Iron deficiency anemia is anemia caused by iron deficiency. Anemia is defined as a decrease in the number of red blood cells or the amount of hemoglobin in the blood. When the onset is slow, symptoms are often unclear, including feeling tired, weak, short of breath, or poor exercise ability. Fast-acting anemia often has greater symptoms, including: confusion, feelings such as a person will pass out, and increased thirst. A significant anemia is needed before a person becomes pale. Problems with growth and development can occur in children. There may be additional symptoms depending on the underlying cause.
Iron deficiency anemia is usually caused by blood loss, insufficient food intake, or poor iron absorption from food. Sources of blood loss can include severe periods, birth, uterine fibroids, stomach ulcers, colon cancer, and urinary tract bleeding. Poor ability to absorb iron may occur as a result of Crohn's disease or gastric bypass. In developing countries, worm parasites, malaria, and HIV/AIDS increase the risk. Diagnosis is generally confirmed by a blood test.
Prevention is to eat a diet high in iron or iron supplements in those at risk. Treatment depends on the underlying cause and may include dietary changes, medications, or surgery. Iron supplements and vitamin C may be recommended. Severe cases can be treated with blood transfusions or iron injections.
Iron deficiency anemia affects about 1.48 billion people by 2015. Lack of iron intake is thought to account for about half of all cases of anemia globally. Women and young children are most often affected. By 2015 anemia due to iron deficiency results in about 54,000 deaths - down from 213,000 deaths in 1990.
Video Iron-deficiency anemia
Signs and symptoms
Iron deficiency anemia is marked by a pale sign (decreased oxyhemoglobin in the skin or mucous membranes), and symptoms of fatigue, mild, and weak. None of these symptoms (or any of the others below) are sensitive or specific. Pale mucous membranes (especially conjunctiva) in children show anemia with the best correlation to disease, but in large studies found only 28% sensitive and 87% specific (with high predictive value) in distinguishing children with anemia [hemoglobin (Hb) & lt; 11.0 g/dl] and 49% sensitivity and 79% specific in differentiating severe anemia (Hb & l ; 7.0 g/dl). Thus, this mark is quite predictive when it exists, but it does not help when it does not exist, because only one-third to one-half of children with anemia (depending on severity) will show pallor.
Because iron deficiency anemia tends to develop slowly, adaptation occurs in the systemic effects that cause anemia, and the disease is often not recognized for some time. In severe cases, dyspnea may occur. Pica can also thrive; pagophagia has been suggested to be "the most specific for iron deficiency."
Other possible symptoms and signs of iron deficiency anemia include:
Child development
Iron deficiency anemia is associated with poor neurological development, including decreased learning ability and motor function changes. The cause is not yet established, but there is likely a long-term impact of this neurological problem.
Maps Iron-deficiency anemia
Cause
The diagnosis of iron deficiency anemia requires further investigation into the cause. This can be due to increased demand/loss of iron or decreased iron intake. For example, chronic gastrointestinal blood loss may be considered, which may be linked to possible malignancy. In infants and teenagers, rapid growth can exceed dietary intake of iron and lead to a deficiency in the absence of disease or a very abnormal diet. In women of childbearing age, heavy menstrual periods can also cause iron deficiency anemia.
Parasitic Disease
The main cause of iron deficiency anemia worldwide is a parasitic disease known as helminthiasis caused by infestation with parasitic worms (worms); Specifically, hookworm, which includes Ancolostoma duodenale Ancylostoma ceylanicum and Necator americanus, is most often responsible for causing iron deficiency anemia. The World Health Organization estimates that "about two billion people are infected with earthworms transmitted around the world." Parasitic worms cause inflammation and chronic blood loss by binding to the human small intestinal mucosa, and through the way they feed and degradation, they can eventually lead to iron deficiency anemia.
Blood loss
Blood contains iron in red blood cells, so the loss of blood leads to the loss of iron. There are several common causes of blood loss. Women with menorrhagia (heavy menstrual periods) are at risk of iron deficiency anemia because they are at a higher risk of normal loss of blood larger during menstruation than are replaced in their diet. Slow and chronic blood loss in the body - such as from peptic ulcer, angiodysplasia, colon polyp or gastrointestinal cancer, or periods that are too severe - can cause iron deficiency anemia. Gastrointestinal bleeding may result from regular use of several treatment groups, such as NSAIDs (eg aspirin), as well as anticoagulants such as clopidogrel and warfarin; However, this is needed in some patients, especially those with circumstances that cause thrombophilia.
