Iron deficienc y anemia

1. Iron deficiency anemia Jiang shayi

2. iron transferrin bloodstream Ferritin hemosiderin myoglobin coenzyme

3. diet Red blood cells 63% Muscle 3.5% Coenzyme 0.4% Blood stream 0.4% Storage pool 38% cells

4. iron + protoporphyrin hemoglobin

5. pathogenesis Hypochromic anemia protoporphyrin ferritin Abnormality of CBC Free erythrocyte protoporphyi ↑ Serum ferrtin ↓

6. cause • Blood loss (polyp intestinal, meckel devirticulum, hookworm disease) • A lack of iron in diet • An inability to absorb iron • Less iron storage

7. Clinical l manifestation • Pale skin color • Fatigue, irritability, dizziness, weakness, • shortness of breath in severe patient • Poor appetite, especially in infants and children with iron deficiency anemia

8. Clinical manifestation • pica persistent eating of non-food items for a period of at least one month. Including dirt, clay, soap, chalk, burnt matches

9. Clinical manifestation • koilonychia Lost convexity Flat or concave

10. Laboratory examination • Serum iron (SI) • Serum iron binding capacity • Serum ferritin (SF) • Biopsy of bone marrow • Complete blood count (CBC)

11. Complete blood count • Mean corpuscular volume (MCV) • Mean corpuscular hemoglobin(MCH) • Mean corpuscular hemoglobin concentration(MCHC)

13. A normal peripheral blood smear indicates the appropriate appearance of red blood cells, with a normal zone of central pallor .

14. Iron deficiency anemia

15. the MCV of the red blood cells is decreased, the zone of central pallor is increased

17. Biopsy of bone marrow——iron stain Normal iron stores Reduced iron stores

18. Diagnosis • Patient history • Clinical manifestation • Complete blood count and iron metabolism tests • Clinical trial of iron supplementation

19. Diagnosis • Determination of etiology Primary disease, such gastrointestinal malformation

20. Differential diagnosis • Thalassemia • Pulmonary hemosiderosis • Sideroblastic anemia

21. Thalassemia • Family history • Unusuall facies • Splenomegaly, hepatomegaly • Target cell • HbF, HbA or HbH, Hb Barts elevate

22. thalassemia

23. Pulmonary hemosiderosis • moderate to severe hypochromic anemia • recurrent pulmonary hemorrhage of unknown cause • cough, coughing up blood (hemoptysis) • lung tissue changes.

24. Sideroblastic anemia • Hypochromic anemia • Iron test are normal or increased • Bone marrow ringed sideroblast

25. Sideroblastic anemia

26. Therapy • Diet • Eating iron fortified food • Breast and cow’s milk are low in iron • Iron is better absorbed from breast milk than cow’s milk • Formula milks (配方奶)are fortified with iron

27. Therapy • Supplement therapy • Ferrous sulfate • Dextran-iron • elemental iron 3-6mg/kg/d • Therapy should be continued for 3 months

28. Therapy • Treating for primary disease

29. Summary metabolism mechanism cause tests manifastation diagnosis therapy

30. 谢谢！