Iron deficiency anemia IDA

Iron deficiency anemia (IDA) is characterized by decreased levels of ferritin (most sensitive marker) and serum iron, as well as decreased transferrin saturation the Hgb and hematocrit (Hct)fall late in the disease. Total iron-binding capacity (TIBC) is increased. RBC morphology includes hypochromia and microcytosis. Most patients with IDA are adequately treated with oral ferrous (Fe +) sulfate therapy, although parenteral iron therapy is necessary in select patient populations. 

However, with the exception of one study (Idjradinata and Pollit, 1993), several reports have shown that children with iron deficiency anemia (IDA) in the first 2 years of life have different cognitive disorders (Table 52.1). It was distressing to find that, in Grantham-McGregor and Ani s revision (2002), anemic children less than 2 years old failed to show benefits in their development when given Fe supplements. 

An estimated 25 percent of the world s population suffers from iron deficiency, the most common nutritional deficiency in the world. Iron is necessary for the production of hemoglobin, the component in red blood cells responsible for the transport of oxygen. An inadequate supply of iron and the resulting shortage of hemoglobin can cause iron deficiency anemia (IDA). Some of the symptoms of IDA are fatigue, weakness, pale color, poor appetite, headache, and light-headedness. 

HIV human immunodeficiency virus IDA iron deficiency anemia... 

MCV represents the average volume of RBCs. Cells are said to be macrocytic if they are larger than normal, microcytic if they are smaller than normal, and normocytic if their size falls within normal limits. Folic acid and vitamin B12 deficiency anemias yield macrocytic morphology, whereas iron deficiency and thalassemia are examples of microcytic anemias. A falsely elevated MCV occurs with reticulo-cytosis because reticulocytes are larger than erythrocytes. The MCV is also falsely elevated in the presence of cold agglutinins and hyperglycemia. When IDA (decreased MCV) is accompanied by folate deficiency (increased MCV), failure to understand that the MCV rep-... 

In the later stages of IDA, the Hgb and Hct fall below normal values, and a microcytic, hypochromic anemia develops. Microcytosis may precede hypochromia, as erythropoiesis is programmed to maintain normal Hgb concentration in deference to ceU size. As a consequence, even slightly abnormal Hgb and Hct levels may indicate significant depletion of iron stores and should not be ignored. In terms of RBC indices, MCV reduction occurs earlier in iron-deficient hematopoiesis than reduction in Hgb concentration. 

With IDA, laboratory abnormalities are similar to those discussed above in the microcytic anemia section. However, serum iron and TIBC decrease with age, making the transferrin saturation ratio less useful in the elderly. MCVs and mean cell Hgb concentrations may appear normal even in the presence of IDA, as patients may have concurrent vitamin Bn or folate deficiency anemias. 

Depending on the type of anemia unveiled, treatment in the elderly is the same as that specified for each type of anemia previously discussed in this chapter. With IDA it is essential to treat the underlying cause if known (i.e., bleeding) as well as with iron supplementation in the dose of 50 to 100 mg of elemental iron three times a day if tolerated. Vitamin B12 deficiency is treated with parenteral or oral... 

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