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Iron-deficiency Anemia
The causes of iron deficiency anemia
The causes of iron deficiency anemia primarily refer to the disruption of the normal dynamic balance between iron absorption and excretion, leading to the consumption of stored iron as well as an increased need for iron and insufficient iron intake, especially in cases of chronic blood loss, resulting in a long-term negative iron balance. The causes of iron deficiency can be divided into two main aspects: insufficient iron intake and excessive iron loss. In the first aspect, decreased iron intake includes dietary insufficiency, meaning inadequate food intake, and reduced absorption, which includes decreased absorption due to lack of stomach acid and reduced absorption following gastric surgery. Excessive iron loss includes the following eight aspects: 1) gastrointestinal bleeding, which includes bleeding caused by tumors, gastrointestinal ulcers, gastritis, as well as bleeding due to parasites and hookworm infections. It also includes bleeding caused by hemorrhoids in men and arteriovenous malformations; 2) excessive menstrual bleeding; 3) frequent blood donations; 4) multiple pregnancies in women; 5) chronic intravascular hemolysis causing hemoglobinuria; 6) hereditary hemorrhagic telangiectasia; 7) primary pulmonary hemosiderosis; and 8) coagulation disorders or the use of anticoagulants leading to iron deficiency. These eight categories all result from excessive loss of iron, causing iron deficiency which leads to iron deficiency anemia.
How is iron deficiency anemia diagnosed?
The diagnosis of iron deficiency anemia includes two aspects: one is to establish whether there is anemia caused by iron deficiency, and the other is to clarify the cause of the iron deficiency. First, we need to carefully inquire and analyze the medical history, combined with the patient's physical examination, which can provide a series of clues for diagnosing iron deficiency anemia. A definitive diagnosis also requires laboratory evidence. Clinically, we can divide iron deficiency and iron deficiency anemia into three stages: iron deficiency, iron-deficient erythropoiesis, and iron deficiency anemia. The following describes the diagnostic criteria for iron deficiency anemia specifically. Iron deficiency anemia is characterized by a significant reduction in hemoglobin in red blood cells, presenting as microcytic hypochromic anemia. Its diagnostic basis includes three aspects: first, conforming to the diagnosis of iron deficiency and iron-deficient erythropoiesis; second, having microcytic hypochromic anemia; and third, effective treatment with iron supplements. These three factors together can confirm the diagnosis of this disease.
The key to curing iron deficiency anemia
Iron deficiency anemia, a common and frequently occurring disease in the department of hematology, is not difficult to diagnose and treat. The key to treatment lies in addressing the cause of the iron deficiency, and it is essential to eliminate the underlying causes as much as possible. Using iron supplements alone can only restore blood counts; neglecting the primary disease will not lead to a complete cure of the anemia and can easily lead to recurrence. Treatment consists of two phases: first, the supplementation with iron supplements. After taking iron supplements for three to four days, an increase in reticulocytes will occur, reaching a peak around seven days, and hemoglobin will significantly rise after two weeks of medication, returning to normal levels after one to two months. However, after hemoglobin levels normalize, some patients may stop taking the medication. It is important to note that continuing to take iron supplements for three months is necessary to replenish the body's iron stores completely.
Characteristics of iron deficiency anemia blood picture
The clinical manifestations of iron deficiency anemia are due to the specific characteristics of anemia caused by iron deficiency and the underlying disease causing the iron deficiency. Its hematological characteristics present as typical microcytic hypochromic anemia. What does this concept mean? It refers to the values in a complete blood count where MCV is less than 80 femtoliters, MCH is less than 27 picograms, and MCHC is less than 30%. MCV refers to the average red blood cell volume, MCH refers to the mean corpuscular hemoglobin concentration, and MCHC refers to the mean corpuscular hemoglobin concentration of red blood cells. The extent of changes in red blood cell indices correlates with the duration and severity of anemia. The blood smear typically shows pale-stained red blood cells with an enlarged central pallor and varying sizes. Platelet count often tends to be high when there is concurrent bleeding and generally tends to be low in infants and children. White blood cell count is usually normal or slightly reduced, with normal differential. These are the hematological characteristics of iron deficiency anemia.
Iron deficiency anemia is what type of anemia?
Iron deficiency anemia refers to the anemia that occurs when the body's stored iron is depleted and cannot meet the needs for normal red blood cell production. Before the production of red blood cells is limited, the body's stored iron has already been exhausted. However, at this stage, the routine blood tests may not yet show obvious signs of anemia; this condition is then referred to as iron deficiency. The characteristics of iron deficiency anemia include a lack of stainable iron in the bone marrow and other tissues, as well as reduced serum ferritin and transferrin saturation, presenting as typical microcytic hypochromic anemia. Therefore, iron deficiency anemia is a type of microcytic hypochromic anemia and is classified according to the level of marrow proliferation as a hyperproliferative anemia.
