Anaemia - Iron-Deficiency Anaemia Flashcards
Causes of Iron Deficiency (4).
- Insufficient Dietary Intake (commonest in kids).
- Requirement Increase e.g. Pregnancy.
- Increase Loss e.g. Slow Bleeding in Cancer, Menorrhagia (commonest in adults).
- Inadequate Absorption.
Absorption of Iron (3).
- At duodenum and jejunum.
- Requires acid from stomach to keep iron in the soluble ferrous (Fe2+) form.
- If acid drops, it becomes insoluble ferric (Fe3+) form.
Give 2 causes of reduced absorption of Iron.
- Diseases that affect the Small Intestine.
- Medications that affect Stomach Acid levels.
Clinical Features of Iron-Deficiency Anaemia (4).
- Brittle Hair (Loss) and Nails.
- Koilonychia (Spoon-Shaped Nails).
- Angular Chelitis.
- Atrophic Glossitis (Smooth Tongue - Atrophy of Papillae).
Investigations in Iron-Deficiency Anaemia (5).
- TIBC.
- Transferrin Saturation.
- Serum Iron.
- Serum Ferritin.
- Transferrin.
What is Transferrin?
The carrier protein that transports Iron as Ferric (Fe3+) ions.
What is TIBC?
Total Iron Binding Capacity - the total space on the Transferrin molecules for the Iron to bind (related to amount of Transferrin).
What is Transferrin Saturation?
Serum Iron ÷ TIBC (indicating total iron in the body).
Why are fasting samples required in terms of Transferrin Saturations?
They can increase temporarily after eating a meal rich in Iron or taking Iron supplements.
What is Ferritin?
The form of Iron when it has been deposited and stored in cells.
Ferritin and Results (2).
- Inflammation - Extra ferritin is released e.g. infection, cancer.
- Iron-Deficiency : Low (can be normal if inflammation).
Results of Iron Studies in Iron-Deficiency Anaemia (2).
- Increase : TIBC, Transferrin.
- Decrease : Ferritin, Iron, Transferrin Saturation.
What can increase the value of all these results?
Iron Overload e.g. Supplementation with Iron, Acute Liver Damage (storage break).
Blood Film in Iron-Deficiency Anaemia (3).
- Anisopoikilocytosis - RBCs of different sizes and shapes.
- Target Cells.
- Pencil Poikilocytes.
Management of Iron-Deficiency Anaemia (2).
- New Iron-Deficiency Anaemia without Clear Underlying Cause - OGD and Colonoscopy.
- Treat Underlying Cause and Correct Anaemia.