2. INTRODUCTION
Anemia is a major killer in India.
Statistics reveal that every second Indian
woman is anemic
One in every five maternal deaths is directly
due to anemia.
Anemia affects both adults and children of
both sexes, although pregnant women and
adolescent girls are most susceptible and
most affected by this disease.
3. ANAEMIA
■Definition:
■Anemia is defined as a
decreased O2 carrying
capacity due to quantitative
and qualitative Reduction in
RBC counts and Hemoglobin
levels.
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4. ANAEMIA
■ ANAEMIA is labelled
when Hb is less than
■ 13gm/dl in Males
■ 11 gm/dl in Females
■ 15gm/dl in Newborn.
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9. DUE TO DECREASED RBC
PRODUCTION.
IRON DEFICIENCY
ANAEMIA.
■ Most common in India.
■ In women of
reproductive age group
(20-45 yrs)
■ In periods of active
growth of infancy,
childhood & adolescence
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10. IRON METABOLISM
■ Total body contains 4-5
gms
■ Forms –
■ Haemoglobin 70%
■ Storage iron 20-23% 2/3rd
Ferritin & 1/3rd
Haemosiderin.
■ Myoglobin in red muscles
5%
■ Intracellular enzymes 2-3%
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11. DAILY REQUIREMENTS &
SOURCES
■ 5-10 mg/day in Males
■ 20 mg/day in
Females.
■ 40 mg/day in
Pregnant & lactating
women.
■ Meat, liver, egg, green
leafy veg, Jaggery &
whole wheat.
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13. IRON
ABSORPTION
■
■
■ Mainly in duodenum &
upper jejunum.
MECHANISM
Transport across brush
borders
■
■
Haeme iron
Non-haeme iron.
■
■
Fate in Enterocytes.
Transport in plasma.
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14. IRON ABSORPTION
■ Transport across brush
borders.
■ Absorption of Haeme
form
■ Absorption of Non-
haeme form
■ Fate in Enterocytes.
■ Transport in plasma.
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15. Factors affecting iron
absorption
■ Form of dietary iron –
■ haem iron
■ Non-haem iron – ferrous form (Fe2+) > ferric form
(Fe3+)
■ Meat & fish ,Human breast milk ,Acid gastric
juice – enhances absorption.
■ Dietary factors – Phytates , phosphates, calcium,
egg white, phenols, tea, coffe wine reduces.
■ Iron stores in body – Negative feedback effect.
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18. APPLIED ASPECTS.
■ Iron deficiency- iron
deficiency Anaemia
■ Iron excess –
Haemosiderin
accumulation –
Haemosiderosis –
damages tissue –
Haemochromatosis.
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19. CAUSES OF IRON DEFICIENCY
ANAEMIA.
■ Inadequate dietary
intake.
■ Increased loss of iron.
■ Increased demand of
iron.
■ Decreased absorption.
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20.
21. Megaloblastic Anaemia
■ Megaloblast –
abnormally large cells
of Erythroid series.
■ Caused by defective
DNA synthesis due to
deficiency of Vit B12 &
Folic acid.
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22. Vit B 12 (Extrinsic
Factor)
■ Vit B12 –
Cyanocobalamin or
extrinsic factor.
■ Daily need – 1-2 μg.
■ Sources – Milk, Meat,
Liver of Animals
■ Also synthesized by
bacterial Flora.
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23. Vit B 12 (Extrinsic
Factor)
■
■
■
Absorption – need
Intrinsic Factor Of Castle ,
a glycoprotein secreted by
parietal cells of gastric
mucosa.
With it form Intrinsic
Factor- Cyanocobalamin
complex
Bound to sp receptors in
ileum & absorbed by
Endocytosis.
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24. Vit B 12 (Extrinsic
Factor)
■ Transport – in blood
transported by
combining with
Transcobalamin-II
■ Storage – In liver &
Muscle
■ Role – required for
synthesis of DNA &
maturation of nucleus &
cell.
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26. Aetiology
.
■ Due to vit B12
deficiency
■ Causes –
■ Inadequate dietary
intake
■ Malabsorption due to
gastric cause
■ Intestinal Cause.
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27. Addisonian Pernicious
Anaemia.
■ Aetiology – vit B12
deficiency due to
failure of secretion of
Intrinsic Factor by
stomach due to
Autoimmune
Atrophy of Gastric
Mucosa.
■ Features.
■ Features of
Megaloblastic anaemia
■ Anti-intrinsic factor
antibodies.
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28. Clinical
Features:
■ Pallor,Weakness, Lethargy,
Breathlessness on exertion
Palpitations heart failure pedal edema
■ General features of Anemia
■
■
■ Special features :
■
■
■ Angular cheilitis, Atrophic glossitis,
Oesophageal atrophy/web Dysphagia,
Koilonychia, brittle nails, gastric atrophy.
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30. LAB FINDINGS
■ Blood picture & red cell
indices.
■ Hb Decreased
■ RBC – Microcytic,
Hypochromic in iron
deficiency
■ Megaloblastic in vit B12 &
FOLIC ACID deficiency
■ Red cell indices – MCV,MCH
& MCHC Decreases
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31. MANAGEMENT
■ General – correction
of causative factor if
possible.
■ Special – oral
administration of fe
salts, FSFA TAB,
Intramuscular inj.
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