iron deficiency

Question 1

define

Answer 1

Diminished RBC production due to low iron stores in the body

Question 2

epidemiology

Answer 2

Most common anaemia globally
Pre-school aged children - highest prevalence

Question 3

aetiology

Answer 3

excessive blood loss:
- menorrhagea
- GI bleeding

inadequate dairy intake
poor intestinal absorption
increased iron requirements eg pregnant

Question 4

clinical features

Answer 4

Clinical Features:
- Anaemia
- Fatigue, SOB on exertion, Pallor
- Palpitations

Iron Deficiency:
- Nail changes: (eg koilonychia and brittle nails)
- Hair loss
- Atrophic glossitis
- Angular stomatitis

Question 5

investigations

Answer 5

history:
- FBC
- serum ferritin level <30 (but can be normal or high so doesnt exclude)
- transferrin/TIBC high but saturation low
- blood film - anispokilocytosis, different shape/size of RBC, target cells, pencil poikilocytes

endoscopy - to rule out malignancies

FIT test:
- looks for and measures amount of blood in GI tract
- should be <9
- if raised then endoscopy needed

Question 6

Management

Answer 6

• Treat underlying cause and exclude malignancy
• Oral ferrous sulphate - continue taking for 3 months after correction to replenish stores (side-effects: nausea, abdo pain, constipation or diarrhoea)
• Ferrous Gluconate can be used if Ferrous Sulphate cannot be tolerated
• Iron-rich diet - leafy green veg, meat, iron fortified bread