This document discusses iron deficiency anemia. It begins by classifying anemias based on red blood cell morphology and etiology. Iron deficiency anemia is then explained in more detail. The symptoms, absorption of iron, and laboratory tests are summarized. The risks factors, treatment involving iron supplements, and prevention through an iron-rich diet are highlighted.

1. ANEMIA
IRON DEFICIENCY
ANEMIA
JINAL CHAUDHARI
B.sc ( in microbiology)

2. CONTENT
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1 Classification of anemia
Iron deficiency anemia
Symptoms of iron
deficiency anemia
Absorption of iron
Laboratory tests in iron
deficiency anemia
6 Treatments and
prevention

3. Anemia
• The term" anemia" (as used in clinical medicine)
refers to a reduction below normal in the
concentration of hemoglobin or red blood cells in
blood. Anemia may be regarded in physiological
term as "reduction in oxygen transporting capacity
of blood"
• Anemia signifies a decreased amount of
hemoglobin in the blood. There is a decrease in
the amount of oxygen reaching the tissues and the
different organs of the body.

4. Classification of anemia
Anemia may be classified in different ways
(1) Based upon the morphology of the red cell or
(2) Upon the etiology (the cause of anemia).
Morphological classification
It is based on MCV, MCH, MCHC and the red
cell morphology on a blood smear.
Normochromic, normocytic anemia
•Reduction in the number of red cells
• Low PCV and reduced hemoglobin
•MCV, MCH, MCHC are normal
•smear impression
few red cells but relatively normal

5. •Clinical conditions
-Anemia of acute blood loss
- Anemia associated with leukemia
- Aplastic anemia
Hypochromic, microcytic anemia
•Decrease in red cells
•Low hemoglobin and PCV
•Reduced MCV, MCH and MCHC
•Smear impression
-Microcytosis
- Hypochromia
•Clinical conditions
- Iron deficiency anemia
- Thalassemia

6. Normochromic, macrocytic anemia
•Reduction in the number of red cells
• Low hemoglobin
•Elevated MCV and MCH
•Normal MCHC
•Smear impression
-Macrocytosis
-Hyperchromia (loss of usual central pallor)
clinical conditions
-pernicious anemia
-anemia of folic acid and vitamin B¹² deficiency
- some cases of plastic anemia

7.  Normochromic, microcytic anemia
• Low hemoglobin
• Reduction in MCV,MCH (not marked)
• normal MCHC
• Blood smear impression
-Hypochromia ( not marked)
• Clinical conditions
-Anemias of chronic infections

8. Etiologic classification
Posthemorrhagic anemia
•Acute blood loss due to accidental injury, surgery, gastrointestinal
bleeding, hematuria, etc.
•Chronic blood loss due to hookworm infestation, prolonged
excessive vaginal bleeding and in bleeding ulcers or
gastrointestinal cancer.
Deficient red cell production in the bone marrow due to -
•Deficiency bstances such as iron, vitamin B. 12 folic acid or
pyridoxine necessary for red cell maturation and hemoglobin
formation.
•Bone marrow disease in which there is (i) Hypoplasia (reduction
in red cells) (ii) Aplastic anemia or (iii) Red cell precursors are,
crowded out of the marrow by other cells or tissue e.g. Leukemia.

9.  Hemolytic anemias (Increased red cell
destruction): It may be due to
• Hereditary spherocytosis
• sickle cell anemia
• thalassemia
or due to abnormal 'environmental '
extrinsic causes such as
• Autoimmune hemolytic anemia
• hemolytic disease of the new born
• malaria parasite infection

10. IRON DEFICIENCY ANEMIA
(IDA)
• The normal adult body contains about
4000 mg of iron. About 10% of this iron
is present in the circulating blood.
• In women of childbearing, the must
common cause of iron deficiency anemia
is a loss of iron in the blood due to heavy
menstruation or pregnancy.
• A poor diet or certain intestinal diseases
that affect how the body absorbs iron
can also cause iron deficiency anemia.

11. Symptoms
• Iron deficiency anemia can cause:
 Extreme fatigue
 weakness
 cold hands and feet
 Inflammation of your tongue
 Poor appetite
 Cracks in the sides of the mouth
 Shortness of breath
 Soreness of the tongue

12.  Chest pain
Dizziness or
lightheadedness
 Brittle nails

13. Pale skin
Fast heart beat

14. Headache
 Cracks in the sides of
the mouth

15. Absorption of iron
Small intestine is highly sensitive to repletion
or depletion of iron stores, and rapidly corrects
imbalance by decreasing or increasing
absorption.
The daily intake of a normal adult contains 10-
20 mg iron Absorption of iron is about 10%
and it is greater in women than in men.

16. Dietary factors that enhance iron
absorption
• Meat
• Fish
• Poultry
• Seafood
• Gastric acid
• Ascorbic acid
• Malic acid
• Citric acid

17. Dietary factors that inhibit iron
absorption
• Phosphate
• Calcium
• Tea (tannic acid)
• Coffee
• Colas
• Soy protein
• High doses of minerals
• Bran/fiber
• Source

18. The Laboratory Tests
① Complete hemogram (with reticulocyte count)
② ESR
③ Osmotic fragility
④ Bone marrow examination
⑤ Routine examination of feces
⑥ Gastric juice analysis
⑦ Routine examination of urine
⑧ Serum bilirubin and SGPT determination
⑨ Electrophoresis of hemoglobin

19. Expected Test Result in Iron Deficiency Anemia
 Hemoglobin estimation: < 10 g/dl
 Examination of peripheral blood film-microcytosis,
elliptocytosis, hypochromia, anisochromia.
 Erythrocyte count: It varies with the severity of anemia.
 MCH =15-26 pg, color index < 0.9
 MCV =60-80 fn, volume index < 0.9
 MCHC= 20-30%, saturation index < 0.9
 RDW =More than 17.5
 Reticulocytes: Usually present, may be over 2% after
hemorrhage.
 Osmotic fragility: slightly reduced
 ESR: Rarely elevated
 Total leukocyte count: Mild to moderate leukopenia in
severe anemia. After hemorrhage, Leukocytosis may

20. Risk factors for iron deficiency, inadequate
iron intake/absorption/stores
 Vegetarian eating styles, especially
vegan diets
 Macrobiotic diet
 Low intakes of meat, fish, poultry or iron
fortified foods
 Low intake of foods rich in ascorbic acid
 Frequent dieting or restricted eating
 Chronic or significant weight loss
 Meal skipping

21.  Heavy/lengthy menstrual periods
 Rapid growth
 Pregnancy (recent or current)
 Inflammatory bowel disease
 Chronic use of aspirin or nonsteroidal anti-
inflammatory drugs (e.g., ibuprofen) or
corticosteroid use
 Participation in endurance sports (e.g., long
distance
 running, swimming, cycling)
 Intensive physical training
 Frequent blood donations
Increased iron requirements/losses

22. Treatment and prevention
IRON
SUPPLEMEN
T
Choose iron rich foods for diet

23. Thank
You
Reference book: text book of medical
laboratory technology by Praful B.
Godkar and Darshan P. Godkar