Diet
The body usually gets the required iron from the food. If a person consumes too little iron, or a non-heme iron, they can become iron deficient over time. Examples of iron-rich foods include meat, eggs, green vegetables, and iron-fortified foods. For proper growth and development, babies and children need iron from their diet. High intake of cow's milk was associated with an increased risk of iron-deficiency anemia. Other risk factors for iron deficiency anemia include low meat intake and low intake of iron-fortified products.
Iron malabsorption
Iron from food is absorbed into the bloodstream in the small intestine, especially in the duodenum. Iron malabsorption is a less common cause of iron deficiency anemia, but many gastrointestinal disorders can reduce the body's ability to absorb iron. There are different mechanisms that may exist.
In celiac disease, abnormal changes in the duodenal structure can decrease the absorption of iron. Abnormalities or surgical removal of the stomach may also cause malabsorption by altering the acidic environment necessary for the iron to be converted into a form that can be absorbed. If there is insufficient production of hydrochloric acid in the stomach, hypochlorhidria/achlorhydria may occur (often caused by chronic H. pylori infection or long-term proton pump inhibitors), inhibit the conversion of ferrous iron to absorbable iron.
Pregnancy
Without iron supplementation, iron deficiency anemia occurs in many pregnant women because their iron stores need to serve up their own blood volume, as well as being a source of hemoglobin for the growing fetus and for placental development.
Other less common causes include intravascular haemolysis and hemoglobinuria.
Iron deficiency in pregnancy appears to cause long-term and irreversible cognitive deficits in infants.
Mechanism
Anemia can occur due to significant iron deficiency. When the body has enough iron to meet its needs (functional iron), the rest is stored for later use in cells, mostly in the bone marrow and liver. These stores are called ferritin complexes and are part of the iron metabolism system of humans (and other animals).
Iron is an important mineral in the formation of red blood cells in the body, especially as an important component of hemoglobin. After being absorbed in the small intestine, iron travels through the blood, bound to transferrin, and eventually ends up in the bone marrow, where it is involved in the formation of red blood cells. When the red blood cells are degraded, the iron is recycled by the body and stored.
When the amount of iron required by the body exceeds the amount of iron available, the body may use a ferritin for a certain period of time, and the formation of red blood cells continues normally. However, as these stores continue to be used, iron eventually runs out to the point that the formation of red blood cells is not normal. Ultimately, anemia occurs, which by definition is the value of the hemoglobin lab below normal limits.
Diagnosis
Conventionally, a definitive diagnosis requires demonstration of the depleted body iron storage obtained from bone marrow aspiration, with a stained marrow for iron. However, with the availability of reliable blood tests that can be more easily collected for the diagnosis of iron deficiency anemia, bone marrow aspiration is usually not obtained. Furthermore, a study published in April 2009 questioned the value of bone marrow iron that was stained after parenteral iron therapy.
History
The diagnosis of iron deficiency anemia will be suggested by a history that includes a common cause of the condition, such as a woman who is menstruating or occult blood (ie, hidden blood) in the stool. Travel history to areas where hookworms and worm worms are endemic may be helpful in determining a particular faecal test for their parasites or eggs.
Although symptoms may play a role in identifying iron deficiency anemia, these are often nonspecific symptoms, especially in mild cases, which may limit their contribution to diagnosis.
Blood tests
Anemia is often found by routine blood tests, which generally include a complete blood count (CBC). A fairly low hemoglobin (Hb) by definition makes the diagnosis of anemia, and a low hematocrit value is also an anemic characteristic. Further research will be conducted to determine the cause of anemia. If anemia is caused by iron deficiency, one of the first abnormal values ​​noted on the CBC, as the body's iron supply begins to decrease, it will become the widest red red cell distribution (RDW), reflecting an increase in variability in red blood cell size (red blood cells ).
A low average corpuscular volume (MCV) also appears during body thinning of the body. This shows the high number of red blood cells that are not normal. A low MCV, a low average corpuscular hemoglobin or average corpuscular hemoglobin concentration (MCH), and the corresponding appearance of red blood cells on visual examination of peripheral blood smear narrow the problem for microcytic anemia (literally, a "red blood cell small "anemia).
