Classification of anemiaCauses of anemia-Blood loss.-Iron deficiency.-Infection.-RBC destruction (hemolysis)e.g. G6PD.-B12...
Iron deficiency anemiaNormal iron metabolism:-The primary function is oxygen transport.-Iron is absorbed by duodenum and j...
Iron + HemIron Metabolism
Iron Absorption1-2 mg onlyPlasma FeTransferrin carriers4 mgBody stores1000 mg (M)300-500 mg (F)Myglobin300 mg20 mg FeRetur...
Dietary iron:Iron is present in food as ferric hydroxides (ferric-proteincomplexes and hem-protein complexes).-meat, liver...
Clinical features:• When ID is developing, the RE stores (hemosiderin andferritin) become completely depleted before anemi...
Causes:• Chronic blood lossFetomaternal Hemorrhage, inheritedbleeding disorders menstrual peroid.• Maternal iron deficienc...
Laboratory findings:•Red cell indices:Low Hb conc.MCV, MCH, MCHC* ↓•Blood film:Hypochromic microcytic Picture.Occasional T...
Hypochromic Microcytic picture (IDA)-ve BM Iron Stain +ve
Reticulocytes
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Ida

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Ida

  1. 1. Classification of anemiaCauses of anemia-Blood loss.-Iron deficiency.-Infection.-RBC destruction (hemolysis)e.g. G6PD.-B12 and Folate deficiency.Red cells size and their indices-Hb concentration and Hematocrit-MCV, MCH, MCHC.↓MCV-IDA-Thal↑MCV-B12-FolatNormal MCV-hemolyticanemia
  2. 2. Iron deficiency anemiaNormal iron metabolism:-The primary function is oxygen transport.-Iron is absorbed by duodenum and jejunim-Average total body iron content 3500-4000 mg.-Approximately 2/3 found in hemoglobin,-Iron is also stored in RE cells (BM, Spleen and liver)as hemosiderin and ferratin.-Also iron found in myglobin and myeloperoxidaseand in certain electron transfer.-Iron is more stable in ferric state (Fe+++) than inferrous state (Fe++).
  3. 3. Iron + HemIron Metabolism
  4. 4. Iron Absorption1-2 mg onlyPlasma FeTransferrin carriers4 mgBody stores1000 mg (M)300-500 mg (F)Myglobin300 mg20 mg FeReturned to immature RBCin BMRBC2500 mgR.E. 20 mgReleased dailyVia RE system90% extra vascular5-10% intra vascularLoss (from GI tract)1-2 mg dailyDaily Fe++turnover continuous process
  5. 5. Dietary iron:Iron is present in food as ferric hydroxides (ferric-proteincomplexes and hem-protein complexes).-meat, liver-vegetables, eggs.-The average diet contains 10-15mg and only 5-10% is normallyabsorbed.Iron requirements:It varies depending on sex and age:Male/female 0.5-1 mg/dayPregnant female 1-2 mg/dayChildren 0.5 mg/day
  6. 6. Clinical features:• When ID is developing, the RE stores (hemosiderin andferritin) become completely depleted before anemia occurs.• At an early stage, no clinical abnormalities.• Later, patient may develops general symptoms and signs ofanemia.• In severe case of IDA ridged or spoon nails.
  7. 7. Causes:• Chronic blood lossFetomaternal Hemorrhage, inheritedbleeding disorders menstrual peroid.• Maternal iron deficiency (neonate).• Growth spurts (infants and children).• Gastrointestinal,peptic ulcer, aspirin ingestion, carcinoma,hookworm, colitis, piles etc.• Pregnancy• Rarely hematouria,self-inflicted blood loss, hemoglobinuria.• Insufficient daily iron intake (poor diet).• Malabsorption.
  8. 8. Laboratory findings:•Red cell indices:Low Hb conc.MCV, MCH, MCHC* ↓•Blood film:Hypochromic microcytic Picture.Occasional Target cells.Pencil shaped poikilocytes.Normal reticulocyte count.•Bone marrow iron:Normal to hypercellular.RBC precursors are increased in number.Iron stain negative.•Chemical testing on serum:Serum iron DecreasedTransferrin/TIBC Normal to HighSerum ferritin Decreased (Very low)
  9. 9. Hypochromic Microcytic picture (IDA)-ve BM Iron Stain +ve
  10. 10. Reticulocytes
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