268b Fe deficient anemia Flashcards Preview

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Flashcards in 268b Fe deficient anemia Deck (15):
1

where is iron absorbed in intestine?

duodenum

"Iron Fist, Bro" = iron (duodenum), folate (jejunum, ileum), B12 (terminal ileum)

2

hepcidin - fxn? decreased by? increased by?

degrades ferroportin, prevents ferritin from releasing iron --> can't transport iron --> low iron, TIBC; high ferritin

decreased by: hypoxia, increased erythroid activity, Fe deficiency

increased by: inflammation (to keep bugs from getting iron), Fe sufficiency

3

ferroportin

iron transporters in macrophages, enterocytes, hepatocytes

4

what does low hepcidin result in? high?

hemochromatosis - iron overload

IRIDA - iron deficiency

5

transferrin - fxn?

binds circulating Fe

takes Fe to bone marrow erythroblasts for hemoblogin (via transferrin receptor -- upregulated in iron deficiency anemia)

6

how is iron measured - serum ion? TIBC? ferritin?

serum iron - Fe bound to transferrin

total iron binding capacity - how much Fe can bind to transferrin

ferritin - measure of total body iron stores

7

Fe deficient anemia -overview?

low iron due to chronic bleeding (GI loss, menorrhagia), malnutrition/absorption (duodenum) disorders or high demand (e.g., pregnancy) --> decreased final step in heme synthesis.

8

Fe deficient anemia- serum iron findings? symptoms? RBC appearance?

low iron, high TIBC, low ferritin.

Fatigue, conjunctival pallor

Microcytosis and hypochromia

**can lead to Plummer-vinson syndrome (Fe def anemia, esophageal webs, atrophic glossitis)

9

anemia of chronic disease/inflammation - overview

Inflammation (IL-6) --> increased hepcidin (released by liver, binds ferroportin on intestinal mucosal cells and macrophages, thus inhibiting iron transport) --> decreased release of iron from macrophages.

10

anemia of chronic disease/inflammation - serum findings?

low iron, low TIBC, high ferritin.

usually normochromic and normocytic but can become microcytic, hypochromic if severe

11

what iron study difference is there between anemia of inflammation and Fe deficient anemia?

**both have reduced Fe and Fe saturation**

anemia of inflammation - increased ferritin (acute phase reactant that stores Fe), EPO not high enough

Fe deficient anemia - reduced, EPO high

12

hemochromatosis - overview? causes? genetics?

Hemosiderosis is the deposition of hemosiderin (iron); hemochromatosis is the disease caused by this iron deposition

Disease may be 1° (autosomal recessive) --> low hepcidin or 2° to chronic transfusion therapy (e.g., B-thalassemia major).

Primary hemochromatosis due to C282Y or H63D mutation on HFE gene. Associated with HLA-A3.

13

hemochromatosis - serum findings

^ ferritin, ^ iron, low TIBC--> high transferrin saturation.

14

hemochromatosis - persentation

Classic triad of micronodular Cirrhosis, Diabetes mellitus, and skin pigmentation --> “bronze” diabetes.

Results in CHF, testicular atrophy, and ^ risk of HCC

"hemochromatosis Can Cause Deposits (CCD)"

15

Hemochromatosis - Rx?

repeated phlebotomy

deferasirox, deferoxamine.