nada mohamed ahmed, md, mt (ascp)i. definition. physiology of iron. causes of iron deficiency. at...
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Iron Deficiency Anemia
Nada Mohamed Ahmed ,MD, MT (ASCP)i
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• Definition .• Physiology of iron. • Causes of iron deficiency.• At risk group .• Stages of IDA (pathophysiology).• Symptoms (clinical presentation ).• Lab diagnosis.
LEARNING OBJECTIVES
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Definition Iron Deficiency Anemia
• Iron deficiency anemia is a condition in which hemoglobin synthesis has been defected due to reduce or lacking of iron in the body .
• Iron is an essential mineral that is needed to form hemoglobin( an oxygen carrying protein inside red blood cells).
• Iron is vital for all living organisms because it is essential for multiple metabolic processes, including oxygen transport, DNA synthesis, and electron transport
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Physiology of iron:
• 1- distribution of iron • 2- source of iron • 3-Iron absorption • 4-Iron transport• 5-storage of iron
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) Distribution (of iron in human body
Distribution:
Synthesis hemoglobin 64%
Synthesis myoglobin 3.2%
Ferritin 32%
Hemosiderin (stored in bone marrow ,liver, spleen.)
The iron-containing Enzymes 0.4%
Transferring 0.4%
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Absorption
• Iron Taken up as ionic iron or haem iron Ferrous, Fe2+, most soluble = most absorbable
•10% of the 10 to 20 mg of dietary iron is absorbed each day to balance the 1 to 2 mg daily loss.
•Iron is absorbed in Duodenum& Jejunum.
•Stored as Ferritin & Hemosiderin.
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INHIBITORS OF IRON ABSORPTION
Food with polyphenol compoundsVegetables such as spinach and spices Beverages like tea, coffee, cocoa and wine. A single cup of tea taken with meal reduces iron absorption by up to 11%.
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IRON TRANSPORT
Red cells
As haemoglobinCannot be exchanged
PlasmaBound to TransferrinCarries iron between body locationse.g between gut, liver, bone marrow, macrophagesIron taken up into cells by transferrin receptors
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STORAGE OF IRON
Tissues with higher requirement for iron ( bone marrow, liver & placenta) contain more
transferrin receptors.
Once in tissues, iron is stored as ferritin & hemosiderin compounds, which are present in the liver & bone marrow.
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Causes of iron deficiency
1-Increased blood loss – hemorrhage(menorrhagia, chronic gastrointestinal blood loss)
2-Increased requirementspregnancy, children (growth)
3-Poor dietary intake ( Malabsorption)
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AT RISK GROUPS
Infants Under 5 childrenChildren of school ageWomen of child bearing age
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• 1-Iron deficiency anemia is the most common form of anemia and it develops over time if the body does not have enough iron to synthesize red blood cells.
• 2-Without enough iron, the body uses up all the iron it has stored in the liver, bone marrow and other organs.
Stages of IDA (pathophysiology)
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• 3-Once the stored iron is depleted, the body is able to make very few red blood cells.
• 4-If erythropoietin is present without sufficient iron, there is insufficient fuel for red blood cell production
• 5-The red blood cells that the body is able to make are abnormal and do not have a normal hemoglobin-carrying capacity, as do normal red blood cells.
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Clinical Presentation(Symptoms )
• Iron-deficiency anemia can cause:brittle nails
cracks in the sides of the mouth
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Extreme fatigue (tiredness)
chest pain
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• Pale skin
• Dizziness or lightheadedness
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General Symptoms (clinical presentation ).
an enlarged spleenCold hands and feetfrequent infections.Irritabilityshortness of breathswelling or soreness of the tongue
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Lab Diagnosis in IDA
Complete blood count(Microcytic hypochromic) anaemiaLow Hb level (< 11.0 g/dl)Low MCV, MCH, MCHCLow serum ferritin
High Transferrin (Iron Binding Capacity)
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Iron Deficiency Anemia
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Iron Deficiency AnemiaNormal blood film
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