the body. 20% of the world’s population is suffering from iron deficiency anemia.

Iron deficiency anemia Pathogenesis

It develops when the supply of iron is insufficient for the requirement of hemoglobin synthesis. Three major factors in the pathogenesis of iron deficiency anemia are:

• Increased Physiologic Demand, i.e., growing children, pregnancy, lactation, and menstruating females.
• Pathological Blood Loss, i.e., hemorrhage from GIT and urinary tract.
• Inadequate Intake, i.e., nutritional deficiency or impaired malabsorption.

Iron-deficiency anemia

“Role of iron supplements in treating anemia”

Iron Deficiency anemia Etiology

• Due to increased blood loss
  • Uterine, For Example. Excessive menstruation in reproductive years, repeated miscarriages at the onset of menarche, postmenopausal uterine bleeding
  • Gastrointestinal, For Example. Peptic ulcer, hemorrhoids, hookworm infestation, cancer of the stomach and large bowel, esophageal varices, hiatus hernia, chronic aspirin ingestion, ulcerative colitis, diverticulosis
  • Renal tract, For Example. hematuria, hemoglobinuria
  • Nose, For Example. repeated epistaxis
  • Lungs, For Example. hemoptysis

“Understanding iron-deficiency anemia: Symptoms and treatment”

• Due to increased requirements
  • Spurts of growth in infancy, childhood, and adolescence
  • Prematurity
  • Pregnancy and lactation
• Due to inadequate dietary intake
  • Poor economic status
  • Anorexia, For Example. in pregnancy
  • Elderly individuals due to poor dentition, apathy, and financial constraints
• Due to decreased absorption
  • Partial or total gastrectomy
  • Achlorhydria
  • Intestinal malabsorption, such as in coeliac disease.

“Importance of early diagnosis of iron-deficiency anemia”

Iron deficiency anemia Clinical Features

• Anemia: Lassitude, weakness, fatigue, dyspnea, palpitations, angina, congestive cardiac failure, and pallor.
• Epithelial tissue changes
  • Nails: Thin, lustreless, brittle, show ridging and flattening; the presence of koilonychia.
  • Tongue: Atrophy of papillae, shiny or glazed tongue, glossitis, and angular stomatitis.
  • Plummer-Vinson syndrome: It is characterized by chronic iron deficiency, dysphagia, and glossitis.
• Pica: It is defined as a craving to eat substances like dirt, clay, salt, and hair and is a typical manifestation of iron deficiency.
• Recurrent infections: Iron deficiency leads to defective lymphocyte-mediated immunity and impaired bacterial killing by phagocytes, leading to impaired immunity and recurrent infections.

Iron-deficiency anemia treatment

“Common causes of iron-deficiency anemia explained”

Iron Deficiency Anemia Laboratory Diagnosis

• General blood parameters
  • Hemoglobin is decreased
  • RBC count is decreased
  • RBC indices, i.e., MCV, MCH, and MCHC, are reduced or low

“Techniques for managing symptoms of iron-deficiency anemia”

“Impact of blood loss on iron-deficiency anemia”

Iron Deficiency Anemia Diagnosis And Treatment Question

Peripheral blood smear

It shows the following features, i.e.

• Microcytic hypochromic cells, i.e., red cells, are smaller than normal and have increased central pallor.
• Anisocytosis or variation in size of the cell. This is indicated by increased red cell distribution width and is more marked in iron deficiency anemia.
• Poikilocytosis or variation in the shape of the cell, i.e., the presence of a tailed variety of RBC, elliptical form, is common.
• In severe anemia, there is the presence of normoblasts, elliptocytes, pencil-shaped cells, and target cells.
• There is the presence of normal, increased, or decreased platelet count and unremarkable WBCs.

“How does menstruation contribute to iron deficiency?”

Reticulocyte count: It is normal or decreased.

Bone marrow

• There is the presence of erythroid hyperplasia, due to which marrow cellularity is increased.
• In the bone marrow, the prominent cell is polychromatic normoblast, which is smaller than normal.
• Cytoplasm shows ragged borders
• Cytoplasmic maturation lags behind that of the nucleus
• Prussian blue stain shows a decrease in iron stores

“Biomechanics of iron absorption in the body”

Iron studies

• There is a decrease in the serum iron
• Total iron binding capacity is high and rises to give less than 10% saturation.
• Serum ferritin is very low, which is indicative of poor tissue iron stores
• Red cell protoporphyrin is very low
• Serum transferrin receptor protein, which is normally present in developing erythroid cells and reflects total red cell mass, is raised in iron deficiency due to its release in circulation.

“Treatment options for managing iron-deficiency anemia”

Iron Deficiency Anemia Causes

• Inadequate intake of iron
• Malabsorption of iron due to hypochlorhydria and diarrhea
• Increased requirement of iron in a growing child and pregnancy
• Increased loss of iron due to injury, recurrent epistaxis, and peptic ulcer
• Chronic blood loss, such as menstrual and menopausal bleeding, and parturition
• Subtotal or complete gastrotomy.