Iron-deficiency anemia

Iron-deficiency anemia

  • Inadequate dietary intake
    • 5% to 10% of ingested iron is absorbed
  • Malabsorption
    • Iron absorption occurs in the duodenum
    • Diseases or surgery that alter, destroy, or remove absorption surface of this area of intestine cause anemia
  • Blood loss
    • 2 mL whole blood contain 1 mg iron
    • Major cause of iron deficiency in adults
    • Chronic blood loss most commonly through GI and GU systems
  • Hemolysis
  • Pregnancy contributes to this condition
  • At-risk groups
    • Premenopausal women
    • Pregnant women
    • Persons from low socioeconomic backgrounds
    • Older adults
    • Individuals experiencing blood loss

Clinical manifestations

  • General manifestations of anemia
    • Pallor is most common
    • Glossitis is second
      • Inflammation of tongue
    • Cheilitis is also found
      • Inflammation of lips

Diagnostic studies

  • Laboratory findings
    • Hgb, Hct, MCV, MCH, MCHC, reticulocytes, serum iron, TIBC, bilirubin, platelets
  • Stool occult blood test
  • Endoscopy
  • Colonoscopy

Interprofessional care

  • Goal
    • Treat underlying disease causing reduced intake or absorption of iron
  • Replace iron
    • Nutritional therapy
    • Oral iron supplements
    • Transfusion of packed RBCs

Drug therapy

  • Parenteral iron
    • Indicated for malabsorption, oral iron intolerance, need for iron beyond normal limits, poor patient compliance
    • Can be given IM or IV
    • IM may stain skin
      • Z-track

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