Iron-deficiency Anemia MLTTP (case study) Bakur Ahmed Wedaa Ali 57752 8/1/2013

Iron-deficiency Anemia Anemia occurs when a person's blood contains insufficient red blood cells. This could result if: The body does not make enough red blood cells Bleeding causes loss of red blood cells more quickly than they can be replaced. Iron-deficiency Anemia must be diagnosed by laboratory testing. Anemia is one result of advanced-stage iron deficiency. When the body has sufficient iron to meet its needs (functional iron), the remainder is stored for later use in all cells, but mostly in the bone marrow, liver, and spleen. These stores are called ferritin complexes and are part of the human (and other animals) iron metabolism systems. Ferritin complexes in humans carry about 4500 iron atoms and form into 24 protein subunits of two different types.

Change in lab values in iron deficiency anemia Other symptoms and signs of iron-deficiency anemia include: Anxiety often resulting in OCD-type compulsions and obsessions Irritability or a low feeling Angina Constipation Sleepiness Tinnitus Mouth ulcers Palpitations Hair loss Fainting or feeling faint Depression Breathlessness Twitching muscles Pale yellow skin Tingling, numbness, or burning sensations Missed menstrual cycle Slow social development Glossitis (inflammation or infection of the tongue) Angular cheilitis (inflammatory lesions at the mouth's corners) Koilonychia (spoon-shaped nails) or nails that are weak or brittle Poor appetite Pruritus (itchiness) Dysphagia due to formation of esophageal webs (Plummer-Vinson syndrome) Insomnia Change in lab values in iron deficiency anemia Change Parameter Decrease ferritin, hemoglobin, MCV Increase TIBC, transferrin, RDW

Causes: # Blood loss. # A lack of iron in the diet. # An inability to absorb iron. # Pregnancy. Treatment Anemia is sometimes treatable, but certain types of anemia may be lifelong. If the cause is dietary iron deficiency, eating more iron-rich foods, such as beans and lentils, or taking iron supplements, usually with iron(II) sulfate, ferrous gluconate, or iron amino acid chelate ferrous bisglycinate, or synthetic chelate NaFerredetate EDTA, will usually correct the anemia. Alternatively, intravenous iron can be administered

Lab Diagnosis Although the history and physical examination can lead to the recognition of the condition and help establish the etiology, iron deficiency anemia is primarily a laboratory diagnosis. Useful tests include a complete blood count (CBC); a peripheral smear; serum iron, total iron-binding capacity (TIBC), and serum ferritin; evaluation for hemosiderinuria, hemoglobinuria, and pulmonary hemosiderosis; hemoglobin electrophoresis and measurement of hemoglobin A2 and fetal hemoglobin; and reticulocyte hemoglobin content. Other laboratory tests (eg, stool testing, incubated osmotic fragility testing, measurement of lead in tissue, and bone marrow aspiration) are useful for establishing the etiology of iron deficiency anemia and for excluding or establishing a diagnosis of 1 of the other microcytic anemias.