Iron Deficiency Anemia: Basic Diagnostic, Therapeutic and Prophylactic Approaches

The article provides information on the main mechanisms of development, as well as modern diagnostic, therapeutic and prophylactic approaches to patients with iron deficiency anemia. Iron deficiency anemia is a clinically-haematological symptom complex that is caused by an inadequate percentage of iron in the body. It is manifested by a decrease in the level of red blood cells and hemoglobin in peripheral blood. In the general structure of all anemias, iron deficiency is ranked first in the frequency of occurrence in adults and children and is at least 80%. In normal conditions, the body of an average healthy adult contains about 5000 mg of iron, which is part of hemoglobin (2/3 of total volume), cytochrome oxidase (300 mg), ferritin and hemosiderin deposited in bone marrow, liver and spleen tissues (up to 1000 mg) and the so-called whey or transport iron (up to 304 mmol/ l). The first necessary iron supply is accumulated by a man during the prenatal period, receiving it from mother through the placental vascular system. In the postnatal period, iron enters the body only with food. In early childhood, the main cause of sideropenic syndrome is the inadequate intrauterine delivery of iron from mother to fetus due to insufficient iron in mother's body, gestosis in the second half of pregnancy, fetoplacental insufficiency, chronic inflammatory processes that aggravated during this period, prematurity, and multiple fertility. Another cause of sideropenic syndrome is an alimentary deficiency of iron. If you do not have time to add meat and fish dishes in the form of feeding, iron deficiency anemia is formed, because they that contain the highest level of food iron. Iron absorption from these products is maximum (18-22%), while from vegetable food we absorb only 0,5-3% of iron. The main ways of removing iron from the body are the sweat glands, the urinary tract and the digestive tract organs. Females after the onset of puberty have another way of iron withdrawal – with menstrual secretions. So, iron deficiency anemia occurs quite often in women. In order not to provoke an iron deficiency anemia it is enough to provide an inflow of iron with food in the amount of 2 grams per day, as precisely this amount of iron is excreted from the body every day. Diagnosis of iron deficiency anemia is based on clinical signs of sideropenia and is confirmed by the indicators of iron metabolism. The most informative is an increase in the total iron binding capacity of the serum and a decrease in the saturation coefficient of transferring by iron. An important diagnostic value is the level of serum ferritin, increased free protoporphyrin and a decrease in the number of sideroblasts in the myelogram: the number of erythrocytes is somewhat reduced; hemoglobin is significantly lowered; color index is below 0,85; possible anisocytosis and poikilocytosis; microcytes, isolated red blood cells that take on rings (anulocytes), as well as erythrocyte precipitates, are predominantly schizocytes. Differential diagnostics are performed with other hypochromic anemias: thalassemia, pyridoxine deficiency anemia and anemia caused by lead poisoning.