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IRON DEFICIENCY ANEMIA
Iron deficiency anemia is the most common type of anemia (more than 80% of all forms), caused by a deficiency of serum iron, bone marrow and depot, which leads to trophic disorders in the tissues.
Normally, the iron content in the plasma is 14-32 µmol / l. The lack of iron in the blood plasma is sideropenia, the lack of it in the tissues is called hyposiderosis. The depletion of tissue reserves in the body (hyposiderosis) leads to the breakdown of redox processes in tissues, which is expressed in the form of trophic disorders on the part of the epithelial integument. Iron deficiency 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 - moderate, and less than 70 g / l - severe anemia.
Tissue hyposiderosis manifests itself as trophic disorders. So, patients have changes in the skin in the form of dryness, cracks, peeling. Longitudinal and transverse striation of nails, their wrong growth, brittleness appear. Sometimes the nails become spoon-shaped (koilonhyia, coil-sunken), hair loss occurs. The mucous membrane of the tongue in the form of atrophic glossitis is affected, cracks appear in the corners of the mouth - angular stomatitis. Sideropenic dysphagia (a symptom of Rossolimo Bekhterev) develops with changes in the esophageal mucosa.
Patients have changes in taste (pica chlorotica) as a predilection for chalk, coal, clay (geophagy), ice (pogophagy), and lime. Patients eat dough, raw minced meat, eggshells. Perversions of smell are manifested by the fact that they like the smell of kerosene, gasoline, exhaust gases.
There is drooling at night, frequent urination in the morning, urinary incontinence during laughter, and incontinence of gases as a reflection of the weakness of the sphincters. Observed swelling under the eyes in the morning and pastos feet in the evening.
In 10-20% of cases, sideropenic fever occurs - the temperature is within 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 during malnutrition, as well as in women during pregnancy and lactation. Previously, in the origin of anemia, a large role was given to the violation of iron absorption with a decrease in gastric secretion.
It should be noted that ideas about the leading role of the stomach in the process of iron absorption are outdated, because ahilia does not cause iron deficiency anemia. The main cause of anemia in adults, as has been said
above, is blood loss, predominantly prescriptive, but prolonged.
In women, blood loss is associated primarily with the menstrual cycle.
If in women who have not given birth, 30 ml of blood are lost during one menstruation, 40-60 ml of women who have given birth on average, while with heavy menstruation, up to 100-500 ml of blood is lost. In men, blood loss from the gastrointestinal tract is of particular importance in the occurrence of anemia. The degree of blood loss can be assessed by the label with radioactive chromium. It was found that melena appears only with the loss of more than 100 ml of blood. Gregersen's reaction determines the amount of blood in excess of 15 ml, so small amounts of blood can not be determined by available tests. It should be remembered that it is necessary to conduct a study of the gastrointestinal tract in
all persons with iron deficiency anemia.
The impairment of the absorption of iron and other substances important for blood formation also occurs after resection of the stomach or part of the small intestine.
Iron deficiency is common in adolescent girls, especially those born to mothers with iron deficiency anemia. According to the WHO, 700 million people suffer from iron deficiency,
that is, each 5-6 people.
According to statistics from 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 deficiency of iron. In the former Soviet Union, a high percentage of iron deficiency anemia occurred in Tajikistan, where women give birth and breastfeed a lot. So, in 1960-1965 there were many sick girls with juvenile chlorosis, because they were born in difficult war and post-war years. Chlorosis occurs during the genital period.
ripening. Fatigue, lethargy, palpitations, drowsiness appear.
Then develops alabaster pallor of the skin, often with a greenish tint. Characterized by a perversion of taste, dysphagia, that is, pronounced symptoms of hyposiderosis.
The course of the disease is chronic, recurrent. Dysfunction of the liver and heart muscle may be noted. There is tachycardia, anemic cardiac noise - systolic murmur at the apex, due to a decrease in blood viscosity, a gyroscope noise on the jugular veins, associated with a decrease in blood viscosity.
Iron deficiency leads to depletion of tissue reserves of iron (hyposiderosis), which in turn leads to a breakdown of redox processes in the tissues and is expressed in the form of trophic disorders on the part of the epithelial integument.
At esophagoscopy and X-ray examination, atrophic changes of the pharyngeal mucosa and esophagus are visible.
