Haem - Iron Deficiency Anaemia Flashcards
What are some causes of iron deficiency anaemia?
- Insufficient dietary iron
- Reduced absorption
- Increased iron requirements
- Loss via by bleeding
What is the most common cause of IDA in adults?
Blood loss
Menstruating women - particularly with heavy periods
Non-menstruating women and men - GI bleeding
What can cause GI bleeding?
Cancer
Oesophagitis and gastritis
Peptic ulcers
IBD
Angiodysplasia
What is the most common cause of IDA in children?
Dietary insufficiency
Pica is a common presentation in kids
Where is iron mainly absorbed?
Duodenum and jejunum
Why do PPIs affect iron absorption?
Stomach acid required to keep iron soluble in its ferrous form Fe2+
If stomach acid is less acidic it changes to insoluble ferric Fe3+
Therefore PPIs can interfere with iron absorption
What is the iron carrier protein?
Transferrin
What is the total iron-binding capacity?
Space for iron to attach on all transferring molecules
Directly related to amount of transferrin in the blood
How is transferrin saturation calculated?
Transferrin saturation = serum iron / total iron-binding capacity
What is ferritin?
Protein that stores iron inside cells
Acute-phase protein released with inflammation
Low ferritin is highly suggestive of iron deficiency
Normal does not exclude deficiency
What can raised ferritin be caused by?
Inflammation
Liver disease
Iron supplements
Haemochromatosis
How does serum iron vary during the day?
Higher in morning and after eating iron-containing meals
When is TIBC higher?
TIBC and transferrin increase with iron deficiency and decrease with iron overload
What does transferrin saturation indicate?
Total iron in the body
Less iron = less saturation
More iron = more saturation
Therefore fasting sample gives most accurate results
What is a normal transferrin saturation?
15-50%
