One, out of five have anemia.
And majority cases of anemia is microcytic anemia.
Anemia is defined as the reduction in circulating red-cell mass below normal levels.
Red blood cells contains hemoglobin, hemoglobin contains iron and proteins.
Iron is the main component of hemoglobin and is the prime carrier of oxygen.
Decreased iron reserves in the body affect the production of hemoglobin,
subsequently hinders the transport of oxygen to the body, leads to tissue hypoxia.
So, Iron deficiency is the main cause of microcytic anemia.
Red blood cells are smaller then usual size. That’s why it is called microcytic.
Cause:
Iron deficiency can develop:
When person doesn’t consume enough iron in the diet.
Or when absorption of iron is poor from the gut.
Increased blood loss in menstrual flow.
Increased demand on iron. For example - pregnancy,
Or during blood loss. Bleeding from gastro intestinal tract, particularly from gastric and duodenal ulcers. Malignancy
or recovering from major trauma or surgery.
People with iron deficiency, sometimes eat non-nutritious substances like clay, ice, and flour. Which is called pica.
The patient may also have complained of food stuck inside the chest, due to esophageal webs along with a swollen tongue ( glossitis).
It is called. Plummer-Vinson syndrome. which is a rare manifestation of iron deficiency.
Pallor Skin, evident on hands as well as conjunctivitis.
Tachycardia, Increased respiratory rate.
Exhaustion and koilonychia (spoon-shaped nails).
Severe anemia may also lead to the production of signs and symptoms of angina due to decreased delivery of oxygen to cardiac myocytes.
Microcytic anemia is common among young women.
Because they lose blood, each menstrual cycle.
Almost half of all pregnant females suffer from anemia also.
Iron from animal sources is in the form of Haeme iron which has a bioavailability of 10% to 20%.
compared to non-heme iron which has a limited bioavailability of 1% to 5%.
An average male contains 6 grams of iron while a female contains 2.5 gm of iron.
Diet is usually sufficient to maintain a healthy iron pool.
Ingested iron is freed from other food constituents by gastric HCL,
while ascorbic acid (vitamin C) is important for iron absorption.
Iron is subsequently absorbed from the duodenum and stored in Liver, muscles and bone marrow.
If person doesn’t consume enough iron, or have chronic diarrhea or vitamin C deficiency. It will also cause microcytic anemia.
Diagnose
The first test to perform is complete blood count.
Hematocrit (the ratio of packed RBCs to blood volume) and the hemoglobin concentration. Are decreased.
The normal size of RBC is about 80 to 100 femtolitre/RBC; however, in iron deficiency anemia, this size decreases below 80 fl/R . This parameter is called Mean corpuscular volume.
In case of microcytic anemia MCHC also decreased.
Treatment:
After the diagnosis of hypochromic microcytic anemia is established, iron replacement therapy can be commenced.
Therapy includes 325 mg of ferrous sulfate three times a day orally.
The impact of this treatment usually appears after 3 weeks, while the full effects will be evident by 2 months.
Parenteral iron products may be used when: Oral drugs is not effective. Or when there is continued blood loss.
Differential Diagnosis
The differential diagnosis of hypochromic microcytic anemia can be thalassemias, anemia of chronic disease, lead poisoning, and X-linked sideroblastic anemia.
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