Anaemia - Iron Deficiency Anaemia Flashcards
Outline the epidemiology of iron deficiency anaemia (3).
- Most common cause of anaemia
- Highest prevalence in low income countries
- Most common in children and premenopausal women
What are the risk factors of iron deficiency anaemia (9)?
- Pregnancy
- Vegetarian and vegan diet
- Menorrhagia
- Hookworm infestation
- Chronic kidney disease (CKD)
- Coeliac disease
- Gastrectomy / achlorhydria
- non-steroidal anti-inflammatory drug (NSAID) use
- Chronic heart failure
Outline the pathogenesis of iron deficiency anaemia.
- Iron is unavailable for haemoglobin production; however, total body iron stores may not be decreased.
Outline the pathophysiology of iron deficiency anaemia (3).
- If iron stores are depleted because more iron is lost or used than can be absorbed, then haemoglobin formation and RBC production are impaired
- This results in IDA, which is characterised by hypochromic and microcytic RBCs
- Symptoms of IDA, such as fatigue, low energy level, and dyspnoea on exertion, occur due to impaired RBC production and decreased oxygen-carrying capacity
How would a patient with iron deficiency anaemia present (10)?
Common:
* Fatigue
* Dyspnoea on exertion
* PICA
* Restless legs syndrome
* Nail changes
* Impaired muscular performance
* Glossitis and angular stomatitis
* Dyspepsia
* Pallor
* Hair loss
Uncommon:
* Dysphagia
* Rectal lesion on examination
* Growth impairment
* Cognitive and behavioural impairment
* Heart failure
* Recurrent infections
What investigations are recommended in suspected iron deficiency anaemia (12)?
- Haemoglobin and haematocrit
- FBC
- Red cell distribution width
- Peripheral blood smear
- Reticulocyte count
- Serum iron
- Total iron-binding capacity
- Transferrin saturation
- Serum ferritin
- Coeliac serology
- Urinalysis
- Helicobacter pylori testing
What would is the diagnostic result of FBC in iron deficiency anaemia?
- Hb
- MCHC
- MCH
- MCV
- Platelet
- WBC count
- Hb: reduced
- MCHC: reduced
- MCH: reduced
- MCV: reduced
- Platelet and WBC count: usually normal (platelet can be normal, elevated, or decreased)
What would is the diagnostic result of haemoglobin and haematocrit in iron deficiency anaemia?
Reduced
What would is the diagnostic result of red cell distribution width in iron deficiency anaemia?
Increased
What would is the diagnostic result of peripheral blood smear in iron deficiency anaemia?
Microcytic, hypochromic pencil red cells
What would is the diagnostic result of reticulocyte count in iron deficiency anaemia?
Low
What would is the diagnostic result of total iron-binding capacity in iron deficiency anaemia?
Increased
What would is the diagnostic result of transferrin saturation in iron deficiency anaemia?
Low
What would is the diagnostic result of serum ferritin in iron deficiency anaemia?
Low
What would is the diagnostic result of coeliac serology in iron deficiency anaemia?
If positive, coeliac disease is likely
