Samwel Mikaye: Clinical Features and Presentation of Iron Deficiency Anaemia
Samwel Mikaye, Medical Doctor at MSK, shared a post on LinkedIn:
“Iron Deficiency Anaemia
Iron deficiency anaemia is a type of microcytic hypochromic anaemia caused by inadequate iron for hemoglobin synthesis.
Causes
Increased iron loss
- Chronic blood loss
- Heavy menstruation
- Gastrointestinal bleeding
- Hookworm infestation
Increased iron requirement
- Pregnancy
- Rapid growth in children and adolescents
Reduced iron intake
- Poor diet
- Malnutrition
Reduced absorption
- Celiac disease
- Gastrectomy
- Chronic diarrhea
Pathophysiology
Iron deficiency leads to reduced hemoglobin production, resulting in:
- Small red blood cells (microcytic)
- Pale red blood cells (hypochromic)
- Reduced oxygen-carrying capacity
Clinical Features
Symptoms
- Fatigue
- Weakness
- Dizziness
- Palpitations
- Shortness of breath
Signs
- Pallor
- Brittle nails
- Koilonychia (spoon-shaped nails)
- Glossitis
- Angular cheilitis
- Tachycardia
- Pica (craving non-food substances)
Investigations
Full blood count
- Low hemoglobin
- Low MCV
- Low MCH
Iron studies
- Low serum ferritin
- Low serum iron
- High total iron-binding capacity (TIBC)
Peripheral blood film
- Microcytic hypochromic cells
Additional tests
- Stool for occult blood or parasites
- Endoscopy if gastrointestinal bleeding suspected
Management
Treat underlying cause
- Control bleeding
- Treat parasites
- Improve diet
Iron replacement
Oral iron therapy
Commonly:
- Ferrous sulfate
- Ferrous fumarate
Usually continued for about 3 months after hemoglobin normalizes.
Dietary advice
Increase intake of:
- Red meat
- Liver
- Beans
- Green leafy vegetables
Vitamin C improves iron absorption.
Severe cases
- Blood transfusion if severe symptomatic anaemia
- Intravenous iron if oral iron not tolerated
Complications
- Heart failure in severe chronic anaemia
- Developmental delay in children
- Reduced immunity
- Pregnancy complications
Prevention
- Iron-rich diet
- Deworming programs
- Iron supplementation in pregnancy
- Early treatment of chronic blood loss”
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