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Iron deficiency anemia is the most common type of anemia (more than 80% of all forms), due to iron deficiency in blood serum, bone marrow and depot, which leads to trophic disorders in tissues.
Normally, the iron content in the plasma is 14-32 μmol / l. Lack of iron in the blood plasma - sideropenia, a lack of it in the tissues is called hypoxidosis. The depletion of tissue reserves in the body (hypysiderosis) leads to a disturbance of oxidation-reduction processes in the tissues, which is expressed as trophic disorders from the epithelial covers. Deficiency of iron develops when its loss exceeds 2 mg / day.
Anemia with a decrease in hemoglobin to 110-90 g / l is considered light, 90-70 g / l - medium gravity and less than 70 g / l - severe anemia.
Tissue hyposiderosis is spun by trophic disorders. So, patients have changes in skin integuments in the form of dryness, cracks, and peeling. There appears longitudinal and transverse striation of the nails, their improper growth, fragility. Sometimes the nails become spoon-like (coilonihia, Koilos-hollow), hair loss is noted. The mucous membrane of the tongue is affected in the form of an atrophic glossitis, cracks appear in the corners of the mouth - angular stomatitis. Sideropenic dysphagia develops (a symptom of Rossolimo-Bekhterev) with changes in the mucosa of the esophagus.
In patients there are changes in taste (pica chlorotica) in the form of addiction to chalk, coal, clay (geophagia), ice (pogophagia), and lime. Patients eat dough, raw forcemeat, eggshell. Perversions of smell are manifested by the fact that they like the smells of kerosene, gasoline, exhaust gases.
There is salivation at night, frequent urination in the morning, urine incontinence with laughter and incontinence of gases as a reflection of the weakness of sphincters. There are edemas under the eyes in the morning and pastose feet in the evening.
In 10-20% of cases there is a sideropenic fever - a temperature in the range 37.2 ° C - 37.6 ° C.
There are two types of iron deficiency - endogenous and exogenous. With exogenous anemia, there is a decrease in iron intake in malnutrition, as well as in women during pregnancy and lactation. Previously, in the origin of anemia, a major role was attributed to a violation of iron absorption with a decrease in gastric secretion.
It should be noted that the concept of the leading role of the stomach in the process of absorption of iron is outdated, because Achilles does not cause iron deficiency anemia. The main cause of anemia in adults, as was said
above, is blood loss, mainly appointive, but prolonged.
In women, blood loss is associated primarily with the menstrual cycle.
If the women who lose their birth lose 30 ml of blood for one menstruation, those who give birth on the average 40-60 ml, then with excessive menstruation, up to 100-500 ml of blood is lost. In men, great importance in the occurrence of anemia is attributed to blood loss from the gastrointestinal tract. The degree of hemorrhage can be estimated from the label with radioactive chromium. It was found that melena appears only when more than 100 ml of blood is lost. Gergersen's reaction determines blood in an amount of more than 15 ml, so that small amounts of blood can not be determined by available tests. It should be remembered that it is necessary to carry out a study of the gastrointestinal tract in
all persons with iron deficiency anemia.
The violation of absorption of iron and other substances important for hematopoiesis also occurs after resection of the stomach or part of the small intestine.
Iron deficiency is common in adolescent girls, especially those born from mothers with iron deficiency anemia. According to the WHO, 700 million people suffer from iron deficiency,
that is, every 5-6 people.
According to the statistics of highly developed countries (Sweden, France, Great Britain), 7.3-11% of all women of childbearing age suffer from iron deficiency anemia, and 30% of women and 50% of young children have a hidden tissue deficit of iron. In the former Soviet Union, a high percentage of iron deficiency anemia was found in Tajikistan, where women give birth and are breastfed for a long time. So, in 1960-1965 there were many sick girls with juvenile chlorosis, for they were born in heavy military and post-war years. Chlorosis occurs during the sexual
maturation. There is fatigue, lethargy, palpitations, drowsiness.
Then the alabaster pallor of the skin develops, often with a greenish tinge. Characteristic distortions of taste, dysphagia, that is, pronounced symptoms of hypoxidosis.
The course of the disease is chronic, relapsing. There may be violations of the liver, heart muscle. Tachycardia, anemic heart murmurs - systolic murmur at the apex, caused by a decrease in blood viscosity, noise of the top on the jugular veins, associated with a decrease in the viscosity of the blood.
Deficiency of iron leads to the depletion of tissue reserves of iron (hypysiderosis), which in turn leads to a disorder of oxidation-reduction processes in tissues and is expressed as trophic disorders from the epithelial cover.
With esophagoscopy and X-ray examination, atrophic changes in the mucous membrane of the pharynx and the esophagus are seen.
The blood picture is characterized by hypochromic anemia - a decrease in hemoglobin concentration and a low color index (0.7 and below).
Morphologically, hypochromia of erythrocytes, their microcytosis, aniso- and poikilocytosis are determined.
