Anemia Of Abnormal Iron Metabolism Pt. 1 Flashcards
When iron levels are low, RBC production is _____
Impaired
Term for when iron is the limiting factor
Iron restriction
2 important causes of iron restricted anemia
Iron-deficiency anemia
Anemia of chronic inflammation
Iron levels in sideroblastic anemia
High iron
Excess accumulation without anemia
Hemochromatoses
Fucntional forms of iron
Hemoglobin - RBC
Myoglobin - muscles
Enzymes in all cells
What type of iron goes inside the body at the start?
Fe3+ (ferric)
What causes the conversion of ferric iron to ferrous?
Acidity of the stomach
What converts ferrous back to ferric form?
Hephaestin
Lifespan of RBC
120 days
What does the liver secrete to regulate the absorption of iron?
Hepcidin
IDA develops when?
Inadequate intake of iron
How much iron is normally lost in the body per day?
1mg
Daily requirement of iron from the diet
1mg
What happens in the RBC production when the body has inadequate iron intake?
Slow production
During what period needs more iron intake?
Infancy, adolescence
What may be the cause of inability to absorb iron even with adequate levels?
Celiac disease
Matriptase-2 protein
Decreased stomach acidity
Drugs that binds to iron
Causes of impaired absorption:
- Inability to absorb iron even with adequate amount
- Decrease stomach acidity
- Drugs that bind to iron inside the intestine
Causes of chronic blood loss:
- Repeated blood donations
- Hemorrhage
- Menorrhagia
- Hemolysis
Stage 1 iron depletion
Storage iron depletion
Modified true or false:
Ferritin level starts to decrease in stage 2
False. Stage 1
Stage 2 iron depletion:
Transport iron depletion
When serum iron levels decrease, what happens to TIBC levels?
Increase
Stage 3 iron depletion:
Functional iron depletion
When diagnosing anemia, what’s the flow?
Check signs and symptoms
See lab results
Check CBC
Check hemoglobin
Check RBC indices
People with high risk of iron-deficiency anemia
Menstruating women
Adolescent girl
Women in childbearing age
Growing children
Elderly
People with parasitic infection
Is it normal for post-menopausal women to lose 5mg/day of iron?
No. Normal is 1mg/day only
How does long-distance running cause iron-deficiency anemia?
Due to exercise-induced hemoglobinuria
What is used for testing early-stage IDA? How about late-stage?
Ferritin
CBC and additional testing
Hgb concentration in IDA
Decreased
RDW value in IDA
> 15%
Assays under diagnostic testing for IDA;
Serum iron
TIBC
Transferrin saturation
Serum ferritin
Transferrin saturation formula
%= (serum iron × 100) / (TIBC)
Specialized tests for IDA
Free erythrocyte protoporphyrin
Why does the cytoplasm remain bluish after the nucleus has begun to condense?
Iron not sensitized
Treatment for IDA
Dietary supplementation
Ferrous sulfate
Oral bovine lactoferrin
IV administration of iron dextrans
When is IV administration of iron dextrans used? Why?
Patients that cannot absorb iron
- gastric achlorhydria
- celiac disease
- matriptase-2 mutations
HGB levels after treatment:
Normal after 2 days
Define porphyria
Blockage of protoporphyrin production —> leads to the accumulation of porphyrins
In what part of the GI tract iron absorbed?
Duodenum
A protein that leads to persisent production of hepcidin
Matriptase-2
