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Iron Deficiency Anemia: Definition, Clinical Diagnosis, Complications, Evolution and Treatment

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Iron Deficiency Anemia: Definition, Clinical Diagnosis, Complications, Evolution and Treatment

Iron Deficiency AnemiaDefinition

Iron deficiency anemia isahypochromic type of anemiacaused by adisorder in hemoglobin synthesisdue todecreased amount of total body iron. The fundamental disorder is responsible for all the signs and symptoms of this disease. This disease is affecting both sexes and occurs at all ages but predominantly in women. It is the most common form of anemia encountered in clinical practice.

Iron Deficiency AnemiaSymptoms

It should be mentioned right at the beginning that anemia occurs most often secondary to other diseases. So patients history is very important to elucidate the diagnosis. Signs of central nervous system and sense organs:

  • Asthenia
  • Morning headache
  • Fatigue
  • Tinnitus
  • Balance disorders
  • Vertigo

The onset is insidious and the progression of signs is gradual.

Examination of skin and mucous membranes:

  • Skin is pale, dry, nails are brittle, break easily, have longitudinal grooves, platonichie type changes (flattened nails) or koilonichie (concave shape or cracks). The hair grows grey faster, may fall more easily and is brittle. Mucous membranes ar pale as well.
Anemia

Anemia

Cardiovascular system signs: Appear parallel with the degree of anemia and patient age:

Signs of the digestive system:

  • Angular stomatitis (cheliosis) may appear or small, very painful, cracks at the mouth corners. Tongueburns appear spontaneous or stimulated by acidic foods or drinksdue toatrophy ofthe lingual papillae. Atrophy of the pharyngeal mucosa leads to dysphagia especially for solid food, sign called Winson Plummer syndrome. These inflammatory changes continue into the esophagus and especially the gastric mucosa where hypertrophic gastritisinstalles. Gastritis has no clinical manifestations, but is sometimes associated with marked reduction of gastric secretion.

Splenomegaly:

  • It is present in 10% of patients, it is moderate in size and returns to normal after correction of iron deficiencys.

Genito-urinary disorders:

  • The most common is themenstrual disorder in women, menorrhagia (an abnormally heavy and prolonged menstrual period at regular intervals), which is relieved after specific treatment.

Other signs and symptoms:

  • Ozaena (nasal mucosal atrophy) occurs in patients with severe iron deficiency
  • Pica: representing appetite for inedible but nontoxic substances (earth, lime) and occurs in iron deficiency anemia with severe mental disorders.
  • Immune deficiencies favoring repeated infections.
Anemia Symptoms

Anemia Symptoms

Iron Deficiency AnemiaComplications

Cardiovascular: mostly occur in elderly with known coronary heart disease, vary from unstable angina to myocardial infarction and heart failure.
Severe mental disorders: dizziness, dementia, anemic coma. Digestive: gastiric cancer, gastric mucosal atrophy, intestinal disorderslike nonspecific enterocolitis.

Iron DeficiencyAnemiaEvolution

Evolution of patients with iron deficiency anemia is closely correlated with the degree of anemia and the time of its diagnosis. Once the diagnosis and cause of iron deficiency anemia has been detected,after awell managedtreatment, theevolution is favorable. Prognosis is good, ad integrum restitutio in most cases.

Iron Deficiency AnemiaTreatment

Etiologic treatment: targets detection and removing the causes of iron deficiency anemia.

Pathogenic therapy (the cause): targeting the correction of iron deficiency. Iron preparations are used orally, bivalent compounds (glutamate, aspartate or iron sulfates), the minimum dose of 100-200 mg / day of elemental iron. The main preparations used are Glubifer 3×2 dg/ day, Ferro-Gradumet 2 dg / day, Sorbifer 1 dg / day, preferably taken in the morning. Because of gastrointestinal side effects (nausea, burns), preparations can be administered after a light diet. Duration of treatment varies from 4-6 months to a year, depending on the severity of anemia. Thetreatment will continue for 4-6 months after correction of hemoglobin valuesfor recovery of iron deposits. Parenteral preparations areadministrated only in case of absolute digestive intolerance, severe enteropathy, severe anemia.

Anemia Treatment

Anemia Treatment

The dose used is 100 mg / day intramuscular, to be mentioned is the risk of anaphylactic shock from injectable iron preparations, and therefore treatment should be started in a hospital under strictmedical supervision and prior totesting. Among the injectable iron preparations , the most common used are : Iron polymaltose 1 vial / day intramuscular, Ferrum Haussmann 1 vial / day intramuscular. Emergency transfusionsto patients with severe anemia (Hb less than 6 g%) associated with ischemic heart disease.