Iron deficiency anemia

•Develops when body stores of iron drop too low to support normal red blood cell (RBC) production

Causes

•Dietary factors (vegan diet, malnutrition)

•Increased needs:

•Adolescence (growth)

•Pregnancy

•Lactation

•Hemorrhage

•Malabsorbtion

Causes of iron-deficiency anemia

•Bleeding

–GIT: gastric and duodenal ulcers, hemorrhoids, tumors, ulcerative colitis, diaphragmatic hernia, drugs (NSAIDs, blood thinners corticosteroids)

–Uterine: menorrhagia, metrorrhagia, tumors, endometriosis

–Pulmonary: cancer, bronchiectases, hemosiderosis

•Increased requirement: children and adolescents, pregnancy, lactation

•Impaired metabolism: chronic infections, malabsorbtion, gastric or intestinal resection, helminthosis

•Dietary factors: vegetarianism

Syndromes in IDA

•Circulatory-hypoxic

•Anemic

•Sideropenic

Stages of iron deficiency

•Prelatent (masked) iron deficiency: no clinical signs, most of the lab tests are normal

•Latent iron deficiency: lack of iron in the tissues and storage. Signs of sideropenic syndrome

•Iron-deficiency anemia: hypoxic and sideropenic syndromes

Symptoms of iron deficiency

•Fatigue and diminished capability to perform hard labor

•Leg cramps on climbing stairs

•Craving ice (in some cases, cold celery or other cold vegetables) to suck or chew

•Poor scholastic performance

•Cold intolerance

•Reduced resistance to infection

•Altered behavior (eg, attention deficit disorder)

•Dysphagia with solid foods (from esophageal webbing)

•Worsened symptoms of comorbid cardiac or pulmonary disease

Clinical presentation of IDA

•Impaired growth in infants

•Pallor of the mucous membranes (a nonspecific finding)

•Spoon-shaped nails (koilonychia)

•A glossy tongue, with atrophy of the lingual papillae

•Fissures at the corners of the mouth (angular stomatitis)

•Splenomegaly (in severe, persistent, untreated cases)

Diagnostics of IDA

•Low Hb, RBC

•Hypochromic microcytic anemia

•Anisocytosis, poikilocytosis

•Decreased ferritin – main marker of iron deficit in the storage

•Decreased iron, transferrin saturation, high iron binding capacity

•Decreased iron-containing normoblasts in the bone marrow <20%

Iron metabolism parameters and CBC changes in iron deficiency