Iron Deficiency

Question 1

Describe iron homeostasis

Answer 1

Red cells live for 120 days so you need 20mg / day. Iron is only absorbed in fe2+ form not ferric (fe3+)

Question 2

What are the factors affecting absorption of iron

Answer 2

1. Diet, 2. Intestine (acid of duodenum), 3. Systemic (pregnancy)

Gut cells alter iron absorption: iron will pass into the epithelial cell but some level of control by basement membrane of epithelial, at basement membrane, ferry potion to transport iron into the blood, hepicidin is a key regulator of the entry of iron into the circulation, if hepicidin is high (when iron levels are high) then it will block ferropotin and stop you from absorbing iron.

Element iron gets taken up by cell, protein shell (transferrin) forms around it to form ferritin micelles, once the iron enters the plasma via ferropotin, it gets linked to transfer in which transports the iron around the body.

Question 3

What is anaemia of chronic disease

Answer 3

Anaemia in patients that are chronically ill. The patient will not be bleeding, not have any bone marrow infiltration and not be iron/ b12 deficient (no obvious cause). Eg: TB/HIV, rheumatoid arthritis, cancer,

Diagnostic features: C-reactive protein (increase), ferritin (increase), F8 (increase), fribinogen (Increase)

Question 4

What are the diagnostic tests for anaemia

Answer 4

1. MCV (microcytic/ macrocytic)
2. Serum iron if low - iron deficiency + ACD (not thalassaemia)
3. If low ferritin - iron deficiency (not ACD)
4. Transferrin high - iron deficiency (NOT ACD)

Look at parameters