iron deficiency anaemia
TRANSCRIPT
Iron Deficiency Anaemia( Hypochromic Microcytic )
Presentation by
Laraib Ayesha
Iron Deficiency Anaemia• Most common cause of iron deficiency anaemia
• Iron Depletion Absent or decresed iron stores.
• Iron Deficiency Depletion of stores + low serum + ferritin
Iron Metabolism• Absorbtion in duodenum and upper jejnum• Transferrin transports iron to the cells• Ferritin and hemosiderin store iron.• 10% of daily iron is absorbed• Body iron is present in Hb• Reticuloendothelial system store iron released from
Hb as ferritin and hemosiderin.
• Total amount of body iron = 3-5g• Normal diet contain = 15 mg/day
Iron Metabolism• Normal Ranges• Iron conc =50-150ug/dl• Total iron binding capacity=250-370ug/dl• serum Transferrin=2-4g/l• Ferritin conc=50-300ug/l
• Daily iron requirements• Male: 1mg• Female: 2-3mg• Pregnant women:3-4mg
Causes of iron deficiency Anaemia• Chronic blood loss• Increased demand• Malabsorbtion of iron• Inadequate iron intake• Intravascular hemolysis
Hemoglobinuria-hemosiderinuria
Clinical Features• Fatigue• Angular somatitis• Plummer vinson syndrome• Gastric atrophy• Nail changes
(a) Brittle/fragility
(b) Koilonchia/spooning• Hair loss• splenomegaly
Lab Diagnosis• Hb,Htc,RBC:Low• MCV,MCH,MCHC:Low• RDW: High• Retics: Normal/Low• Plt:Normal/Low/High• WBC:Normal/Low• Smear:
Hypochromia,anisocytosis,microcytosis, poikilocytosis
Peripheral blood smear
Peripheral blood smear of a patient with severe iron deficient anaemia. Note the important microcytosis (compare red blood cells with lymphocyte) as well as hypochromia, target cells, and poikilocytosis
Lab Diagnosis• Serum Iron: (N: 60 – 180 μg/dL)• TIBC: (250 - 430 μg/dL)• Serum Ferritin • Transferrin saturation (Fe/TIBC): (<15%)
<5%:definitely indicates iron deficiency• Serum Transferrin Receptor: • Free Erythrocyte Protoporphyrin (17 – 27 μg/dL)
• Bone marrow : – Erythroid hyperplasia, – Absence of hemosiderin
Differential Diagnosis
• Microcytic anemias– Iron deficiency anemia– Thalassemia ,HbC,HbE etc– Sideroblastic anemia– Lead poisoning– Anemia of chronic diseases (sometimes)