Iron deficiency anemia Investigations

IRON DEFICIENCY ANEMIA

AMIT K. KATIYAR (110301166)

LAB INVESTIGATIONS

Anemia : a state in which blood Hb is below the normal range for the patients age , sex & altitude of residence

NORMAL:

Males 13- 16 g/dL

Females 11.5- 15 g/dL

Cytometric Classification :

1. Normochromic , normocytic anemia

Anemia of chronic diseaseHemolytic anemiasAnemia of acute hemorrhageAplastic anemias

2. Hypochromic , microcytic anemia

Iron deficiency anemiaThalassemias

3. Macrocytic anemia

Vitamin B12 deficiencyFolate deficiency

• Iron deficiency anemia

a condition in which the body lacks enough R.B.C. to transport oxygen to body tissues

Most common form of anemia

Causes

> Physiological Post natal growth spurtAdolescent growth spurtMenstruation Pregnancy

> Iron loss due to bleedingHook worm InfestationsHemorrhagePeptic ulcersErosions from anti-inflammatory drugs

> Inadequate diet

> Malabsorption Inflammatory bowel diseaseHelicobacter pylori gastritis

Symptoms:

Fatigue, dyspnoea, palpitations

Dizziness, headache, syncope

Irritability, lack of concentration

Anorexia, bowel disturbances

Angina, intermittent claudication

Signs:

Pallor of skin, palm, mucous membrane,

nail beds & palpebral conjunctiva

Tachycardia, wide pulse pressure

Oedema

Hyperdynamic precordium

Ejection systolic murmur

Clinical features of IDA

Angular stomatitis

Glossitis

Brittle finger nails

Platonychia

Koilonychia

Pica

Plummer-Vinson syndrome

Iron deficiency anemia

Glossitis

Koilonychia

Post-cricoid web (results in dysphagia)

• Lab Investigations

1. To confirm Iron deficiency anemia

2. To determine the cause of anemia

To confirm Iron deficiency anemia

Blood investigations:

1) Haemoglobin

2) Mean Corpuscular Volume(MCV)

below 80 fL (80-100 fL)

3) Peripheral smear- Microcytosis

Hypochromia

4) Reticulocyte count- Normal (0.5 -1.5 %)

Bone marrow study

Moderate erythroid hyperplasia

Bone marrow iron stores - or absent

Plasma Iron

(50-170 μg/dL Female)

(65- 176μg/dL Male )

TIBC (Total iron binding capacity)

(240- 450 μg/dL)

Plasma transferrin saturation (<10% )

(20-50%)

Serum ferritin level

(Normal >100 µg/L)

Red cell protoporphyrin

(Normal <30 µg/dL)

To determine cause of anemia

> Stool – For occult blood & hook worm infestation

> Sigmoidoscopy & colonoscopy

> Upper gastrointestinal endoscopy

> Barium meal swallow & barium enema

> Urine – for schistosomiasis