Anaemia
Content
• Anaemia
• Classification of anaemia
• Etiology of iron deficiency anaemia
• Pathogenesis of IDA
• Clinical features
Objective
At the end of this PDF Notes, students able to
• Explain different types of haematological
diseases
• Explain the etiology of iron
deficiency anaemia
• Elaborate the pathogenesis of iron
deficiency anaemia and its treatment
Haematological diseases
BLOOD
• Components of Blood
Anemia
• Condition in which the oxygen-carrying capacity of blood is reduced
• Characterized by reduced numbers of RBCs or a decreased amount of
hemoglobin in the blood
General manifestations of anemia
Reduced oxygen delivery can result in the
following:
• Ischemia
• Fatigability
• Breathlessness upon exertion
• Exercise intolerance
• Pallor
• Increased susceptibility to infection
Classification of Anemia
1) Based on Size changes
2) Color changes (due to altered hemoglobin
content)
• Normochromic — Normal hemoglobin concentration
• Hypochromic — Reduced
hemoglobin concentration
Example: Iron deficiency anemia may be
classified as a microcytic, hypochromic anemia as both red blood cell size and
hemoglobin content are reduced
3) Blood loss anemia: Anemia that results from acute blood loss.
4) Iron-deficiency anemia: It can occur as a result of iron-deficient
diets
5) Cobalamin-deficiency or folate-deficiency anemia
6) Inherited anemia- Sickle cell anaemia
Iron Deficiency Anemia
• The commonest nutritional deficiency disorder present throughout the
world is iron deficiency
Absorption
• Haem iron is better in absorption than non haem iron
• Non-haem iron is released as ferrous or
ferric form
• Transport across the membrane by divalent metal transporter 1 (DMT
1)
TRANSPORT:
• Iron
is transported in plasma bound to a β-globulin, transferrin, synthesised
in the liver
• Transferrin bound iron utilise for haemoglobin synthesis.
• Transferrin is reutilised after iron is released from it.
EXCRETION:
The body is unable to regulate its iron
content by excretion alone. The amount of iron lost per day is 0.5-1 mg.
DISTRIBUTION. In an adult, iron is distributed in the body as under:
• 1. Haemoglobin—(65%).
• 2. Myoglobin—(3.5%).
• 3. Haem and non-haem enzymes—(0.5%).
• 4. Transferrin-bound iron—(0.5%)
• 5. Ferritin and haemosiderin—a (30%).
Iron absorption
Pathogenesis of Iron deficiency anaemia
• Iron deficiency anaemia develops when the supply of iron is
inadequate for the requirement of haemoglobin synthesis.
• The development of iron deficiency depends upon one or more of the following factors:
Etiology of Iron deficiency anaemia
I. INCREASED BLOOD LOSS
1. Uterine e.g. excessive
menstruation in reproductive years, repeated miscarriages, at onset of
menarche, post-menopausal
uterine bleeding
2. Gastrointestinal e.g. peptic
ulcer, haemorrhoids, hookworm infestation, cancer of stomach and large bowel,
oesophageal varices, hiatus hernia, chronic aspirin ingestion, ulcerative
colitis, diverticulosis
3. Renal tract e.g. haematuria,
haemoglobinuria
4. Nose e.g. repeated epistaxis
5. Lungs e.g. haemoptysis
II. INCREASED REQUIREMENTS
1. Spurts of growth in infancy, childhood
and adolescence
2. Prematurity
3. Pregnancy and lactation
III. INADEQUATE DIETARY INTAKE
1. Poor economic status
2. Anorexia e.g.
in pregnancy
3. Elderly individuals due to poor
dentition, apathy and financial constraints
IV. DECREASED ABSORPTION
1. Partial or total gastrectomy
2. Achlorhydria
3. Intestinal malabsorption such as in
coeliac disease
Clinical Features of Iron deficiency anaemia
• Iron deficiency anaemia is much more common in women between the age
of 20 and 45 years than in men
• More frequent in premature infants.
Clinical consequences of iron deficiency:
1)anemia
2)epithelial tissue changes
Treatment of Iron deficiency anaemia
The management of iron deficiency anaemia
consists of 2 essential principles:
1) Correction of disorder causing the anaemia: checkup and
investigations.
2) 2)Correction of iron deficiency: i) Oral therapy
ii) Parenteral therapy
Summary
• Anaemia is the condition in which the oxygen-carrying capacity of
blood is reduced
• Characterized by reduced numbers of RBCs or a decreased amount of
hemoglobin in the blood
• The commonest nutritional deficiency disorder present throughout the
world is iron deficiency
• Iron deficiency anaemia develops when the supply of iron is inadequate for the requirement of haemoglobin synthesis
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