Iron Deficiency
IRON DEFICIENCY ANEMIA
- Iron deficiency can be divided into 3 stages-
- Negative iron balance
- Iron deficient erythropoiesis
- Iron deficiency anemia- microcytic hypochromic anemia
Causes of Iron Deficiency Anemia-
- Increased demand for iron- pregnancy, erythropoietin therapy, growth period.
- Increased Iron loss- acute & chronic blood loss, phlebotomy
- Decreased iron absorption- diet, malabsorption of iron, surgery or gastrectomy.
Lab diagnosis-
- Decreased serum ferritin
- Total iron binding capacity increased.
- Iron deficiency can be indicated by MCHC.
- Test to detect iron deficiency is serum ferritin.
- Mentzer index more than 13 suggests a diagnosis of iron deficiency anemia.
Clinical features-
- Fatigue, pallor
- Chielosis
- Koilonychias
Treatment
- Red cell transfusion
- Oral iron therapy- 200mg per day (100- 150 mg per day)
- Parenteral iron therapy– iv iron,
- Total parenteral iron requirement can be calculated by : 4.3 x Body weight (kg) x Hb deficit (g/dl)
- Ferumoxytol delivers 510 mg of iron per injection, ferric gluconate 125mg per injection, ferric carboxymaltose 750 mg per injection, and iron sucrose 200 mg per injection.
- Iron dextran (highest risk of anaphylaxis).
Exam Important
- Iron deficiency anemia- microcytic hypochromic anemia
- Causes- Decreased iron absorption- diet, malabsorption of iron, surgery or gastrectomy.
- Lab diagnosis-
- Decreased serum ferritin
- Total iron binding capacity increased.
- Iron deficiency can be indicated by MCHC.
- Test to detect iron deficiency is serum ferritin.
- Mentzer index more than 13 suggests a diagnosis of iron deficiency anemia.
Treatment
- Red cell transfusion
- Oral iron therapy- 200mg per day (100- 150 mg per day)
- Parenteral iron therapy– iv iron,
- Total parenteral iron requirement can be calculated by : 4.3 x Body weight (kg) x Hb deficit (g/dl)
- Ferumoxytol delivers 510 mg of iron per injection, ferric gluconate 125 mg per injection, ferric carboxymaltose 750 mg per injection, and iron sucrose 200 mg per injection.
- Iron dextran (highest risk of anaphylaxis).
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