Iron Deficiency Anemia

Definition

Iron deficiency anemia is a common type of anemia — a condition in which blood has inadequate healthy red blood cells due to the lack of iron nutrient.

Signs & Symptoms

Extreme fatigue, Weakness, Pallor, Chest pain, fast heartbeat or shortness of breath, Headache, dizziness or lightheadedness, Cold hands and feet, Koilonychia, angular cheilosis, pica and Poor appetite, especially in infants and children with iron deficiency anemia

Risk Factors

Women, infants and children, vegetarians

Causes

Blood loss, lack of dietary iron, inability to absorb iron (e.g. celiac disease), pregnancy

Pathophysiology

Iron is required for the formation of the haem moiety in haemoglobin, myoglobin, and haem enzymes, also known as cytochromes. Adults lose approximately 1 mg (men) to 1.5 mg (premenopausal women) a day in faeces and desquamated mucosal and skin cells. The haem from destroyed or senescent red blood cells is recycled back into new RBCs. Iron, which is absorbed mostly in the jejunum, is transported by transferrin and stored in either ferritin or haemosiderin forms. If more iron is lost or needed than can be absorbed, iron stores are used up, and the patient becomes iron deficient. Poor iron stores result in impaired haemoglobin synthesis and a hypochromic, microcytic anaemia. Anaemia then results in decreased oxygen-carrying capacity and the resultant symptoms of fatigue, low energy level, and dyspnoea on exertion.

Peripheral blood characteristics

Microcytic and hypochromic RBCs with marked anisopoikilocytosis in chronic cases. Platelets usually are increased.

Important investigations & related results

Low serum ferritin level

Treatment & management

Correct the etiology and replenish iron stores. Iron therapy: Oral ferrous (sulphate) iron salts, Reserve parenteral iron for those unable to absorb oral iron or with increasing anemia despite adequate doses of oral iron, Reserve transfusion of packed RBCs for those experiencing significant acute bleeding or in danger of hypoxia or coronary insufficiency

Anisopoikilocytic hypochromic, microcytic cells in the peripheral blood smear

Normal Iron store in the bone marrow

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