Iron deficiency anemia (IDA) 00:06 - definition 00:29 - pathogenesis 01:50 - epidemiology 02:34 - etiology 06:04 - classification 06:54 - clinical picture 14:16 - diagnostics 44:20 - differential diagnostics 45:05 - treatment 58:33 - prevention Iron deficiency anemia (IDA) is a hematological syndrome characterized by impaired hemoglobin synthesis due to iron deficiency and manifested by anemia and sideropenia. The main causes of IDA are hidden (occult) bleeding, insufficient iron intake with food and inflammatory diseases of the small intestine. Classification Depending on the severity of the decrease in hemoglobin levels, three degrees of anemia severity are distinguished: mild - hemoglobin level above 90 g / l; moderate – hemoglobin within 90‑70 g/l; severe – hemoglobin level less than 70 g/l. Etiology Iron deficiency is caused by imbalance in favor of iron expenditure over intake, observed in various physiological conditions or diseases: blood loss of various origins; increased iron expenditure (growth period, pregnancy, breastfeeding); impaired iron absorption; congenital iron deficiency; impaired iron transport due to transferrin deficiency[ Unbalanced nutrition Impaired iron absorption Impaired iron absorption can be caused by inflammatory, cicatricial or atrophic processes in the small intestine, resection of the small intestine There are two periods in a child’s life when there is an increased need for iron. The first period is the first to second year of life, when the child is growing rapidly. The second period is the period of puberty, when rapid development of the body begins again, and girls experience additional iron consumption due to menstrual bleeding. Pathogenesis Iron deficiency anemia is associated with the physiological role of iron in the body and its participation in tissue respiration processes. It is part of heme, a compound capable of reversibly binding oxygen. Heme is a prosthetic part of the hemoglobin and myoglobin molecule. Ferritin and hemosiderin are of primary importance in iron deposition in the body. Iron is transported in the body by the protein transferrin (siderophilin). Clinical picture and stages of disease development IDA is the last stage of iron deficiency in the body. There are no clinical signs of iron deficiency in the initial stages, and diagnosis of preclinical stages of iron deficiency has become possible only due to the development of laboratory diagnostic methods. Depending on the severity of iron deficiency in the body, three stages are distinguished: prelatent iron deficiency in the body; latent iron deficiency in the body; iron deficiency anemia. Diagnostics Clinical blood test IDA refers to microcytic anemia. A clinical blood test shows a combination of decreased hemoglobin levels and decreased red blood cell sizes (MCV below normal). In rare cases, when iron deficiency is combined with folate and/or vitamin B12 deficiency, red blood cell sizes may remain normal. Blood chemistry When IDA develops, a blood chemistry test always shows a decrease in ferritin levels. In addition, the following may be noted: decreased serum iron concentration; increased TIBC; decreased transferrin saturation with iron. Differential diagnostics When diagnosing IDA, it is necessary to conduct a differential diagnosis with other hypochromic anemias. Iron redistribution anemia is a fairly common pathology and ranks second in frequency of development among all anemias (after IDA). It develops in acute and chronic infectious and inflammatory diseases, sepsis, tuberculosis, rheumatoid arthritis, liver diseases, cancer, coronary heart disease, etc. The mechanism of development of hypochromic anemia in these conditions is associated with the redistribution of iron in the body (it is located mainly in the depot) and a violation of the mechanism of iron reutilization from the depot. In the above diseases, the macrophage system is activated, when macrophages under activation conditions firmly retain iron, thereby disrupting the process of its reutilization. A general blood test shows a moderate decrease in hemoglobin (less than 80 g / l). The main difference from IDA is: an increased level of serum ferritin, which indicates an increased iron content in the depot; the level of serum iron can remain within normal values ​​​​or be moderately reduced; TIBC remains within normal values ​​​​or decreases, which indicates the absence of Fe starvation of serum #zhda #hematology #medicine