| ID | 146 |
|---|---|
| Name | IRON- DEFICIENCY ANEMIA1 |
| Cause | |
| Signs Symptoms | |
| Diagnosis | |
| Investigations | Investigations: 1. Blood examinations: Hb%, R.B.C. counts are low, M.C.V. low (50fi-80fl) M.C.H. low (15-26pg). M.C.H.C. low (24-30g/dl) Peripheral blood film shows microcytic, hypochromic, anisocytosis, poikilocytosis etc. Reticulocyte count may be increased. 2. Blood biochemistry: Serum iron level is below 60mg/dl, Iron binding capacity of serum is increased. 3. Bone marrow: It is hypocellular with hyperplasia. Iron content of the bone marrow is decreased or absent. 4. Investigation for detection of causes. |
| Management | |
| Introduction | It is the commonest type of anemia recognised clinically. lassitude and others. |
| History | |
| Etiology | Etiology: 1. Haemorrhagic- chronic blood loss by hookworm infestation, bleeding,from GI tract, excessive menstruation etc. 2. Low intake of iron in food as in poor people and infants. 3. Malabsorption of iron. 4. Increased requirement as in growing infants and in pregnancy & lactation. 5. Hemoglobinuria. 6. Iron sequestration (pulmonary hemosiderosis). |
| Clinical Features | Clinical features: 1. General features: weakness, fatigue, exertional dyspnoea, giddiness, headache, insomnia, dimn-ess of vision, anorexia and dyspnoea. There may be anginal attack, palpitation and tachycardia. 2. Specific features: glossitis, angular stomatitis, Koilonychia, Splenomegaly, britle finger nails, plummer vinsion syndrome, pica (the eating of stange items). |
| Preventions | |
| Treatment | Treatment: 1. Protein rich diet e.g. adequate fish, meat, liver & eggs. 2. When Hb% is 40-60% iron should be given in oral route. Tab Ferrous Fumerate or Ferrous Gluconate, 200-300 mg thrice daily after meal untill Hb% level become satisfactory. After one week. Hb% increase 1 gm% per week. 3. If Hb% is below 40% then give blood transfusion and the iron either in oral or in injection form. Perenteral iron-preparations: a. Iron dextran i.m. or i.v. b. Iron sorbital citric acid complex i.m only. 2 c.c daily till total dose is ful filled (deep i.m). About 250mg of iron are required to increase the haemoglobin level by Igm/dl but tolal dose should not exceed 2.5gm iron. Indications for perenteral iron: a. Intolerable by mouth, b. Diarrhoea and malabsorption. c. Patients who are unreliable in taking drugs for 3 months, d. Chronic bleeding causes loss of iron, e.g. fibroid uterus. e. Treatment of cause as- if Iron-deficiency anemia is due to hook worm infestation, give antihelminthic drugs. |
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