Fe (iron) Deficiency Flashcards
What type of anemia is this?
Microcytic
Definition of Fe deficiency anemia
Non inherited iron deficiency, impairing Hb synthesis
Mc anemia world wide
500 million cases
Fe deficiency anemia causes in:
Infants
Children
Adults
Elderly (60+)
Infants:
-Malnutrition
-Prolonged breast feeding (poor Fe source)
-Coeliacs
-Bleeding
-ALL
-Infection
Children:
Malnutrition, malabsorption (coeliac, IBD)
Adults:
Malnutrition, malabsorption (coeliac, IBD), menorrhagia (heavy period - female)
hookworm (mc worldwide cause : results in GI blood loss)
Elderly
Rare; red flag for colon cancer bleeding
What does nice recommend for 60+ with Fe anemia?
Urgent endoscopy for any 60+ with Fe anemia
Pathology of Fe deficiency anemia
Fe absorbed in duodenum, circulates bound to transferin and stored as ferritin or used in Hb
Fe deficiency (loss, Malab, malnutrition) = low Hb synthesis therefore microcytic anemia (smaller RBC)
Symptoms Fe deficiency anemia
General &
Koilonychia (spoon shaped nails)
angular stomatitis (ulcers at mouth corners)
Atrophic glossitis (tongue enlarged)
PICA (eating non food eg. dirt)
Diagnosis of Fe deficiency anemia
FBC = low Hb, low MCV <95 (microcytic anemia)
Blood film = Hypochromic RBC (pale due to less Hb), target cell (non specific, bulls eye pattern), Howell Jolly bodies (non specific, nucleated RBCs)
Fe Studies =
low serum Fe,
Low ferritin,
high TIBC (total iron binding capacity - unbound transferrin in blood),
low transferrin saturation
endoscopy if 60+
Treatment
Treat underlying cause
Oral Fe - ferrous sulfate (have with oj acidic to help absorption)
If poorly tolerated, consider ferrous gluconate
Side effects of Ferrous sulphate
GI Upset, diarrhoea/constipation, black stool
what is a typical presentation of Fe deficiency in kids?
Excessive consumption of cows milk in infants = low iron content + not well absorbed
