This document discusses iron deficiency anemia, including its causes, signs and symptoms, diagnostic tests, and differential diagnosis. It notes that iron deficiency anemia is the most common cause of anemia and results from absent or decreased iron stores combined with low serum ferritin levels. The document outlines how iron is absorbed, transported, and stored in the body. It also lists common signs of iron deficiency anemia such as fatigue, angular stomatitis, and nail changes. Diagnostic tests discussed include complete blood count, serum iron, total iron binding capacity, serum ferritin, and bone marrow examination. Thalassemia, lead poisoning, and anemia of chronic disease are mentioned as conditions in the differential diagnosis.

1. Presentation by
Laraib Ayesha

2. • Most common cause of iron deficiency anaemia
Absent or decresed iron stores.
Depletion of stores + low serum + ferritin

3. • Absorbtion in duodenum and upper jejnum
• Transferrin transports iron to the cells
• Ferritin and hemosiderin store iron.
• 10% of daily iron is absorbed
• Body iron is present in Hb
• Reticuloendothelial system store iron released from
Hb as ferritin and hemosiderin.
• Total amount of body iron = 3-5g
• Normal diet contain = 15 mg/day

4. • Iron conc =50-150ug/dl
• Total iron binding capacity=250-370ug/dl
• serum Transferrin=2-4g/l
• Ferritin conc=50-300ug/l
• Male: 1mg
• Female: 2-3mg
• Pregnant women:3-4mg

5. • Chronic blood loss
• Increased demand
• Malabsorbtion of iron
• Inadequate iron intake
• Intravascular hemolysis
Hemoglobinuria-hemosiderinuria

6. • Fatigue
• Angular somatitis
• Plummer vinson syndrome
• Gastric atrophy
• Nail changes
(a) Brittle/fragility
(b) Koilonchia/spooning
• Hair loss
• splenomegaly

7. • Hb,Htc,RBC:Low
• MCV,MCH,MCHC:Low
• RDW: High
• Retics: Normal/Low
• Plt:Normal/Low/High
• WBC:Normal/Low
• Smear:
Hypochromia,anisocytosis,microcytosis,
poikilocytosis

8. Peripheral blood
smear of a patient
with severe iron
deficient anaemia.
Note the
important
microcytosis
(compare red
blood cells with
lymphocyte) as
well as
hypochromia,
target cells, and
poikilocytosis

10. • Serum Iron:  (N: 60 – 180 μg/dL)
• TIBC:  (250 - 430 μg/dL)
• Serum Ferritin 
• Transferrin saturation (Fe/TIBC):  (<15%)
<5%:definitely indicates iron deficiency
• Serum Transferrin Receptor: 
• Free Erythrocyte Protoporphyrin  (17 – 27 μg/dL)
• Bone marrow :
– Erythroid hyperplasia,
– Absence of hemosiderin

12. – Iron deficiency anemia
– Thalassemia ,HbC,HbE etc
– Sideroblastic anemia
– Lead poisoning
– Anemia of chronic diseases (sometimes)