Iron deficiency anaemia

Iron deficiency anaemia

1. Most common anaemia

2. Hypochromic microcytic

3. Arises from inadequate iron intake in diet or inadequate reutilization of iron in red cells due to chronic blood loss

   • Women with excessive menstrual loss
   • In adults- chronic blood loss from GI tract from bleeding ulcer
   • too frequent blood donations

4. Tests

   • Serum ferritin - low
   • Serum iron- low
   • Serum iron-binding capacity - much higher than normal

5. Dietary sources of iron include red meat, fish, raisins, eggs, vegetables

6. Food/ drugs that impair iron absorption

   • Milk/ Tea
   • Antacids
   • Phytates
   • Tetracyclines
   • Fluoroquinolones

7. Foods that aid iron absoprtion

   • Vitamin C
   • Orange juice
   • Meat

8. Iron supplements

   • Oral route
     • Side effects- nausea, abdominal cramps and diarrhoea
   • Parenteral route
     • In patients unable to absorb oral iron due to surgical procedure, inflammation of the GIT or malabsorption syndromes
     • Patients with chronic renal failure receiving treatment with erythropoietin
     • Iron- dextran - deep intramuscular or slow IV infusion
     • Iron- Sucrose- slow IV infusion
     • Can cause anaphylactoid reactions
   • Acute iron toxicity
     • Usually seen in young children who accidentally take too many iron tablets, results in severe gastritis with vomiting, haemorrhage and diarrhoea followed by circulatory collapse
   • Chronic iron toxicity
     • Iron overload almost always caused by conditions such as chronic haemolytic anaemias or repeated blood transfusions

9. Symptoms

   • Pallor
   • Tachycardia
   • lightheadedness
   • breathlessness
   • fatigue
   • headache
   • sensitivity to cold
   • loss of skin tone