Causes of Iron Deficiency Anemia
There are many reasons for iron deficiency anemia, which we can categorize into several aspects. The first aspect is a decrease in iron intake, including diet, meaning insufficient dietary intake. The second aspect is decreased absorption, such as the absence of a target organ for absorption or the lack of stomach acid affecting its absorption efficacy. The second aspect refers to excessive loss, most commonly chronic gastrointestinal bleeding, such as in patients with tumors, duodenal ulcers, gastric ulcers, gastritis, ulcerative colitis, a parasitic infection with hookworms, as well as hemorrhoids, and arteriovenous malformations, all of which can cause gastrointestinal bleeding leading to increased iron loss. Excessive menstrual flow in female patients, multiple blood donations, and multiple pregnancies can all lead to iron deficiency. These are the various causes related to iron deficiency.
What are the symptoms of iron deficiency anemia?
Iron deficiency anemia is a type of anemia that exhibits common symptoms found in all anemia patients. It is characterized by a range of clinical symptoms caused by oxygen deficiency in tissue organs due to a lack of blood in the body. Common symptoms include dizziness, headaches, fatigue, shortness of breath and palpitations after activity, easy fatigability, difficulty concentrating, and decreased memory. Some patients may also experience blurred vision, ringing in the ears, and in severe cases, fainting, transient darkening of vision, and even arrhythmias. Because iron deficiency anemia is also accompanied by iron deficiency, it presents a range of clinical symptoms specific to iron deficiency, including pica, angular cheilitis, glossitis, unusual tongue conditions, decreased appetite, and even constipation among other symptoms.
What are the symptoms of iron deficiency anemia in children?
Iron deficiency anemia can manifest as: 1. Gradual pallor of the skin and mucous membranes, especially noticeable on the lips, oral mucosa, and nail beds. Older children may experience dizziness, darkening before the eyes, and tinnitus. Additionally, anemia can lead to extramedullary hematopoiesis, and enlargement of the liver, spleen, and lymph nodes can occur. The younger the age and the longer the duration of the disease, the more severe the anemia and the more prominent the enlargement of the liver and spleen. 2. In terms of gastrointestinal tract: reduced appetite, pica, vomiting, diarrhea, and stomatitis may occur. 3. Nervous system manifestations include: restlessness or lethargy, lack of concentration, reduced memory, and intelligence often lower than peers of the same age. 4. Cardiovascular system: an increased heart rate may be observed, and in severe cases, cardiac enlargement and even heart failure can occur. 5. Immune system: Iron deficiency can affect hematopoietic function, often leading to reduced cell-mediated immune function and combined infections.
Symptoms of iron deficiency anemia
The clinical manifestations of iron deficiency anemia consist of symptoms due to the anemia itself, specific manifestations of iron deficiency, and the underlying diseases causing the iron deficiency. The onset of anemia is often insidious, with some patients progressing very slowly. Initially, patients can adapt well to daily life and continue with their work, making it difficult to detect. It is usually not until the anemia becomes moderate to severe and symptoms become apparent that it is discovered. Common symptoms of anemia include dizziness, headaches, weakness, easy fatigue, palpitations, and shortness of breath after activity. Some patients might also experience a decline in memory and suffer from tinnitus and blurred vision. Some affected children may exhibit delayed growth and development or even abnormal behaviors, which can manifest as irritability, restlessness, inattention in class, and declining academic performance. A few patients may develop pica, a specific manifestation of iron deficiency anemia. Additionally, some patients might suffer from angular cheilitis, glossitis, and even atrophy of the tongue papillae. Severe cases can experience transient blindness and fainting, hence it is crucial to seek medical attention for iron deficiency anemia at the earliest.
What is the fastest way to treat iron deficiency anemia?
Iron deficiency anemia is a type of anemia caused by a lack of storage iron in the body, affecting the synthesis of hemoglobin. It is characterized by a lack of available iron in tissues and organs such as bone marrow, liver, and spleen, with decreased serum iron concentration, transferrin saturation, and serum ferritin levels. Typically, iron deficiency anemia presents as microcytic hypochromic anemia. Iron, as one of the essential trace elements in the human body, is contained in all functioning cells and is broadly involved in metabolic processes within the body. Therefore, the treatment principle for iron deficiency anemia involves replenishing sufficient iron until normal iron stores are restored and addressing the underlying causes that led to the iron deficiency to effectively and quickly replenish iron. Oral iron supplements are the preferred treatment option for iron deficiency anemia, such as ferrous sulfate, ferrous succinate, and iron dextran which are effective oral iron agents.