Iron Deficiency Anemia - All you need to know - Causes, Symptoms, Diagnosis, Treatment

Summary

This video delves into iron deficiency anemia, the most common form of anemia worldwide. It explains the causes, including nutritional deficiencies, malabsorption, blood loss, and increased demand, especially in high-risk groups like women, children, and the elderly. Symptoms include fatigue, pallor, and irritability, with additional signs like restless leg syndrome and spoon-shaped nails. Diagnosis involves blood tests, with low MCV and ferritin levels. Treatment usually starts with oral iron supplements, but may require IV or IM iron if oral methods fail. The video emphasizes the importance of accurate diagnosis and the complexities of managing this common condition.

Takeaways

• 😀 Iron deficiency anemia is the most common anemia worldwide, often caused by nutritional deficiencies in developing countries and blood loss (e.g., peptic ulcer disease) in developed countries.
• 😀 Risk factors for iron deficiency anemia include menstruation (especially in females), children with high iron demands, strict vegans, and premature infants.
• 😀 The causes of iron deficiency anemia can be categorized as decreased supply (e.g., malabsorption, nutritional deficiency), increased demand (e.g., pregnancy, growth), or blood loss (e.g., GI bleeding, hookworm infections).
• 😀 In iron deficiency anemia, hemoglobin, hematocrit, MCV, MCH, and MCHC are all decreased, while reticulocytes are low due to insufficient iron for RBC production.
• 😀 Key lab findings in iron deficiency anemia include low serum iron, low ferritin, high TIBC, decreased iron saturation, and high RDW due to the variability in RBC sizes.
• 😀 Ferritin, an acute phase reactant, may be falsely elevated if there is concurrent inflammation, making the soluble transferrin receptor (STFR) a more reliable diagnostic marker.
• 😀 The gold standard for diagnosing iron deficiency anemia is a bone marrow biopsy, though a simpler approach is to trial iron supplementation and observe if the patient improves.
• 😀 Common clinical signs of iron deficiency anemia include fatigue, pale skin, weakness, irritability, and potential associations like Plummer-Vinson syndrome, restless leg syndrome, and pica (craving for non-food items like ice).
• 😀 Iron deficiency anemia can cause specific physical symptoms like spoon-shaped nails (koilonychia) and beeturia (red urine after eating beets).
• 😀 Treatment of iron deficiency anemia typically begins with oral ferrous sulfate, with potential side effects like constipation, diarrhea, and black stools. If oral iron fails, IV or IM iron may be used, but anaphylaxis is a risk with certain formulations.

Q & A

What is the most common cause of iron deficiency anemia in the developing world?

In the developing world, the most common cause of iron deficiency anemia is nutritional deficiency, often due to inadequate dietary intake of iron.

What are the two types of iron mentioned in the script, and which one is better absorbed?

The two types of iron mentioned are heme iron (found in meat) and non-heme iron (found in vegetables). Heme iron is better absorbed than non-heme iron.

What role does hydrochloric acid (HCl) play in iron absorption?

Hydrochloric acid (HCl) is essential for converting ferric iron (Fe3+) into ferrous iron (Fe2+), which is more readily absorbed by the body.

How does the body respond to iron deficiency in terms of transferrin and ferritin?

In response to iron deficiency, transferrin (the carrier protein) increases to try to capture more iron, while ferritin (the storage form) decreases due to a lack of iron.

What is the primary reason for iron deficiency anemia in pregnant women?

Pregnant women are at high risk for iron deficiency anemia because they require more iron to support both their own body and the developing fetus, increasing iron demand.

What are some of the common symptoms associated with iron deficiency anemia?

Common symptoms of iron deficiency anemia include fatigue, pallor (paleness), weakness, irritability, and exercise intolerance. Other symptoms may include angina, murmurs, and restless leg syndrome.

What is Pica, and how is it associated with iron deficiency anemia?

Pica is the craving for non-nutritional substances like ice or dirt, and it is associated with iron deficiency anemia. A specific form, pagophagia, is the craving for ice.

What is the most accurate diagnostic test for iron deficiency anemia?

The most accurate diagnostic test for iron deficiency anemia is a bone marrow biopsy, although it is typically not used as the first diagnostic tool due to its invasive nature.

Why might a patient with iron deficiency anemia have a high RDW (red cell distribution width)?

The RDW is often high in iron deficiency anemia because the red blood cells vary in size as the bone marrow gradually produces smaller cells due to a lack of iron.

What should be done if oral iron supplementation fails in treating iron deficiency anemia?

If oral iron supplementation fails, intramuscular (IM) or intravenous (IV) iron can be administered. However, a potential side effect of IV iron is anaphylaxis, especially with certain preparations like dextran.