1. Causes
1.1. Dietary deficiency, impaired absorption, increased requirement, chronic blood loss, , surgical procedures,
2. Diagnostic tests
2.1. Serum ferritin <30 ng/mL
2.1.1. widely used measurement of iron status
2.2. Free erythrocyte protoporphyrin (FEP)
2.3. Serum transferrin receptor (sTfR)
2.4. Transferrin saturation <19%
2.5. Bone marrow biospy
2.5.1. Iron staining
3. Common Findings/Manifestations
3.1. Earrly Symptoms:
3.1.1. Fatigue, weakness, shortness of breath, pale earlobes/palms/conjuntivae
3.2. Later Symptoms
3.2.1. Fingernails become brittle, thin, coursely ridged, "spoon shaped" or concave koilonychia, pain, angular stomatitis, difficulty swallowing, gastritis, vasomotor disturbances, and neuromuscular disturbances. restless leg syndrome
4. Key Points
4.1. Iron Deficiency Anemia (IDA) is the most common type of nutritional disorder worldwide
5. Prevlance
5.1. Iron deficiency anemia affects >12% of the worlds population
6. Metabolic/Functional Pathophysiology
6.1. Insufficient iron delivery to bone marrow
6.2. Impaired use of iron within bone marrow
7. Pathophysiologic etiolgy
7.1. hypochromic-microcytic anemia
7.1.1. RBCs are abnormally small with low levels of hemoglobin
7.2. When the body's iron demand exceeds that of its supply
7.3. Two Types
7.3.1. Iron store depletion
7.3.2. metabolic/functional
8. Risk Factors
8.1. Bariatric patients, Use of arpirin, Use of NSAIDs, eating disorders,
9. Treatments
9.1. Severe or Life-threatening?
9.1.1. RBC Transfusion
9.2. Not Life-threatening
9.2.1. IV Iron
9.2.1.1. Iron dextran
9.2.2. Oral Iron
9.2.2.1. Ferrous sulfate
9.2.2.2. Ferrous gluconate
9.2.2.3. Ferrous fumarate
9.2.2.4. Polysaccharide iron
10. Findings
10.1. Low RBC, Low hemoglobin, Low hematocrit, Low absolute reticulocyte count, Low MCV, Low MCH
11. Infection/Inflammation
11.1. Inflammatory response of body in response to infection may contribute to an acute form of IDA
11.1.1. Iron regulates immune effector mechanisms
11.1.1.1. Cytokine activity
11.1.1.2. Nitric oxide formation
11.1.1.3. T-cell proliferation
12. Iron Store Depletion Pathophysiology
12.1. Inadequate dietary intake
12.2. Excessive blood loss
12.2.1. depleting iron stores faster than replacing combined while increasing bodys demand for iron