IRON DEFICIENCY ANEMIA (IDA)

Definition:
It is a common type of anemia caused by insufficient dietary intake and absorption of iron, and/or loss from bleeding which can originate from a range of sources such as the intestinal, uterine or urinary tract.

IRON DEFICIENCY ANEMIA

• As the name implies, iron deficiency anemia is due to insufficient iron.
• Without enough iron, the body can’t produce enough of a substance in red blood cells that enables them to carry oxygen (hemoglobin).
• As a result, iron deficiency anemia may leave a patient tired and short of breath.

AETIOLOGY (IDA)

• Inadequate intake of iron & of food, which enhances iron absorption.
• High intake of inhibitors of iron absorption.
• Hookworm infestation.
• Blood loss (heavy menses & use of aspirin & NSAID).
• High fertility rate in women.
• Low iron stores in newborns.

DIAGNOSIS OF IDA

• Clinically

  • ➢ Symptoms: fatigue, dizziness, palpitations
  • ➢ Signs: pallor, smooth tongue, Koilonychia, splenomegaly.

• Laboratory

  • Stainable iron in bone marrow
  • Response to iron supplements

Diagnosis of IDA

• Mild anemia may have no or very limited symptoms.
• As hematocrit approaches 30%: fatigue and poor exercise tolerance
• As hematocrit lowers to 25%: tachycardia, palpitations, dyspnea on exertion, and pallor.
• More severe anemia results in:
  • lightheadedness
  • confusion
  • syncope
  • chest pain
  • A systolic ejection murmur (“flow” murmur).
• Symptoms specific to iron deficiency are rare:
  • brittle nails
  • spoon-shaped nails
  • glossitis
  • pica.
• Iron deficiency anemia as a specific diagnosis is determined by laboratory findings, not symptoms.

LAB FINDINGS IN IDA

• Microcytic hypochromic anaemia
• Low Hb level (< 11.0 g/dl)
• Low MCV, MCH, MCHC
• Low serum ferritin
• High RDW more than 16% denoting anisocytosis
• High iron binding capacity

Normal Blood Film

Treatment

• Oral administration of simple ferrous salt:
  • 6 - 10 mg / kg / day of elemental iron.
• Parenteral iron is seldom indicated.
• Severely anemic children with HB level
  • < 4 gm / dl may be given blood transfusion.
• Dietary education.
• Treat the underlying cause.

Prevention

• Adequate diet include vegetables rich in iron, meat and vitamins for full term infants.

• Administration of iron (2 mg/kg) from the age of 2 months for low birth weight and premature infants.