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    Classification of Anemia

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    Raluca Haba
    Iron deficiency anemia is caused by insufficient iron intake or absorption leading to depleted iron stores. It results in a hypochromic microcytic anemia with low hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. The red blood cells appear small and pale on blood smear. Bone marrow iron stain is negative despite possible hypercellularity of the bone marrow. Serum iron and ferritin are low while transferrin and total iron binding capacity may be normal or high. Chronic blood loss, pregnancy, growth periods, and malabsorption are common causes of iron deficiency anemia.

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    Classification of Anemia

    Uploaded by

    Raluca Haba
    36 views12 pages
    Iron deficiency anemia is caused by insufficient iron intake or absorption leading to depleted iron stores. It results in a hypochromic microcytic anemia with low hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. The red blood cells appear small and pale on blood smear. Bone marrow iron stain is negative despite possible hypercellularity of the bone marrow. Serum iron and ferritin are low while transferrin and total iron binding capacity may be normal or high. Chronic blood loss, pregnancy, growth periods, and malabsorption are common causes of iron deficiency anemia.

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    IDA

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    Iron deficiency anemia is caused by insufficient iron intake or absorption leading to depleted iron stores. It results in a hypochromic microcytic anemia with low hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. The red blood cells appear small and pale on blood smear. Bone marrow iron stain is negative despite possible hypercellularity of the bone marrow. Serum iron and ferritin are low while transferrin and total iron binding capacity may be normal or high. Chronic blood loss, pregnancy, growth periods, and malabsorption are common causes of iron deficiency anemia.

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    36 views12 pages

    Classification of Anemia

    Uploaded by

    Raluca Haba
    Iron deficiency anemia is caused by insufficient iron intake or absorption leading to depleted iron stores. It results in a hypochromic microcytic anemia with low hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. The red blood cells appear small and pale on blood smear. Bone marrow iron stain is negative despite possible hypercellularity of the bone marrow. Serum iron and ferritin are low while transferrin and total iron binding capacity may be normal or high. Chronic blood loss, pregnancy, growth periods, and malabsorption are common causes of iron deficiency anemia.

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    of 12

    Classification of anemia

    Causes of anemia Red cells size and their indices


    -Blood loss. -Hb concentration and Hematocrit
    -Iron deficiency. -MCV, MCH, MCHC.
    -Infection.
    -RBC destruction (hemolysis) MCV MCV
    e.g. G6PD.
    -IDA Normal MCV -B12
    -hemolytic -Folat
    -B12 and Folate deficiency.
    -Thal anemia
    Iron deficiency anemia

    Normal iron metabolism:


    -The primary function is oxygen transport.
    -Iron is absorbed by duodenum and jejunim
    -Average total body iron content 3500-4000 mg.
    -Approximately 2/3 found in hemoglobin,
    -Iron is also stored in RE cells (BM, Spleen and liver)
    as hemosiderin and ferratin.
    -Also iron found in myglobin and myeloperoxidase
    and in certain electron transfer.
    -Iron is more stable in ferric state (Fe+++) than in
    ferrous state (Fe++).
    Iron + Hem

    Iron Metabolism
    Daily Fe++ turnover continuous process

    RBC
    2500 mg

    R.E. 20 mg 20 mg Fe
    Via RE system
    90% extra vascular Released daily Returned to immature RBC
    5-10% intra vascular in BM

    Iron Absorption
    1-2 mg only
    Plasma Fe Loss (from GI tract)
    Transferrin carriers 1-2 mg daily
    4 mg

    Body stores
    1000 mg (M) Myglobin
    300 mg
    300-500 mg (F)
    Dietary iron:
    Iron is present in food as ferric hydroxides (ferric-protein
    complexes and hem-protein complexes).
    -meat, liver
    -vegetables, eggs.
    -The average diet contains 10-15mg and only 5-10% is normally
    absorbed.

    Iron requirements:
    It varies depending on sex and age:
    Male/female 0.5-1 mg/day
    Pregnant female 1-2 mg/day
    Children 0.5 mg/day
    Clinical features:
    • When ID is developing, the RE stores (hemosiderin and
    ferritin) become completely depleted before anemia occurs.
    • At an early stage, no clinical abnormalities.
    • Later, patient may develops general symptoms and signs of
    anemia.
    • In severe case of IDA ridged or spoon nails.
    Causes:
    • Chronic blood loss
    Fetomaternal Hemorrhage, inherited
    bleeding disorders menstrual peroid.
    • Maternal iron deficiency (neonate).
    • Growth spurts (infants and children).
    • Gastrointestinal,
    peptic ulcer, aspirin ingestion, carcinoma,
    hookworm, colitis, piles etc.
    • Pregnancy
    • Rarely hematouria,
    self-inflicted blood loss, hemoglobinuria.
    • Insufficient daily iron intake (poor diet).
    • Malabsorption.
    Laboratory findings:
    •Red cell indices:
    Low Hb conc.
    MCV, MCH, MCHC* 
    •Blood film:
    Hypochromic microcytic Picture.
    Occasional Target cells.
    Pencil shaped poikilocytes.
    Normal reticulocyte count.
    •Bone marrow iron:
    Normal to hypercellular.
    RBC precursors are increased in number.
    Iron stain negative.
    •Chemical testing on serum:
    Serum iron Decreased
    Transferrin/TIBC Normal to High
    Serum ferritin Decreased (Very low)
    Hypochromic Microcytic picture (IDA)

    -ve BM Iron Stain +ve


    Reticulocytes

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