Iron deficiency anemia indicators

Transferrin saturation (serum iron/TIBC)—indicates the amount of transferrin that is bound with iron it is lower in iron-deficiency anemia. 

The earliest and most sensitive laboratory change for iron-deficiency anemia is decreased serum ferritin (storage iron), which should be interpreted in conjunction with decreased transferrin saturation and increased total iron-binding capacity (TIBC). Hb, hematocrit, and RBC indices usually remain normal until later stages of iron-deficiency anemia. 

Indication Iron deficiency anemia in Patients with docu- Iron deficiency anemia... 

The only clinical indication for the use of iron preparations is the treatment or prevention of iron deficiency anemia. Iron deficiency is commonly seen in populations with increased iron... 

There is an association between iron deficiency anemia and RLS thus patients should be screened with complete blood count indices and for serum ferritin level. The iron deficit will not be found using normal parameters such as a complete blood count and iron level. A serum ferritin level of <50 is associated with RLS. 

Perhaps the most dramatic indication of the indispensable role of transferrin as an iron donor, however, is provided by an experiment of nature. Individuals afflicted with atransferrinemia, a genetic inability to synthesize transferrin, suffer from a paradoxical co-existence of iron deficiency anemia and generalized iron overload (68, 69). Without transferrin, neither the delivery of iron to hemoglobin-synthesizing cells nor its mobilization from stores is successfully regulated. 

A DF of <65 is associated with thalassemia minor and a value >75 is associated with iron deficiency anemia. Values between 65 and 75 are classified as equivocal and may indicate a combined iron deficiency anemia with an underlying thalassemia. 

Hemoglobin studies indicate that iron-deficiency anemia is quite common in our population, especially in women between ages 15 and 50. 

Indication Treatment of iron deficiency anemia in patients undergoing chronic hemodialysis who are receiving supplemental erythropoietin therapy Treatment of patients with documented iron deficiency in whom oral therapy is unsatisfactory or impossible Treatment of iron deficiency anemia in patients undergoing chronic hemodialysis who are receiving supplemental epoetin alfa therapy... 

Wians EH, Urban JE, Keffer JH, Kroft SH. Discriminahng between iron deficiency anemia and anemia of chronic disease using tradihonal indices of iron status vs transferrin receptor concentrahon. Am J CUn Pathol 2001 115 112-118. 

Clinical practice guidelines to guide the appropriate use of erythropoietic agents have been developed (Fig. 124-14). The first step is to evaluate the underlying cause of the anemia and initiate specific therapy as indicated. For example, patients with iron deficiency anemia should receive iron supplementation. Patients with chronic bleeding or hemolysis should not receive erythropoietic therapy, as... 

Whether particular drugs are well tolerated or not, anthelmintic therapy frequently requires adjunctive therapy. Thus allergic reactions to tissue infestation by parasites may require antihistamines, or even steroids. Iron-deficiency anemia (due to blood losses) sometimes has to be counteracted. Gastric effects have to be treated traditionally, as do any secondary bacterial infections. With some agents cathartics may be indicated to expel dead or incapacitated worms. 

Iron dextran is an iron product that replenishes hemoglobin and depleted iron stores. It is indicated in the treatment of iron deficiency anemia when oral administration of iron is unsatisfactory or impossible. 

C. Clinical Use Iron deficiency anemia is the only indication for the use of iron. Iron deficiency can be diagnosed from red blood cell changes (microcytic cell size, from diminished hemoglobin content of blood) and Irom measurements of. serum and bone marrow iron stores. The disease is treated by dietary ferrous iron supplementation and, in special cases, by par-... 

Iron deficiency is associated with anemia—a decrease in the oxygencarrying capacity of the blood, as indicated by low red blood cell or heme concentrations. Iron-deficiency anemia is the most common nutritional deficiency disease in both developed and underdeveloped nations. Early symptoms include muscle fatigue and lethargy. The ability to fight off invading bacteria is also diminished. Continued anemia creates defects in the structure and function of skin, fingernails, mouth, and stomach. 

Interpretation of Signs, Symptoms, and Laboratory Tests. Most cases of anemia are due to iron deficiency, although there are several other causes for anemia. The other types of anemia constitute only a small minority of cases. Nevertheless, they need to be considered when persons with anemia do not respond to iron therapy, or when the symptoms of their anemia differ from those normally found in iron deficiency. One of the problems in the diagnosis of iron-deficiency anemia is the disagreement among both scientists and health practitioners as to the levels of hemoglobin which indicate the presence of the disorder. 

Even for a healthy woman on a good diet, providing sufficient milk to meet all the demands of a rapid- growing infant is a physiological strain. So, supplemental feeding, i.e., the substitution of a bottle feed for one or more breast feeds and/ or the early introduction of solid foods, may be indicated. Also, it is important that the mother s hemoglobin should be checked during the period between childbirth and the return of the uterus to its normal size. Iron deficiency anemia is rather common at this time, especially if blood loss was excessive at or after delivery. 

Observations on a Medellin population with iron deficiency anemia presented in this report indicated an identical spectrum of gastric lesions to those described by Correa et al. (1976). 

Table 1 Indicators for assessing the progression of iron deficiency from depletion of iron stores to iron deficiency anemia...

Elevated circulating TfRs are a sensitive indicator of the tissue demand for iron. Circulating TfR is not affected by inflammation, a limitation of other indicators of iron status. Furthermore, expressing TfR as a ratio with ferritin appears to distinguish with a great deal of sensitivity iron deficiency anemia from anemia of chronic disease, making this combined measure potentially very useful in settings in which these conditions coexist. 

Data from the US NHANES III (1988-1994) survey, which used a variety of indicators of iron status, showed that 9% of US toddlers were iron deficient and 3% had iron deficiency anemia. Eleven percent of adolescent females and women of reproductive age were iron deficient, and 3-5% of these women had iron deficiency anemia. Iron deficiency in the developed world is more common among low-income minorities. 

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