iron utilization anemia
Introduction
Introduction to iron utilization anemia Iron-utilized anemia is an anemia that occurs when iron storage in the body does not meet the needs of normal red blood cell production. It is due to insufficient iron intake, decreased absorption, increased demand, and excessive iron utilization or loss. Morphological manifestations of small cell hypochromic anemia. Iron utilization anemia is not a disease, but a symptom of the disease, and the symptoms are related to the degree of anemia and the onset of onset. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: stomatitis
Cause
Cause of iron utilization anemia
The demand for iron is increased and the intake is insufficient (30%):
In fast-growing infants, children, menorrhagia, women during pregnancy or lactation, the need for iron increases, and if the diet is absent, it is prone to iron anemia. The occurrence of iron-utilized anemia is gradually formed over a long period of time. During the iron depletion period, the stored iron is depleted and the serum ferritin is reduced. There is no anemia at this time. If the iron deficiency is further aggravated, the stored iron is exhausted.
Blood loss (30%):
Blood loss, especially chronic blood loss, is the most common cause of iron deficiency anemia. The most important causes are gastrointestinal bleeding such as ulcer disease, cancer, hookworm disease, esophageal varices bleeding, hemorrhoids, and gastric antrum after taking salicylate. Inflammation and other diseases that can cause chronic bleeding, women with menorrhagia and hemolytic anemia with hemosiderin or hemoglobinuria can cause iron utilization anemia.
Poor absorption of iron (30%):
Serum ferritin and serum iron decreased, total iron binding capacity increased, and iron-deficient anemia occurred due to iron absorption disorder, and iron deficiency anemia was rare.
Prevention
Iron utilization anemia prevention
Health education and preventive measures should be emphasized in people prone to such anemia, such as:
1 Improve the baby's breastfeeding method and increase the appropriate supplementary food in time.
2 Actively implement family planning to prevent excessive childbirth.
3 Oral ferrous sulfate 0.2 or 0.3g per day during the late pregnancy and lactation.
4 Conduct large-scale prevention and control of parasitic diseases in areas where hookworm disease is endemic.
5 timely treatment of chronic hemorrhagic foci.
Complication
Complications of iron utilization anemia Complications stomatitis
Complications: susceptible to infection, such as stomatitis, glossitis.
Symptom
Symptoms of iron utilization anemia Common symptoms Malnourished skin dry tongue inflammation splenomegaly easy to be inattentive attention to nipple edema
The clinical manifestations of this disease
1 clinical manifestations of primary disease;
2 symptoms caused by anemia itself;
3 Symptoms caused by respiratory disorders in tissues and organs due to reduced activity of iron-containing enzymes.
symptom
1. Symptoms caused by epithelial tissue damage:
The decrease in intracellular iron-containing enzyme is the main cause of epithelial changes.
(1) angular cheilitis and glossitis: about 10-70% of patients have angular keratitis, smooth tongue and atrophy of the tongue, especially in the elderly.
(2) Esophageal spasm.
(3) Atrophic gastritis and gastric acid deficiency.
(4) skin and nail changes: dry skin, keratinization and atrophy, hair easy to fold and fall off; nails are not smooth, flat nails, anti-A and gray armor.
2, the symptoms of the nervous system:
About 15-30% of patients show neuralgia (mainly headache), paresthesia, severe cases may have increased intracranial pressure and papilledema, 5-50% of patients have mental, behavioral abnormalities, such as inattention Excitability, mental retardation and ecstasy, because iron deficiency not only affects oxidative metabolism and nerve conduction in brain tissue, but also leads to decreased activity of mitochondrial monoamine oxidase associated with behavior.
3, splenomegaly: the reason is related to the shortening of red blood cell life.
Examine
Iron use anemia check
First, the blood picture:
Early or mild iron deficiency can be free of anemia or only mild anemia. Late or severe iron deficiency has typical small cell hypopigmentemia, and the degree of reduction in hematocrit and hemoglobin concentration is reduced by red blood cell count.
Second, the bone marrow image:
Active bone marrow hyperplasia, red blood cell ratio decreased, red blood cell system hyperplasia was active, the proportion of young and middle red blood cells increased, the volume was slightly smaller than the average young red blood cells, the edges were not neat, the cytoplasm was less, the staining was blue, and the nuclear condensing resembled the young red blood cells. , indicating that cytoplasmic development lags behind the nucleus, and the number and morphology of granulocyte and megakaryocytes are normal.
Third, bone marrow iron staining.
Fourth, serum ferritin.
Fifth, serum iron.
Diagnosis
Diagnosis and diagnosis of iron utilization anemia
diagnosis
1, medical history questions: pay attention
1 eating habits, whether there is a partial eclipse or a eclipse.
2 Whether there are digestive diseases (atrophic gastritis, gastric ulcer or duodenal ulcer, etc.), hookworm disease; whether women have menorrhagia; whether they have had gastrointestinal surgery, etc., male and postmenopausal women should consider whether it is stomach The first symptoms of intestinal tumors.
2, clinical symptoms: generally fatigue, irritability, palpitations, shortness of breath, dizziness, headache, children with poor growth and development, attention is not concentrated, some patients have anorexia, heartburn, flatulence, nausea and constipation and other gastrointestinal symptoms, A small number of serious patients may have difficulty swallowing, angular cheilitis and glossitis.
3. Laboratory data.
Differential diagnosis
1. Thalassemia: There is a family history. A large number of target red blood cells can be seen in the blood, and hemoglobin A2 is increased, and serum ferritin and bone marrow can increase iron.
2, chronic inflammatory anemia: total iron binding capacity is normal or decreased, serum ferritin increased.
3, iron granulocyte anemia: visible ring iron granule cells, serum iron and ferritin increased, total iron binding capacity decreased.
