Ravilya2013 Hematology Iron Def Anemia

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Iron Deficiency Anemia

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Definition. An anemia with diminished red blood cell production and an Mcv <80 characterized
by hypochromic cells and low levels of stored iron in the body

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Iron Deficiency Anemia
Etiology.The most common type of blood loss is

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almost always caused by an increased level of blood loss
from the body.Other etiologies are increased urinary
loss of blood, malabsorption, hemolysis) and poor oral intake.

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Iron Deficiency Anemia
A man requires about ....per day and a woman
about ....mg per dayon average. It is difficultfor

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. Iron
absorption is tightly regulated in the body.A man requires about 1 mg per day and a woman
about 2-3 mg per dayon average. It is difficultfor the body to increasethe levelof iron absorption.
If there is even a modest increasein blood loss-occult blood in the stool)a heaviermenstrual
flow, or an increaseddemand such as during pregnancy-the body is poorly equipped to
increaseits levelof absorption to exceed 3-4 mg per day

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Iron Deficiency Anemia Clinical Presentation.

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Clinical Presentation. Mild anemia may result in absent or very limited symptoms. As the
hematocrit approaches 30%, symptoms of fatigue and poor exercise tolerance may develop. As
the hematocrit lowers to 25%) tachycardia, palpitations, dyspnea on exertion,and pallor develop.
Older patients and those with coronary artery disease may become dyspneic at higher levels
of hematocrit. More severe anemia results in lightheartedness, confusion, syncope, and chest
pain.Asystolic ejection murmur ("flow" murmur) may develop in any patient with moderately
severe anemia. These symptoms are not specific for iron deficiency anemia and may develop
with any form of anemia provided it is sufficiently severe.

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Iron Deficiency Anemia symptoms not specvhific

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Symptoms specific to iron deficiency are very rare and cannot be relied upon to determine the
diagnosis. These include brittle nails, spoon shaped nails, glossitis, and pica

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Iron deficiency
anemia as a specific diagnosisis determined by

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Iron deficiency
anemia as a specific diagnosisis determined by laboratory findings,not symptoms.

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Iron deficiency
anemia
ds ferritin

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Diagnosis.A low serum ferritin <10 ng/mL is the most characteristic finding of iron deficiency anemia.
Low ferritin has good specificity (>99%) but poor sensitivity (60%) because the
ferritin level maybe falsely elevated because it is an acute phase reactant and maybe elevated in
other inflammatory states or with malignancy.

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MCV is.. is i/d anemia

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MCV is low in individuals with anemia except
in very early cases. The

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iron def amnemia
The serum iron...
total iron binding capacit

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The serum iron is low and the total iron binding capacityis high.

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iron Def anemia RDW

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RDW
is elevated.

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The most specific test, although rarely necessary IN IRON /DEF ANEMIA

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The most specific test, although rarely necessary, is a bone marrow biopsy looking
for stainable iron stores

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IRON /DEF ANEMIAreticulocyte

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The reticulocyte count should be low.

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IRON /DEF ANEMIA Treatment

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Treatment. Oral therapy with ferrous sulfate tablets is the most common method of therapy

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Parenteral ironTreatment in...

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Parenteral iron is used in patients with malabsorption) very high requirements, and in those
who cannot tolerate oral therapy.

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most effective method of delivering
iron

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Bloodtransfusion is the most effective method of delivering
iron but, of course, is not a standard method of correcting iron deficiency anemia.

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if old with iron df anemia think of

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colon cr

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if young fem with iron df anemia think of

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mesnst blood loss

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adult with diarrhea and iron def anemia think of

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celiac disease

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best initial test in iron def anemia

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serum ferritin ..,10ng/ml- specific and sensitive for Fe def anemia

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other tests in iron def anemia

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low serum fe
high TIBS ( because it measure unbound site of transferrin-- lots of open sites and---- capacity or unbound increased

LOW TRANSFERRIN SATURATION

INCREASED rwd

HIGH SOLUBLE FERRITIN RECEPTOR ESSAY

Transferrin saturation, abbreviated as TSAT and measured as a percentage, is a medical laboratory value. It is the ratio of serum iron and total iron-binding capacity, multiplied by 100. Of the transferrin that is available to bind iron, this value tells a clinician how much serum iron is actually bound. For instance, a value of 15 % means that 15 % of free iron is being carried by transferrin. For an explanation of some clinical situations in which this ratio is important, see Total iron-binding capacity. The three results are usually reported together.
[edit] Usual values

Normal reference ranges are:

Serum iron: 60–170 μg/dl (10–30μmol/L)
TIBC: 240–450 μg/dl
Transferrin saturation: 15–50% (males), 12–45% (females)