Iron Deficiency Anemia (Causes, Signs, Symptoms, investigation, Treatment)

Iron deficiency anemia is commonest cause of anaemia and is a a microcytic hypochromic anemia.

CAUSES:

Increased requirement in infancy pregnancy chronic infections etc. Due to blood loss in menorrhagia , bleeding due to hookworms, hemoptysis theatres hernia, peptic ulcer, epistaxis, haemophilia, bleeding disorders, and frequent blood donations.

Inadequate dietary intake : in poor economic status, anorexia.
Decrease iron absorption in gastrectomy and intestinal malabsorption.


CLINICAL FEATURES:

SYMPTOMS :


1) Tiredness , fatigue , pounding in ears.
2) Syncope.
3) weakness.
4) lethargy.
5) loss of appetite.
6) Breathlessness.
7) Epigastric discomfort.
8) Pallor, post urinal discomfort.



SIGNS:

1) angular stomatitis.
2) spoon shaped nails.
3) pale tongue.
4) glossitis.
5) hepatosplenomegaly.
6) plummer vinson syndrome.
7) raised Central venous pressure.
8) basal crackles.
9) bilateral ankle edema.
10) orthopnoea,PND.




INVESTIGATION:



every case of anaemia should have the following investigation to detect degree and cause of anaemia.

• Hemoglobin count decreases.
• RBC count, packed cell volume, mean corpuscular volume, mean corpuscular hemoglobin concentration. Total leukocyte count and differential leukocyte count.
• Peripheral blood film for type of anemia and ID ID shape of RBCs and ID presence of any abnormal cells.
• Clotting time and bleeding time in hemolytic anemia blood platelets.

Bone marrow examination is done when cause of the the disease required for the investigation specially to detect type of erythropoiesis.

Other investigations.

• Tools for parasites: test for presence of blood and stools are done in patients suspected to chronic blood loss.
• Urine for albumin, bile salt, pigments and urobilinogen.
• Gastric analysis: histamine fast achlorhydria in pernicious anemia and megaloblastic anemia .

MANAGEMENT :

• Normal iron Level - 50- 150mg.
• Proper physical and mental rest.
• Good nourishing diet and supplementation food rich in iron.
• Oral Iron therapy : iron solbitol citric acid complex 1.5 mg/kg body weight is given as IM/IV iron dextran in 5% of glucose is given.
• Blood Transfusion : Transfusion of packed Red cells is given.