Iron Metab Flashcards
A 63yr old woman complained of weakness and fainting attacks. On exam, she appears pale. The pulse rate was 104bpm, normal BP. The cardiac apex is hyperkinetic, but no signs of cardiac failure
FBC: Hb 7.2 g/dl (low)
MCV: low; MCHC: low
Plasma Fe: 6umol/l (9 - 30)
Plasma transferrin: 6g/L (2 – 3.6)
Ferritin: 8ug/L (15 – 300)
Stool occult blood: positive
Calculate the %saturation. Ref: (20 – 55%)
What is the type of her anaemia?
What is the possible cause of her anaemia?
What treatment would you advise?
%saturation= plasma iron conc ( umol /
————————-
2*transferrin( umol /L
Microcytic anameia
Iron deficiency
Desferrioxamine
A 45 yr old diabetic man presented with 2wk history of pain of his left knee joints. On exam, there is skin hyperpigmentation, hepatomegaly.
Plasma Fe 36uM (9 – 30)
TIBC 40 uM (45 – 70)
Ferritin >1500ug/L (15-300)
What is the likely diagnosis?
What is the cause of the hyperpigmentation?
What is the molecular defect in this disorder?
What is the mode of inheritance?
How will you treat this patient?
Heamatochomatosis type 1
Signs of heamachromatosis
Liver cirrhosis
Arthritis
Skin pigmentation
Bronze diabetics
Cardiac failure
Haemachromatosis is defined as
Iron overload in the body
Heamchromatosis is due to
Mutation of the HFE gene
Homeostatic iron regulator gene
HFE gene does what
Synthesize hepcidin
Iron is transported in the blood by
Transferrin
Function of ferropotin
It takes iron from the membrane into the blood
Function of divalent metal transporter
Takes iron from the git tract into the mucosa
What blocks feeropotin
Hepcidin
Iron is stored in the body as
Ferritin and heamodessirin
In iron overload
Plasma iron
Ferritin
Transferrin
What are there levels
High
High
Low
In iron deficiency
Plasma iron
Ferritin
Transferrin
What are there levels
Low
Low
High
In chronic illness
Plasma iron
Ferritin
Transferrin
What are there levels
Low
Normal/high
Normal/low
What is used in the treatment of heamachromatosis
Venesection
Reducing ferritin levels
