Management Of Iron Deficiency Anemia.

Lab Findings:

With strong history relevance and clinical suspicion, we can highly suspect Iron Deficiency Anemia.
Following are the investigation required to confirm anemia.
1) Complete Blood Picture
It will show microcytosis, hypochromia, poikilocytosis, nucleated RBCs i-e
Decreased Hb
Decreased MCV
Decreased MCH
Increase RDW
Lower Reticulocytes
2) Decrease in Serum Ferratin
3) Increase in TIBC
4) Occult blood in stool examination can be seen in early cow milk ingestion.

TREATMENT:

DIETARY MODIFICATION:

It include dark green leafy vegetables like Spinach, Apples, Appricots, Dates, Olives, Mushrooms.

ORAL THERAPY;

Ferrous Sulphate Tablets is most common method of therapy. 

Dosage: 5mg per kg per day in two divided doses.

CONSIDERATIONS:

A) Limit Milk. It will increase dietary iron.

Peripheral Reticulocytosis occurs within 72-96 hours while increase in hemoglobin occurs over 4-30 days.

B) Continue iron for 8 weeks after blood values normalize because depletion of iron occurs in 1 to 3 months after start of treatment.

PARENTERAL THERAPY:

Indications of Parenteral Therapy includes:

1) Malabsorbtion Syndrom

2) Those who cannot tolerate oral therpy.

BLOOD TRANSFUSSION:

Blood transfusion is the most effective method to deliver iron but is not standard method of correcting iron deficiency anemia.

In case of Parasite infestation, Albandazole or Mebendazole or other anti-parasitic drugs are given.

Pale skin is sign of Iron Deficiency Anemia.

The most typical signs of anemia are pale skin.
A common symptom associated with iron deficiency is pale skin. As your iron levels are depleted, your body is unable to manufacture the chemical hemoglobin, a reddish compound, which is an essential part of red blood cells. When this occurs, you develop a condition called iron deficiency anemia. As anemia worsens, your skin begins to lose its normal color and become pale. If you notice that your skin is paler than usual, consult a doctor and ask about iron deficiency and anemia.

Chest Pain is a Symptom of Iron Deficiency Anemia.

Iron Deficiency Anemia can lead to chest pain leading to heart attack. Older people with iron deficiency anaemia may get angina (pain in the chest) because the heart has to work harder to supply enough oxygen to the body.

Extreme fatigue (tiredness) is symptom of Iron Deficiency Anemia.

Iron is an essential nutrient, critical for producing hemoglobin, the substance in red blood cells that transports oxygen all over the body. If you don¹t have enough iron, your body has to work a whole lot harder to get the energy it needs, which can leave you feeling tired, weak, irritable and unable to focus.
Many equate iron deficiency with anemia, the condition in which your body has a lower than normal number of red blood cells. But research shows that there's a whole other category of iron deficiency that precedes anemia. To diagnose it, a blood test must measure ferritin levels, the iron stores in your blood.

Your Nails can tell about your disease !!!

Your nails can tell about your disease. Some of them can be checked with the following table.

Nail Appearance	Associated Condition
White nails	Liver diseases, such as hepatitis
Yellowish, thickened, slow-growing nails	Lung diseases, such as emphysema
Yellowish nails with a slight blush at the base	Diabetes
Half-white, half-pink nails	Kidney disease
Red nail beds	Heart disease
Pale or white nail beds	Anemia
Pitting or rippling of the nail surface	Psoriasis or inflammatory arthritis
"Clubbing," a painless increase in tissue around the ends of the fingers, or inversion of the nail	Lung diseases
Irregular red lines at the base of the nail fold	Lupus or connective tissue disease
Dark lines beneath the nail	Melanoma

Brittle Nails is a Sign of Iron Deficiency Anemia

 Brittle Nails is a Sign of Iron Deficiency Anemia

If you have brittle nails, you may be suffering from the most common form of anemia: iron deficiency. According to the U.S. National Library of Medicine, 20 percent of all women, 50 percent of pregnant women and 3 percent of men lack the right amount of iron. Your treatment program depends upon the cause of your iron shortage.

Iron & Your Nails

Your fingernails and toenails, consisting of hardened layers of protein called keratin, serve to protect the soft tissue of your fingers and toes. The Mayo Clinic says that when you suffer from anemia caused by iron deficiency, your body can't produce enough hemoglobin--the substance in red blood cells that carries oxygen throughout your system. This lack of oxygen prohibits the healthy growth of your nails.

Important Iron Deficiency Anemia Signs and Symptoms

• Clinical Presentation
  • Iron-deficiency anemia can cause:
  • brittle nails
  • cracks in the sides of the mouth
• • Extreme fatigue (tiredness)
  • chest pain
• • Pale skin
  • Dizziness or lightheadedness
• • Fast heart rate
  • Headache
• • an enlarged spleen
  • Cold hands and feet
  • Frequent infections.
  • Irritability
  • Shortness of breath
  • Swelling or soreness of the tongue
• • An unusual craving for non-nutritive substances such as:
  • Ice
  • Dirt
  • Paint or starch.
  • This craving is called pica.
  • Some people who have iron-deficiency anemia develop restless legs syndrome (RLS). RLS is a disorder that causes a strong urge to move the legs.
• • Some signs and symptoms of iron-deficiency anemia are related to the condition's causes.
  • A sign of intestinal bleeding is bright red blood in the stools or black, tarry-looking stools.
  • Very heavy menstrual bleeding, long periods, or other vaginal bleeding may suggest that a woman is at risk for iron-deficiency anemia.
• • Severe iron-deficiency anemia can lead to:
  • Problems with growth and development
  • in children
  • Angina (chest pain)
  • Leg pains (intermittent claudication)

