Iron deficiency anemia: (Microcytic anemia):



A condition in which iron loss exceeds intake.

May occur when dietary intake is insufficient for the patient’s needs (eg, when needs are by growth or pregnancy) or in the setting of chronic blood loss, usually 2° to menstruation or GI bleeding.

Toddlers, adolescent girls, and women of childbearing age are most commonly affected.

Don’t Forget: Iron deficiency anemia in an elderly patient may be due to colorectal cancer and must therefore be evaluated to rule out malignancy.



  • fatigue, weakness, brittle nails, and pica.
  • glossitis
  • angular cheilitis
  • koilonychia (“spoon nails”).





  • Peripheral blood smear shows hypochromic and microcytic RBCs with a low reticulocyte count. & Doughnut cells with central pallor
  • Low serum ferritin reflects low body stores of iron and confirms the diagnosis. However, ferritin is also an acute-phase reactant and may thus obscure evidence of iron deficiency.
  • Red cell distribution width (RDW) elevation is a highly specific test for iron deficiency anemia.




  • Treat with replacement iron for 4–6 months. Oral iron sulfate but It may lead to nausea, constipation, diarrhea, and abdominal pain. Antacids may interfere with iron absorption.
  • If necessary, IV iron dextran can be administered but is associated with a 10% risk of serious side effects, including anaphylaxis.
  • Other parenteral preparations are available with less allergic risk, such as iron sucrose.
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One thought on “Iron deficiency anemia: (Microcytic anemia): High Yield Notes

  1. Anonymous says:

    Iron dextran is virtually obsolete. Ferric carboxy maltose is the commonly used parenteral iron preparation though iron sucrose may be preferred owing to cost of FCM

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