The blood picture is characterized by hypochromic anemia - a decrease in the concentration of hemoglobin and a low color index (0.7 and below).
Erythrocyte hypochromia, their microcytosis, aniso- and poikilocytosis are determined morphologically.
Iron refractory or sideroachrestic anemia is a group of anemic conditions characterized by a high content of serum iron and refractoriness to iron treatment. Hereditary iron deficiency anemia 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 impaired activity of enzyme systems involved in the synthesis of heme. Patients have 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 transfusion. Symptoms of cirrhosis of the liver, lesions of the gastric gland (diabetes mellitus), heart failure.
Blood tests show marked red cell hypochromia.
With a slightly reduced red blood cell count, hemoglobin figures 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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IRON DEFICIENCY ANEMIA
- Clinic of iron deficiency anemia
The development of iron deficiency in the body has a clear staging. The following consistently developing stages of iron deficiency are distinguished: • prelarent iron deficiency, • latent iron deficiency, • iron deficiency anemia. Prelactive iron deficiency is the first stage of development of the iron deficiency state, characterized by depletion of iron reserves in the bone marrow and liver. The patient
- Laboratory criteria for the diagnosis of iron deficiency anemia
Diagnosis of IDA is based on the establishment of laboratory signs of anemia itself and iron deficiency in the body. Iron deficiency anemia is hypochromic, microcytic anemia. During the analysis of peripheral blood on a hematology analyzer, the following disorders are noted 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 average
- Iron deficiency anemia
Iron deficiency anemia (IDA) is a clinical and hematological 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 anemias. 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 combines numerous, different etiologies of anemic syndromes, the main pathogenetic factor of which is the lack of iron in the body (sideropenia, hyposiderosis). Hyposiderosis in the broad sense of the word means not only anemia on the basis of impaired hemoglobin formation. Depletion of tissue reserves of iron leads to frustration
- SYMPTOMATIC IRON DEFICIENCY ANEMIA, CHLORANEMIA
Symptomatic iron deficiency anemia develops against the background of a specific etiologic factor: chronic enteritis, chronic nephritis (hloranemiya "braytikov"), in relation to gastric resection (agastricheskaya hloranemiya), occult blood loss (with hiatal hernia, "hernial" disease), malignant neoplasms ( cancrosis hyposiderosis), 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 raise the awareness of pediatricians and parents about possible latent iron deficiency in order to guarantee the earliest possible start of treatment in all children. Targeted and effective prevention of IDA
- Treatment of iron deficiency anemia
The goal of treatment of iron deficiency is to eliminate iron deficiency and restore its reserves in the body. Etiological treatment involves the elimination of causes leading to the development of iron deficiency. Mode. An important link in the treatment of IDA is the proper organization of the regime and nutrition. An effective treatment and preventive measure is a long stay in the fresh air. Children
- Treatment of iron deficiency anemia
Treatment of IDA should be comprehensive. Etiological treatment involves the elimination of causes leading to the development of iron deficiency. Regime The important links in complex therapy are proper organization of the regimen and nutrition. An effective treatment and preventive measure is a long stay in the fresh air. Children need sparing mode: physical exercise restriction,
- Prevention of iron deficiency anemia
Antenatal prophylaxis of IDA is reduced to the observance of the correct mode and nutrition of the pregnant woman, measures against premature birth, elimination of toxicosis, timely detection and treatment of anemia in pregnant women. Iron preparations are prescribed to women from risk groups: ¦ women of reproductive age who suffer from heavy and prolonged menstrual blood loss; ¦ staffing
- Risk factors for iron deficiency anemia and contraindications for pregnancy
Prevention of anemia is primarily necessary for pregnant women with a high risk of its development. The following main etiological factors for the development of iron deficiency anemia are distinguished. 1. Alimentary factor: • reduction of iron intake in the body with food (veggie diet, anorexia). 2. Burdened somatic history: • chronic diseases of internal organs (rheumatism, heart defects,
- The role of the nutritional factor in the development of iron deficiency anemia
Nutritional disorders occupy an important place among the causes of iron deficiency anemia. These disorders can lead to a decrease in iron intake in the child’s body, a breakdown in iron absorption, or an increase in its elimination from the body. When considering the issue of iron intake with food in the body of children, a separate analysis is necessary in children who are on the chest and artificial