Iron deficiency anemia: (Microcytic anemia):

(HIGH YIELD NOTES FOR |MBBS|NEETPG|NEXT|INICET|FMGE)

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.

Symptoms:

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

Diagnosis:

• 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.

Treatment:

• 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.