IRON DEFICIENCY ANAEMIA

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IRON DEFICIENCY ANAEMIA
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Physiological functions

• transport and storage of oxygen
• formation and maturation of red blood cells
• cellular respiration
• ( cytochromes and respiratory enzymes )
• oxidation in nerve cells

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Daily requirement

• Infants 10-15 mg
• Children
• 1-3 yrs 15 mg
• 4-10 yrs 10 mg
• Older children and adults (Males)
• 11-18 yrs 18 mg
• After 19 yrs 10 mg
• Females
• 11-50 yrs 15-18 mg
• During pregnancy or lactation 20 mg
• After 51 yrs 12-15 mg

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Factors affecting iron absorption

• Increase
• Gastric acidity
• Proteins of low molecular weight
• Alcohol
• Chlorophyll and bile pigments
• Vitamin C and Calcium
• Heme found in meat more readily absorbed than
  inorganic iron

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Factors affecting iron absorption

• Decrease
• Intestinal malfunction
• Phosphates
• Phytic acid and oxalates
• Copper deficiency
• Tannates in tea

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Storage

• 1. Ferritin
• apoferritin ferric hydroxide ferritin
• Iron content 17 to 33
• Water soluble
• Readily available form
• Cannot be visualised by microscopy

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Storage

• 2. Haemosiderin
• If iron supply in excess hemosiderin
• 50 iron by weight
• Golden brown granules,
• Stains blue with Perls or Prussian blue
  reaction
• Derived from ferritin

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Excretion

• Urine 0.5-1.5 mg
• Faeces 0.3-0.75 mg
• Bile and sweat 0.5-1 mg
• Menstrual flow 1-3 mg
• Faeces - unabsorbed food iron
• Pregnancy - iron to the foetus
• Sweat, hair loss, nail clippings

• Iron content regulation of the body
• By absorption only, not by excretion

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Laboratory testing for iron

• Serum iron - ( 70 201 µg / dl )
• Serum iron binding capacity
• TIBC ( 253 435 µg / dl )
• Serum ferritin - 20 250 ng / ml
• Complete blood count (CBC)
• Bone marrow biopsy
• Liver biopsy

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Iron deficiency Anaemia

• CAUSES
• Dietary lack
• Impaired absorption
• Increased requirement
• Chronic blood loss
• Uterine abnormalities
• GI bleeding

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Symptoms

• Fatigue, dyspnea on exertion, palpitations,
  pallor, headache, dizziness, apathy, impaired
  attention, irritability, lowered memory
• Symptomatology of acute anaemia is mainly caused
  by fall in blood volume and not by reduced
  haemoglobin level
• Epithelial changes such in nails, tongue, mouth,
  hair, GIT
• Plummer-vinson syndrome

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Severe Pallor
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Koilonychia
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Angular cheilosis
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Bald , fissured tongue
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Post-cricoid web, Plummer-Vinson syndrome
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Multiple retinal hemorrhages
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P.S. Microcytic, hypochromic red cells
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80 100 fl.
27 34 pgms.
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Perls stain - Normal marrow -Prussian blue
reaction
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Absence of stainable Iron in bone marrow
aspirate
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Lack of stainable Iron
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