Iron refractory or sideroachrastic anemia is a group of anemic conditions characterized by a high content of serum iron and refractory to iron treatment. Hereditary iron deficiency anemia are linked to the X chromosome and are found exclusively in boys and young men, acquired - at any age in men and women. The etiology and pathogenesis of this anemia are associated with a disruption in the activity of enzyme systems involved in heme synthesis. Patients with pale skin and mucous membranes. Unused iron is excessively deposited in tissues and organs, which leads to the development of secondary hemosiderosis, especially in individuals receiving frequent blood transfusions. The symptoms of liver cirrhosis, pancreatic lesions (diabetes mellitus), heart failure develop.
In blood tests, marked red blood cell hypochromia is noted.
If the erythrocyte content is not very low, the hemoglobin numbers reach 70-80 g / l, and the color index is 0.4-0.5, hypersideremia is noted. The bone marrow is characterized by the absolute predominance of erythroid cells.
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- Clinic of iron deficiency anemia
The development of iron deficiency in the body has a distinct staging. The following consistently developing stages of iron deficiency status are distinguished: • prelatent iron deficiency, • latent iron deficiency, • iron deficiency anemia. Prelatent iron deficiency - the first stage of the development of iron deficiency, is characterized by depletion of iron stores in the bone marrow and liver. The patient
- Laboratory criteria for the diagnosis of iron deficiency anemia
The diagnosis of IDA is based on the establishment of laboratory signs of anemia proper and iron deficiency in the body. Iron deficiency anemia is hypochromic, microcytic anemia. In the analysis of peripheral blood on the hematological analyzer, the following abnormalities are observed in IDA: • a decrease in hemoglobin of less than 110 g / l to 6 years, less than 120 g / l over 6 years, • a decrease in the mean
- Iron deficiency anemia
Iron deficiency anemia (IDA) is a clinico-hematologic syndrome, based on a violation of hemoglobin synthesis due to iron deficiency. IDA is the most common anemic syndrome and accounts for approximately 80% of all anemia. According to WHO, the number of people suffering from iron deficiency reaches 200 million people. Most often, IDA is detected in young children,
- IRON-DEFICIENCY ANEMIA
The group of iron deficiency anemia unites numerous, different etiologies of anemic syndromes, the main pathogenetic factor of which is a lack of iron in the body (sideropenia, hypoxidosis). Hypoxiderosis in the broad sense of the word means not only anemia due to hemoglobin formation disorders. Depletion of tissue reserves of iron leads to frustration
- SYMPTOMATIC IRON-DEFICIENCY ANEMIA, CHLORANEMIA
Symptomatic iron deficiency anemia develops against a background of a certain etiological factor: chronic enteritis, chronic nephritis (chloranemia of "brajetics"), in connection with gastrectomy (agaric chloranemia), occult blood loss (with hernia of the esophageal aperture of the diaphragm, "hernia" anemia), malignant neoplasms cancas hypoxidosis), chronic infection
- Prevention of iron deficiency anemia
Prevention of iron deficiency in children and adolescents is a very urgent problem of pediatrics, especially in the first year of life. It is very important to increase the awareness of pediatricians and parents about the possible latent iron deficiency in order to guarantee the earliest possible start of treatment in all children. Purposeful and effective prevention of IDA
- Treatment of iron deficiency anemia
The goal of iron deficiency therapy is to eliminate iron deficiency and restore its reserves in the body. Etiological treatment involves eliminating the causes leading to the development of iron deficiency. Mode. An important part of IDA therapy is the proper organization of diet and nutrition. An effective therapeutic and preventive measure is a long stay in the open air. Children
- Treatment of iron deficiency anemia
Treatment of IDA should be comprehensive. Etiological treatment involves eliminating the causes leading to the development of iron deficiency. Mode The proper organization of diet and nutrition is an important part of complex therapy. An effective therapeutic and preventive measure is a long stay in the open air. Children need a sparing regimen: limiting physical activity,
- Prevention of iron deficiency anemia
Antenatal prophylaxis of IDA is reduced to adherence to the correct mode and nutrition of a pregnant woman, measures against anti-premature wear, elimination of toxicoses, timely detection and treatment of anemia in pregnant women. Iron preparations are prescribed for women at risk: | women of reproductive age, suffering from heavy and prolonged menstrual blood loss; | Staffing
- Risk factors for the development of iron deficiency anemia and contraindications to pregnancy
Prevention of anemia is primarily necessary for pregnant women with a high risk of its development. The following main etiological factors of the development of iron deficiency anemia are distinguished. 1. Almentary factor: • decrease in the intake of iron in the body with food (veggie diet, anorexia). 2. Weighed somatic anamnesis: • chronic diseases of internal organs (rheumatism, heart defects,
- The role of the alimentary factor in the development of iron deficiency anemia
Alimentary disorders occupy an important place among the causes of the development of iron deficiency anemia. These disorders can lead to a decrease in the intake of iron in the child's body, a violation of the assimilation of iron, or an increase in its excretion from the body. When considering the question of the intake of iron from food in the body of children, a separate analysis is needed for infants who are on the thoracic and artificial