Iron Deficiency Anemia Flashcards
Iron deficiency anemia?
Most common hematologist disease in infancy and childhood
Etiology of IDA?
Nutritional
Low birth weight
Rapid growth
Consumption of large amount of cow’s milk { >32 oz whole cow’s milk/days}
Impaired absorption
Primary iron deficiency
Malabsorption syndrome
Blood loss
Gastrointestinal
Primary iron deficiency
Cow’s milk allergy pr exudative enteropathy
Lesions: Meckel’s, vascular malformation
Parasites; hooks worm
Genitourinary
Menstrual
Hemoglobinuria
Hemosiderinuria
Pulmonary
Goodpasture’s syndrome
Pulmonary hemosiderosis
Clinical presentation IDA?
Pallor
Pagophagia: desire to eat unusual substance as ice, dirt
If Hb level falls<5 g/dl
Irritability
Anorexia
Tachycardia
Systolic murmur
Laboratory findings of IDA?
Low serum ferritin {depleted iron stores}
Low serum iron - may fluctuate
Increased TIBC- serum transferrin
RBCs become more microcytic, hypochromic and increased poikilocytosis as disease progresses
Increased RBV distribution width RDW
Normal WBC
Thrombocytosis 600,000
Low reticulocyte count
Mentzer index >13 {MCV/RBC}
Treatment of IDA?
Response to iron therapy is diagnostic and therapeutic
Oral administration of ferrous salts at dose of 4-6 mg/kg of elemental iron in three divided diseases
Rapid correction of anemia with transfusion may precipitate heart failure
In severely anemic children <4 mg dL transfusion can be administered at a very slow rate 2-3 ml/kg
If there is evidence of HF present , modified exchange transfusion using fresh PRBCs cab be considered
Changes after treatment with iron:
Within 12-24 hr: irritability decrease, increased appetite
36-48hr: initial bone marrow response with erythroid hyperplasia
48-72 hr: reticulocytosis, peaking at 5-7 days
1-3 months: depletion of stores
Hb may increase by 0.5 g/dL/day
Iron therapy should be continued for at least 2 months after the HgB normalize to stores
Limit cow’s to less than 500 cc/day
