ANEMIAS:

1
ANEMIAS
2
IRON DEFICIENCY ANAEMIA
3
Physiological functions

• transport and storage of oxygen
• formation and maturation of red blood cells
• cellular respiration
• ( cytochromes and respiratory enzymes )
• oxidation in nerve cells

4
Daily requirement

• Infants 10-15 mg
• Children
• 1-3 yrs 15 mg
• 4-10 yrs 10 mg
• Older children and adults (Males)
• 11-18 yrs 18 mg
• After 19 yrs 10 mg
• Females
• 11-50 yrs 15-18 mg
• During pregnancy or lactation 20 mg
• After 51 yrs 12-15 mg

5
Factors affecting iron absorption

• Increase
• Gastric acidity
• Proteins of low molecular weight
• Alcohol
• Chlorophyll and bile pigments
• Vitamin C and Calcium
• Heme found in meat more readily absorbed than
  inorganic iron

6
Factors affecting iron absorption

• Decrease
• Intestinal malfunction
• Phosphates
• Phytic acid and oxalates
• Copper deficiency
• Tannates in tea

7
Storage

• 1. Ferritin
• apoferritin ferric hydroxide ferritin
• Iron content 17 to 33
• Water soluble
• Readily available form
• Cannot be visualized by microscopy

8
Storage

• 2. Haemosiderin
• If iron supply in excess Haemosiderin
• 50 iron by weight
• Golden brown granules,
• Stains blue with Pearls or Prussian blue
  reaction
• Derived from ferritin

9
Excretion

• Urine 0.5-1.5 mg
• Faeces 0.3-0.75 mg
• Bile and sweat 0.5-1 mg
• Menstrual flow 1-3 mg
• Faeces - unabsorbed food iron
• Pregnancy - iron to the fetus
• Sweat, hair loss, nail clippings

• Iron content regulation of the body
• By absorption only, not by excretion

10
Laboratory testing for iron

• Serum iron - ( 70 201 µg / dl )
• Serum iron binding capacity
• TIBC ( 253 435 µg / dl )
• Serum ferritin - 20 250 ng / ml
• Complete blood count (CBC)
• Bone marrow biopsy
• Liver biopsy

11
Iron deficiency Anemia

• CAUSES
• Dietary lack
• Impaired absorption
• Increased requirement
• Chronic blood loss
• Uterine abnormalities
• GI bleeding

12
Symptoms

• Fatigue, dyspnea on exertion, palpitations,
  pallor, headache, dizziness, apathy, impaired
  attention, irritability, lowered memory
• Symptomatology of acute anemia is mainly caused
  by fall in blood volume and not by reduced
  hemoglobin level
• Epithelial changes such in nails, tongue, mouth,
  hair, GIT
• Plummer-Vinson syndrome

13
Iron-deficiency anemia pallor of mucous
Membranes (lips) and skin in a 69-year-old
Female. Hb 8.1 g/dl RBC 4.13x10/12/l
PCV 26.8 MCV 65 fl MCH 19.6 pg.
14
Severe Pallor
15
(No Transcript)
16
Koilonychias
17
Angular cheilosis
18
Bald , fissured tongue
19
Post-cricoid web, Plummer-Vinson syndrome
20
Multiple retinal hemorrhages
21
P.S. Microcytic, hypochromic red cells
22
(No Transcript)
23
(No Transcript)
24
80 100 fl.
27 34 pgms.
25
(No Transcript)
26
Pearls stain - Normal marrow -Prussian blue
reaction
27
Absence of stainable Iron in bone marrow
aspirate
28
Lack of stainable Iron
29
MACROCYTIC ANEMIA
30
The red blood cells here are normal, happy RBC's.
31
Hypersegmented neutrophils that is present with
megaloblastic anemia
32
Hypersegmented neutrophils that is present with
megaloblastic anemia
33
megaloblastic anemia
34
THANK YOU