Iron Deficiency Anaemia Flashcards
How do patients become iron deficient?
Insufficient dietary iron
Iron requirements increase (for example in pregnancy)
Iron is being lost (for example slow bleeding from a colon cancer)
Inadequate iron absorption
Where is iron mainly absorbed?
Duodenum and jejunum
Causes of iron deficiency anaemia
Blood loss is the most common cause in adults
Dietary Insufficiency is the most common cause in growing children
Poor iron absorption
Increased requirements during pregnancy
What conditions can cause blood loss leading to iron deficiency anaemia?
Menorrhagia
GI cancer
Oesophagitis/gastritis
IBD
Investigation of iron deficiency
Investigate if cause unclear
OGD
Colonoscopy
Management of iron deficiency anaemia
Blood transfusion - immediately corrects anaemia but not the underlying iron deficiency
Iron infusion e.g. “cosmofer” - quickly corrects the iron deficiency (avoid during sepsis as iron “feeds” bacteria)
Oral iron e.g. ferrous sulphate 200mg three times daily - slowly corrects iron deficiency
What method of iron replacement is unsuitable in malabsorption?
Oral iron
Blood results in iron deficiency anaemia
Low Hb
Microcytic picture
Low ferritin
High transferrin/TIBC
Signs of longstanding iron deficiency anaemia
Brittle nails
Atrophy of tongue papillae
Angular stomatitis
Brittle hair
What might be seen on blood film in iron deficiency anaemia?
Target cells
Pencil cells
What is transferrin (saturation)?
Binding protein which transports iron in blood
Transferrin saturation is an indicator of total iron in body
Calculation for transferrin saturation
Transferrin saturation = serum iron / TIBC
What is total iron binding capacity?
What does this mean?
The total space on transferrin for iron to bind
Marker for how much iron is in the blood (easier to measure than transferrin)
What is (serum) ferritin?
Form in which iron is stored in cells
Extra is released during inflammation
Low = iron deficiency
Can be normal if there is iron deficiency & inflammation
What would a picture of iron overload look like?
Increased values for transferrin saturation, serum ferritin, and serum iron
Low TIBC
