microcytic anemia Flashcards
what are the classifications of anemia according to MCV ?
microcytic
normocytic
macrocytic
what is the usual cause of microcytic anemia ?
low hemoglobin levels
where is iron absorbed ?
duodenal epithelial cells , vitamin C is needed for the conversion and absorption
what is the iron transporter ?
ferroporotin
what are the transferrin levels in association with iron defeciency anemia ?
there is more transferrin being produced by the liver (TIBC)
but the transferrin saturation is decreased
what are the scenarios associated with inadequate GI uptake causing iron deficiency anemia ?
1- in babies where the iron stores are depleted
due to exclusive breast feeding
2- malapbsorption or GI process involving the duodenum or decreased production of acid
3- malnutrition
what is the most common cause of iron deficiency ?
bleeding - menses , peptic ulcers, colon cancer
what are the more rare causes of iron defeciency ?
hookworms
plummer vinsion syndrome - anemia , esophageal webs , beefy red tongue , dysphagia
what are the lab findings associated with IDA ?
decreased ferritin levels
increased transferrin levels
decreased serum iron
decreased percent saturation
what type of anemia is associated with IDA ?
microcytic hypochromic anemia
what are the levels of protoporphyrin levels in IDA ?
increased
treatment for IDA ?
oral supplemettion of iron
what is the MOA associated with anemia of chronic disease ?
associated with inflammation
has mild anemia which is mostly triggered by cytokine release (IL6 anf TNF alpha)
what is the most sensitive marker for iron stores ?
ferritin
what are the lab findings associated with anemia of chronic disease ?
low Hb level normal ferritin levels
high hepcidin levels
what is the most common etiology associated with anemia of chronic disease ?
usually associated with renal failure , cytokine mediated EPO defeciency
what is the role of hepcidin in anemia of chronic disease ?
normally if iron levels are high then hepcidin levels are low
hepcidin production is increased in anemia of chronic disease
what are features of anemia associated with lead poisoning ?
lead causes an inhibition of ALA and ferrochelatase
causing an increase in ALA
what are the classic cases associated with lead poisoining?
a child eating paint chips from an old house
older person who comes with confusion after hunting or making alcohol at home
what are the accumulated substances associated with lead poisoning ?
portoporphyrin
ALA
what are the presenting symptoms associated with lead poisoning ?
microcytic anemia
mental deterioration
lead colic
lead lines in the gums blue lines
nephropathy
neuropathy - drop wrist drop foot
what is seen on peripheral blood smear of lead poisoning ?
associated with basophilic stippling
ringed sideroblasts in the bone marrow
what is the management of lead poisoning ?
calcium EDTA
dimercaprol
succimer - DMSA
what is sideroblastic anemia ?
associated with a deficiency in delta ALA synthetase
fsilure to make protoporphyin - iron accumulation in the mitochondria
