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Iron deficiency anemia
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Iron deficiency anemia

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  • 1. IRON DEFICIENCY ANEMIA (IDA)
  • 2. IRON 4 % of Earth’s Crust 4 ±1 gm total Body Iron in Adult Human Hb 2± 0.5 gm Storage (Fe+++) 1 ± 0.5 gm Ferritin Haemosiderin Essential iron: Myoglobin & Iron-Containing Enz. (e.g.cytochromes, catalases) Plasma 4 ± 1 mg
  • 3. Variable ~ 450.000 Molecular weight 37 20 % of iron in the structure Variable ~4500 iron atoms /molecule of apof. Binding Visible in macrophage & normoblasts Not visible In Perls’ - reaction (Prussian blue-reaction) under light microscope Derived from partial lysosomal digestion of aggregates of ferritin molecules Apoferritin ( outer prtn.coat ) & iron-phosphate- hydroxide core structure Insoluble Water-soluble Solubility Haemosiderin Ferritin Protein-iron complex
  • 4. Daily Iron Cycle
  • 5. Enterocytes &Iron absorption
  • 6. HEPCIDIN
    • A polypeptide produced by the liver
    • The major hormonal regulator of
    • iron homeostasis
    • It inhibits iron release from macrophages, intestinal epithelial cells & from placental syncytiotrophoblasts
    • by accelerating degradation of ferroportin mRNA
    • Iron deficiency , hypoxia & ineffective erythropoiesis
    • inhibits hepcidin production
    • iron release from pre-mentioned cells
    • As acute phase protein,
    • hepcidin production is induced by inflammation via IL-6
  • 7.  
  • 8.  
  • 9. Ancylostoma
  • 10. Sequence of Events in IDA
  • 11. SEQUENCE OF EVENTS IN IDA I Hb 15 g/dL RCC 5 million/ µL MCH 30 pg Hct. 45 % MCHC 33 g/dL MCV 86 fL Serum Iron UIBC 20 µmol/L 40 µmol/L TIBC= 60 µmol/L Saturation 33% p.ferritin N. 15-300 µg/L WBC 7,500/µL Platelet 400,000/µL
  • 12. SEQUENCE OF EVENTS IN IDA II BLEEDING 40 ml/ Day 20 mg IRON Iron Absorption up to 5 mg/Day Net Daily Loss= 20-5 = 15 mg 1500 ------ = 100 Days 15 Latent Iron Deficiency No Clinical Features Normal Blood Values If Iron Stores= 1500 mg
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  • 18. 1/3 of ACD are microcytic hypochromic Causes of microcytic hypochromic anemias The 1 st step in the evaluation of microcytic anemia is to rule out IDA, HOW ?
  • 19.  
  • 20.