A person's blood smear with iron-deficiency anemia shows a lot of hypochromic (pale, relatively colorless) and small red blood cells, and may also show poikilocytosis (variation in shape) and anisocytosis (size variation). With more severe iron deficiency anemia, peripheral blood smears may show hypochromic, pencil-shaped cells and, occasionally, small amounts of nucleated red blood cells. Platelet counts may be slightly above the normal high limit of iron deficiency anemia (called mild thrombocytosis), but severe cases can occur with thrombocytopenia (low platelet count).
Iron deficiency anemia is confirmed by tests that include serum ferritin, iron serum levels, serum transferrin, and total iron binding capacity (TIBC). Low serum ferritin is most commonly found. However, serum ferritin may be elevated by all types of chronic inflammation and thus not consistently decreased in iron deficiency anemia. Serum iron levels can be measured, but serum iron concentrations are unreliable as measurements of serum iron and serum binding serum (TIBC) serum levels. The ratio of iron serum to TIBC (called iron saturation or transferrin saturation index or percent) is a value with a prescribed parameter that can help to confirm the diagnosis of iron deficiency anemia; However, other conditions should also be considered, including other types of anemia.
Another finding that can be used is the level of free erythrocyte protoporfirin (FEP). During the synthesis of hemoglobin, the amount of trace zinc will be inserted into protoporphyrin in place of less iron. We can separate the protoporfirin from the zinc maize and measure it, known as FEP, giving an indirect measurement of the zinc-protoporphyrin complex. FEP levels are expressed in whole blood glu dl or g/dl RBC. Iron insufficiency in bone marrow can be detected very early by increased FEP.
Further tests may be needed to distinguish iron deficiency anemia from other disorders, such as minor thalassemia. It is important not to treat people with thalassemia with iron supplements, as this can cause hemochromatosis. Hemoglobin electrophoresis provides useful evidence to distinguish these two conditions, along with iron studies.
Screening
It is unclear whether screening of pregnant women for iron deficiency anemia during pregnancy improves outcomes in the United States. The same applies to screening children aged "6 to 24 months".
Treatment
When treating iron-deficiency anemia, consideration of appropriate treatment methods is done considering the "cause and severity" of the condition. If iron deficiency anemia is a downstream effect of blood loss or other causes, treatment is directed to address the underlying cause whenever possible. In severe acute cases, treatment measures are taken for immediate management, such as blood transfusions or even intravenous iron.
Treatment of iron deficiency anemia for less severe cases includes dietary changes to include iron-rich foods into oral intake. Foods rich in ascorbic acid (vitamin C) can also be beneficial, as ascorbic acid increases the absorption of iron. Another oral option is iron supplements in the form of pills or drops for children.
Because iron deficiency anemia becomes more severe, or if anemia does not respond to oral care, other measures may be necessary. In addition to the previously mentioned indications for iron or intravenous blood transfusion, intravenous iron may also be used when oral intake is not tolerated, as well as for other indications. In particular, for those who undergo dialysis, parenteral iron is commonly used. Individuals on dialysis who take the form of erythropoietin or some "erythropoiesis stimulant agent" are given parenteral iron, which helps the body respond to erythropoietin agents and produce red blood cells.
Various forms of treatment are not without the possible side effects. Iron supplements by mouth generally cause negative gastrointestinal effects, including constipation. Intravenous iron can induce an allergic response that can be as serious as anaphylaxis, although different formulations have reduced the likelihood of this adverse effect.
Epidemiology
The moderate rate of iron-deficiency anemia affects about 610 million people worldwide or 8.8% of the population. It is slightly more common in women (9.9%) than in men (7.8%). Mild iron deficiency anemia affects another 375 million.
The prevalence of iron deficiency as a cause of anemia varies between countries; in the group where the most common anemia, including children and a subset of nonpregnant women, iron deficiency accounts for a small proportion of cases of anemia in these groups ("25% and 37%, respectively"). Iron deficiency is a common cause of anemia in other groups, including pregnant women.
In the United States, iron deficiency anemia affects about 2% of adult men, 10.5% Caucasian women, and 20% African-American and Mexican-American women.
References
External links
- Importance of Iron - From IronTherapy.Org
- Interactive material on Iron Metabolism - From IronAtlas.com
- Sets the cause of anemia - From AnaemiaWorld.com
- Handout: Iron Deficiency Anemia - From the National Anemia Action Council
- NPS News 70: Iron deficiency anemia: NPS - Better choice, better health - From National Prescription Service
Source of the article : Wikipedia
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