Iron Deficiency Anaemia

Comprehensive practice flashcards covering iron metabolism, clinical and laboratory features, and the management of Iron Deficiency Anaemia based on the lecture by Nabila Ado Ya'u.

Iron Deficiency Anaemia (IDA)

A condition that develops when body iron stores are completely depleted, level of circulating iron is reduced, and there is insufficient iron available for erythropoeisis.

Ferric form

The oxidation state of iron known as $Fe^{3+}$.

Ferrous form

The oxidation state of iron known as $Fe^{2+}$, which is the form in which iron is absorbed.

Male iron distribution

The amount of iron in a healthy adult male is approximately $50\,mg/kg$.

Female iron distribution

The amount of iron in a healthy adult female is approximately $40\,mg/kg$.

Ferritin

A water-soluble storage form of iron consisting of an apoferritin protein shell and a ferric oxyhydroxide core; it forms the majority of storage iron.

Haemosiderin

A water-insoluble storage form of iron found mainly in macrophages, formed by lysosomal digestion of ferritin aggregates and visible by light microscopy with Prussian blue staining.

Hepcidin

A protein that regulates iron metabolism; absorption is favored when serum levels are reduced and inhibited when serum levels are increased.

Sideroblast

Erythroblasts containing aggregates of ferritin; they normally constitute $25\text{-}30\%$ of the nucleated cells in the bone marrow.

DMT1 (Divalent metal transporter 1)

The transporter responsible for moving iron from the apical cell surface into the epithelial cells of the duodenum and upper jejunum.

Haphaestin

An enzyme located on the basal border of enterocytes that converts iron back into the ferric form as it is transported into the plasma.

Transferrin

A glycoprotein produced in the liver that carries two atoms of iron in the plasma to erythroblasts and other body cells.

TIBC (Total Iron Binding Capacity)

A measure reflecting the amount of transferrin in circulation, which usually ranges from $300\text{-}400\,\mu g/dl$ and increases in IDA.

Apotransferrin

The form of transferrin that is devoid of iron after it has released its load into the cytoplasm of the cell.

Ferrochelatase

An enzyme located inside the mitochondria that mediates the incorporation of iron into protoporphyrin to form haem.

Pica

A clinical feature of iron deficiency characterized by an abnormal and strong desire to eat strange substances such as clay, paint, cardboard, or coal.

Koilonychia

A physical sign of iron deficiency manifest as spoon-shaped nails.

Plummer Vinson syndrome

A triad of clinical features including iron deficiency anaemia, dysphagia, and glossitis.

Pencil cells

Elongated red blood cells seen on a peripheral blood film that are characteristic of iron deficiency anaemia.

Micronormoblastic erythropoiesis

A bone marrow finding in IDA where erythroblasts are smaller than normal with reduced, vacuolated cytoplasm and ragged borders.

Perls Prussian blue reaction

A staining method used on bone marrow aspirations to detect the presence of stainable iron; iron is absent in IDA.

Serum ferritin threshold for IDA

Values below $12\,\mu g/l$ strongly indicate a lack of storage iron.

Transferrin saturation in IDA

The ratio of serum iron to TIBC, which is normally $30\%$ but drops to $<15\%$ in iron deficiency anaemia.

Free erythrocyte protoporphyrin (FEP)

A laboratory parameter that increases in IDA because protoporphyrin cannot combine with iron to form haem; it is normal in thalassemia.

Ferrous sulphate treatment

A $200\,mg$ oral dose containing $60\,mg$ of elemental iron, typically taken for $6$ months to replace body iron stores.