Iron Deficiency Anaemia

Question 1

What kind of anaemia is iron deficiency?

Answer 1

Microcytic

Question 2

What are the normal daily requirments of iron?

Answer 2

Daily requirements

• Female = 1.5mg/day
• Pregnancy = 7.5mg/day
• Male = 1 mg/day

Question 3

How is iron used by the body?

Answer 3

• Absorbed by small intestine
• Transported in blood via transferrin
• Stored attached to ferritin

Question 4

CAUSES: Iron Deficiency

Answer 4

1. Chronic blood loss

• Menorrhagia
• GI loss (peptic ulcer, diverticulitis, parasitic)

2. GI malignancy (in elderly assume colon cancer until proven otherwise
3. Malabsorption (Coeliac, Crohn’s)
4. Poor diet (developing countries)

Question 5

CLINICAL FEATURES: Iron deficiency

Answer 5

Peripheral signs

• Koilonychia (spoon nails)
• Sore tongue
• Angular stomatitis

Other

• Plummer-Vinson syndrome (dysphagia secondary to oesophageal web)
• Painless gastritis

Question 6

INVESTIGATIONS: Iron Deficiency Anaemia

Answer 6

Bloods

• FBC = microcytic anaemia
• Iron = Low
• Ferritin = Low
• TIBC = high
• Transferrin saturation = low
• Imaging*
• Barium enema
• Scope*
• OGD
• Colonoscopy

Question 7

MANAGEMENT: Iron Deficiency Anaemia

Answer 7

TREAT UNDERLYING CAUSES

• Ferrous sulphate tablets until HB and MCV normal
• Blood transfusion if patietn symptomatic or a cardiac patient (keep Hb >10g/dL)