Iron deficiency anemia

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Iron deficiency anemia

• Jiang shayi

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iron
transferrin
bloodstream
Ferritin hemosiderin
myoglobin
coenzyme
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diet
Red blood cells 63
Muscle 3.5
Coenzyme 0.4
Blood stream 0.4
Storage pool 38
cells
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iron protoporphyrin
hemoglobin
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pathogenesis
Hypochromic anemia
protoporphyrin
ferritin
Abnormality of CBC
Free erythrocyte protoporphyi ?
Serum ferrtin ?
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cause

• Blood loss (polyp intestinal, meckel
  devirticulum, hookworm disease)
• A lack of iron in diet
• An inability to absorb iron
• Less iron storage

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Clinical l manifestation

• Pale skin color
• Fatigue, irritability, dizziness, weakness,
• shortness of breath in severe patient
• Poor appetite, especially in infants and children
  with iron deficiency anemia

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Clinical manifestation

• pica
• persistent eating of non-food items for a
  period of at least one month. Including dirt,
  clay, soap, chalk, burnt matches

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Clinical manifestation

• koilonychia
• Lost convexity
• Flat or concave

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Laboratory examination

• Serum iron (SI)
• Serum iron binding capacity
• Serum ferritin (SF)
• Biopsy of bone marrow
• Complete blood count (CBC)

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Complete blood count

• Mean corpuscular volume (MCV)
• Mean corpuscular hemoglobin(MCH)
• Mean corpuscular hemoglobin concentration(MCHC)

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A normal peripheral blood smear indicates the
appropriate appearance of red blood cells, with a
normal zone of central pallor .
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Iron deficiency anemia
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the MCV of the red blood cells is decreased, the
zone of central pallor is increased
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(No Transcript)
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Biopsy of bone marrowiron stain
Reduced iron stores
Normal iron stores
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Diagnosis

• Patient history
• Clinical manifestation
• Complete blood count and iron metabolism tests
• Clinical trial of iron supplementation

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Diagnosis

• Determination of etiology
• Primary disease, such gastrointestinal
  malformation

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Differential diagnosis

• Thalassemia
• Pulmonary hemosiderosis
• Sideroblastic anemia

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Thalassemia

• Family history
• Unusuall facies
• Splenomegaly, hepatomegaly
• Target cell
• HbF, HbA or HbH, Hb Barts elevate

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thalassemia
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Pulmonary hemosiderosis

• moderate to severe hypochromic anemia
• recurrent pulmonary hemorrhage of unknown cause
• cough, coughing up blood (hemoptysis)
• lung tissue changes.

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Sideroblastic anemia

• Hypochromic anemia
• Iron test are normal or increased
• Bone marrow ringed sideroblast

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Sideroblastic anemia
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Therapy

• Diet
• Eating iron fortified food
• Breast and cows milk are low in iron
• Iron is better absorbed from breast milk than
  cows milk
• Formula milks (???)are fortified with iron

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Therapy

• Supplement therapy
• Ferrous sulfate
• Dextran-iron
• elemental iron 3-6mg/kg/d
• Therapy should be continued for 3 months

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Therapy

• Treating for primary disease

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Summary
metabolism
mechanism
cause
tests
manifastation
diagnosis
therapy
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