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Iron Deficiency Anemia (IDA) - Coggle Diagram
Iron Deficiency Anemia (IDA)
iron demand of the body is not met by dietary consumption of iron
Dietary factors
Low iron, heme iron
Low vit C
Excess phytate
Excess tea/coffee
Fad diets
Causes
Due to increased demands
Pregnancy
Childhood
Blood loss
Due to decreased availability
Poor intake from vegetarian/vegan diets
Poor absorption
3 stages
Iron depletion
Initial stage, asymptomatic
Iron storage significantly reduced
low serum ferritin level
Iron deficient erythropoiesis
NO stored iron, insufficient iron transport
Limited production of RBCs
Hb and Hct may still be normal
Iron deficient anemia
Insufficient iron stores to maintain RBC synthesis
Significant reduction in Hb levels
Decreased MCV
Hypochromic microcytic RBC
Signs & symptoms
Specific (in severe cases)
Swollen, painful fissures at the corners of the mouth → Angular stomatitis
Swollen and inflamed tongue → Glossitis
Curved, spoon-like shaped nail(s) → Koilonychia
Sore tongue, cracks around corners of mouth, nasopharyngeal reflux → Esophageal webbing
Difficulty in swallowing → Dysphagia
Common
Fatigue
Dizziness
Headaches
Weakness
Lab investigations
Decreased serum iron
Serum ferritin
Increased TIBC
Serum transferrin receptor (TfR)
Zinc protoporphyrin (ZPP) or Free erythrocyte protoporphyrin (FEP)
Hypochromic microcytic
Decreased reticulocyte
BM examination
Erythroid hyperplasia w/ hypochromia
Hemosiderin NOT seen
Decreased %Transferrin saturation
Iron Profiles
Transferrin
TIBC
Max amt of Fe needed to saturate transferrin
TIBC = serum Fe + UIBC
Normal range: 250-460 mg/dL
%Transferrin saturation (%TS)
Transferrin bound to Fe
Normal: only ⅓ of transferrin bind w/ Fe
%TS = (serum Fe/TIBC) x 100
Serum Iron
Amt of circulating Fe bound to transferrin
Normal range: 50-175 mg/dL
Ferritin
In serum → reflects the level of Fe stored w/in cell
Acute-phase protein
Elevated in inflammation, infection, and malignant conditions
Transferrin receptor (sTfR)
Amt of TfR expressed on a cell is proportional to cell’s need for Fe
In IDA, erythroblast requires more Fe to increase erythropoiesis leading to sTfR elevation
Zinc protoporphyrin (ZPP)
Treatment
Oral supplementation for nutrition deficiency
Ferrous sulfate
Parenteral iron (iron dextrans)
In cases of intestine absorption of iron impaired