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MLAB 1315- Hematology Keri Brophy-Martinez

MLAB 1315- Hematology Keri Brophy-Martinez. Unit 9: Iron Metabolism and Hypochromic Anemias. Iron Metabolism. Primary function of iron is oxygen transport Iron absorption and storage is influenced by: The amount and type of available iron in the diet

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MLAB 1315- Hematology Keri Brophy-Martinez

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  1. MLAB 1315- HematologyKeri Brophy-Martinez Unit 9: Iron Metabolism and Hypochromic Anemias

  2. Iron Metabolism • Primary function of iron is oxygen transport • Iron absorption and storage is influenced by: • The amount and type of available iron in the diet • Incomplete absorption due to GI tract problems • Current iron stores • Increased demand (pregnancy, the growth years) • Excessive loss due to acute or chronic hemorrhage • menstrual period for women of childbearing years, GI bleeding for men

  3. Clinical Syndromes of Iron Metabolism • Iron Deficiency Anemia (IDA) • This is the most common form of anemia. • IDA occurs when the iron stores in the body are inadequate to preserve homeostasis. • Peripheral blood smear in IDA is microcytic-hypochromic. If IDA is caused by bleeding, leukocytosis and thrombocytosis are possible. • Typical lab findings in addition to low RBC, Hgb, Hct, MCV, MCH, MCHC: • to normal retic • Serum iron • ↑ Total iron-binding capacity (TIBC) • ↓ Serum ferritin

  4. Clinical Syndromes of Iron Metabolism • Dysfunction of Iron Utilization • Usually this is due to an existing disease condition and is known as anemia of chronic disease. This will be discussed in a later section.

  5. Clinical Syndromes of Iron Metabolism • Iron Excess and Sideroblastic States • Hemosiderosis - accumulation of excess iron in tissue macrophages which could be due to organ bleeding • Hemochromatosis • Hereditary condition caused by increased iron absorption which deposits in vital organs such as the liver, spleen and pancreas which then become fibrotic. • People with this take on a bronze color. • Therapy consists of iron removal by therapeutic phlebotomy or chelation

  6. Clinical Syndromes of Iron Metabolism • Iron Excess and Sideroblastic States • Sideroblastic anemia • Primary is genetic • Secondary caused by: • Certain therapeutic drugs • Chronic transfusions (for aplastic anemia, leukemia, thalassemia) • Alcoholism and food fads • Use of iron utensils or increased iron in water • Diagnostic lab finding is ringed sideroblasts in the bone marrow and Pappenheimer bodies in peripheral blood.

  7. Clinical Syndromes of Iron Metabolism • Iron Excess and Sideroblastic States • Lead poisoning • Lead interferes with iron storage in the mitochondria • Lead damages the activity of enzymes used for heme synthesis (basophilic stippling)

  8. Clinical Syndromes of Iron Metabolism • Heme synthesis • Porphyria - excessive production of porphyrins in the bone marrow (or liver) • Rare disease caused by accumulation of porphyrins in developing RBC’s • Characterized by dermal photosensitivy and rash caused by the sun. The original werewolf was probably a person with erythropoietic porphyria.

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