1. Classification of anemia
Causes 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
-Folat
Normal MCV
-hemolytic
anemia
2. Iron deficiency anemia
Normal 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 myeloperoxidase and
in certain electron transfer.
-Iron is more stable in ferric state (Fe+++) than in
ferrous state (Fe++).
5. Iron Absorption
1-2 mg only
Plasma Fe
Transferrin carriers
4 mg
Body stores
1000 mg (M)
300-500 mg (F)
Myglobin
300 mg
20 mg Fe
Returned to immature RBC
in BM
RBC
2500 mg
R.E. 20 mg
Released daily
Via RE system
90% extra vascular
5-10% intra vascular
Loss (from GI tract)
1-2 mg daily
Daily Fe++ turnover continuous process
6. Dietary iron:
Iron is present in food as ferric hydroxides (ferric-protein complexes
and hem-protein complexes).
-meat, liver
-vegetables, eggs.
-The average diet contains 10-15mg and only 5-10% is normally
absorbed.
Iron requirements:
It varies depending on sex and age:
Male/female 0.5-1 mg/day
Pregnant female 1-2 mg/day
Children 0.5 mg/day
7. Clinical features:
• When ID is developing, the RE stores (hemosiderin and ferritin)
become completely depleted before anemia occurs.
• At an early stage, no clinical abnormalities.
• Later, patient may develops general symptoms and signs of
anemia.
• In severe case of IDA ridged or spoon nails.