Understanding Macrocytic Hypochromic Anemia

Macrocytic hypochromic anemia is a blood disorder which can cause a wide variety of complications if not treated properly. This health problem is characterized by abnormally large red blood cells. These, in turn, carry abnormally high levels of hemoglobin, which is responsible for the transport of oxygen throughout the body. In addition to the abnormal size of the red blood cells, people who suffer from this form of anemia also have fewer of these cells than a healthier person would. While this disorder is not necessarily life-threatening, it does need to be monitored to avoid the development of additional health problems.

What are the Symptoms of Macrocytic Hypochromic Anemia?

The early symptoms of this disorder are quite mild, and as such may be mistaken for a cold or flu. Shortness of breath after exercise, tiredness, lightheadedness, headaches and fatigue are some of the early symptoms. When these symptoms develop into headaches, loss of appetite, difficulty in concentrating, and sleeping problems it may be necessary to contact a doctor. Unfortunately, most people will brush these off as a symptom of a weakened immune system and will try to treat themselves at home.

In later stages, this type of anemia causes more noticeable health problems. Brittle nails, pale lips, and a sore mouth are all an indication of this blood disorder. A person suffering from this disease will also notice that they have a rapid or irregular heartbeat, chest pain, and difficulty swallowing. All of these symptoms can be particularly alarming at first, which is why an expert opinion must be sought.

If there is any suspicion of this disorder, patients should seek medical assistance. Leaving the problem for too long could cause irreparable damage to the liver and other vital organs. If caught in the early stages,the disorder can easily be treated. If, however, the patient leaves the problem unaddressed, more extensive treatment may be needed to repair additional damage to the body.

What is the Treatment for Macrocytic Hypochromic Anemia?

Generally, doctors will need to determine the underlying cause of the disorder before they can prescribe a course of treatment. In most cases, B12 supplementation will be the first course of action. People suffering from this form of anemia will need to adjust their diets to ensure that they have an adequate intake of B12 and folates. More often than not, B12 injections will also become an everyday part of their lives.

Three of the major causes of this condition are pancreatitis, blind-loop syndrome, and Zollinger-Ellison syndrome. Each of these three health problems need to be addressed separately from the anemia. In some cases, treating the underlying cause will eliminate the symptoms of the blood disease. In other cases, the anemia will need to be treated in addition to the treatment program already in place.

Alcoholism and liver disease can also be responsible for the onset of the disease. In these cases, patients will need to completely eliminate any intake of alcohol in order to lessen the symptoms of the blood disorder. Again, B12 supplementation will be the treatment chosen for the disorder.

Iron Deficiency Anemia

What is iron Deficiency Anemia:

It is a common anemia in which  hemoglobin levels are low due to insufficient dietary intake and absorption of iron, and/or iron loss from bleeding which can originate from a range of sources such as the intestinal, uterine or urinary tract.

Common Causes:

In Pediatrics Age Group:

1) Dietary Deficiency

2) Large Consumption Of Cow Milk

3) Parasite Infestations like Hook Worm

In Adult Age Group:

1) During growth spurt

2) Dietary Deficiency

3) Malabsorption Syndrome

4) Menstruation

Etiological Classification of Anemia

Etiological Classification of Anemia:

This includes 3 Main types :
A. Impaired RBC production
B. Excessive destruction
C. Blood loss

A.Impaired RBC Production:

1. Abnormal bone marrow
1.1 Aplastic anemia
1.2 Myelophthisis : Myelofibrosis, Leukemia, Cancer metastasis
2. Essential factors deficiency
2.1 Deficiency anemia : Fe, Vit. B12, Folic acid, etc
2.2 Anemia in renal disease : Erythropoietin
3. Stimulation factor deficiency
3.1 Anemia in chronic disease
3.2 Anemia in hypopituitarism
3.3 Anemia in hypothyroidism

B.Excessive Destruction of RBC:

Hemolytic anemia

1. Intracorpuscular defect

1.1 Membrane : Hereditary spherocytosis Hereditary ovalocytosis, etc.
1.2 Enzyme : G-6PD deficiency, PK def., etc.
1.3 Hemoglobin : Thalassemia, Hemoglobino- pathies

2. Extracorpuscular defect

2.1 Mechanical : March hemolytic anemia MAHA (Microangiopathic HA)
2.2 Chemical/Physical
2.3 Infection : Clostridium tetani
2.4 Antibodies : HTR, SLE
2.5 Hypersplenism

C.Blood Loss:

 1. Acute blood loss : Accident, GI bleeding
 2. Chronic blood loss : Hypermenorrhea Parasitic infestation

Classification of Anemia?

Types and sub types of Anemia:

 I. Etiologic Classification
1. Impaired RBC production
2. Excessive destruction
3. Blood loss
II. Morphologic Classification
1. Macrocytic anemia
2. Microcytic hypochromic anemia
3. Normochromic normocytic anemia

What is Anemia?

Definition of Anemia:

 Anemia is defined as a condition in which there is a deficiency of red cells or of haemoglobin in the blood, resulting in pallor and weariness