Dive into a real-life case study exploring the diagnosis, management, and outcomes of iron deficiency anemia. Gain valuable insights into the clinical presentation, laboratory findings, and treatment strategies employed in addressing this common nutritional deficiency disorder.

1. Patient with Iron Deficiency Anemia
By Sunidhi Singh
IM 434

2. Iron Deficinecy Anemia
• Iron deficiency anemia is a common type of anemia - a
condition in which blood lacks adequate healthy red blood
cells.
• Iron-deficiency anemia is a common type of anemia that
occurs if you do not have enough iron in your body.

3. • A 35 year old woman is seen for easy fatigue for many
months. She is now 24 weeks pregnant with her 3rd child
in 3 years. She does not see any obstetrician and does
not take any vitamins. Lately, she has developed a taste
for eating ice. She has no other complaint. Family and
past history are negative. She does not smoke or drink.
Physical examination is positive for pale conjunctiva, mild
spooning of nails, and a II/VI systolic murmur at left lower
sternal border. Stools are negative for occult blood.

4. • Labs: Complete blood count (CBC) - Hg 7.1 gm/dl, Hct
23%, WBC 5,400/mm3 (differential is normal), platelets
450,000/mm3; Mean Corpuscular volume (MCV) is 74 fl
(normal 85-95 fl); Red cell Distribution Width (RDW) is
17.1% (normal 13-15).

5. Syndromes and Differential Diagnosis:
• Syndromes:
• Anemic Syndrome
• Sideropenic Syndrome
• Asthenic Syndrome
• Cytopenic Syndrome
• Hemolytic Syndrome
• Differential Diagnosis:
• thalassemia
• Sideroblastic anemia
• Lead poisoning
• GERD

6. Diagnosis and evaluation plan
• Physical Exam and History:
• indicates paleness of skin and conjuctiva.
• Lethargy
• Dyspnoe
• Dysphagia
• Glossitis
• Spooning of nails
• Craving of ice
• Hair loss

7. • Laboratory Exam:
• Complete blood count:
• Low hemoglobin
• Decreased MCV
• Increased RDW
• Normal or increased platelet
• Low reticulocyte count
• Peripheral blood count:
microcytic and hypochromic RBCs.

8. many of the red cells are microcytic (compare size of red cell with the lymphocyte nucleus) and
hypochromic (wide central pallor).

9. Diagnosis
• Iron Profile Evaluation:
• Serum ferritin less than 45ng/ml
• Increased total iron binding capacity
• Transferrin Saturation is less than 16%
• and, Low serum iron
• Additional tests:
• Bone Marrow biopsy can be carried out, but it isnt
necessary.

10. • Clinical Diagnosis:
• Based on lab tests and physical exam findings, acute iron
deficiency anemia is confirmed.
• Degree: moderate-severe

11. Treatment:
• Primary Goal:
• Oral iron replacement therapy
• Daily oral iron replacement tablets.
ferrous sulfate: 2-3 mg/kg/day orally given
in 2-4 divided doses
Dose expressed as elemental iron
ferrous gluconate: 2-3 mg/kg/day orally given in 2-4 divided doses Dose expressed as
elemental iron.
ascorbic acid: 500 mg orally two to three times daily
*the dose should be doubled in case of twin pregnancy.

12. Treatment
• Follow Up:
• The reticulocyte count should peak at 1 to 2 weeks and
haemoglobin should show improvement at 3 to 4 weeks
(by 20 g/L [2 g/dL]) with normalisation of haemoglobin
after 2 to 4 months and replacement of iron stores after 6
months

13. • Recommendations:
• Diet with high iron content
• Adequate calories and good quality protein
• patient should avoid alcohol and smoking completely.
• Prognosis:
• upon continuation of the treatment and recommendations,
recovery is likely and the outcome is favorable.

14. the end
Thank You