In iron deficiency anemia all are true except
(B) (MCHC increased) (278- Harsh mohan 7th)Laboratory Diagnosis of Hypochromic AnaemiasTestIron DeficiencyChronic DisordersThalassaemia minorSideroblastic Anaemia1. MCV, MCH, MCHC,ReducedLow normal to reducedVery lowVery low (except MCV raised in acquired type)2. S. ironReducedReducedNormalRaised3. TIBCRaisedLow to normalNormalNormal4. S. ferritinReducedRaisedNormalRaised (complete saturation)5. Marrow iron storesAbsentPresentHighHigh6. Iron in normoblastsAbsentAbsentPresentRing sideroblasts7. Hb electrophoresisNormalNormalAbnormalNormalIRON DEFICIENCY ANEMIA* Common cause of nutritional anemia* S. ferritin is good indicator of the adequacy of body iron stores (<12 mcg/1)* Anisocytosis, and poikilocytosis, Target cell elliptical forms and polychromatic cell and often present* Common causes of restless leq syndrome is Iron deficiency anemia and CRF* Cyanosis does not occure in severe anemia because critical concentration of Hb required to produced cyanosis is reduced. If the total concentration of Hb is <4 gn/dl as they occure in severe anemia cynosis will not by manifested* RDW (RBC distribution width) is a measure of the variation of RBC width that is reported as part of a standard complete blood count, usually RBC are a standared size of about 6-8 um blood. It is the coefficient of variation of red blood cell volume.* Normal reference range in human RBC is 11-14%* Increased in fe deficiency anemia & normal in B!2 deficiency *** Most common cause of Ted RBC protoporphrin level are absolute or relative iron deficiency ** and lead poisoning *** Iron absorption is increased when body iron stores are depleted or when erythropoiesis is increased even in the face of normal or increased iron stores.1. Iron absorption increased in - pregnancy, Malignancy, Erythroid hyperplasia, iron deficiency anemia infections,Hypoxia *, acidic pH of stomach*, vitamin C, Aminoacids, decreased fe stores low phosphate2. Iron absorption decreased in - Apastic anemia Fanconi's anemia pure red cell aplasia (Macrocytic anemia)Alkaline pH, Hypochlorhydria, phytates, phosphates, oxalates, copper deficiency malabsorption syndrome* Iron absorption occurs mainly in duodenum** also in proximal ileum. Iron is absorbed in ferrous state*** First increase of reticulocyte count*** after 48-72 hours of iron therapy.* Iron therapy should continue for 3-6 months ** after restoration of normal haematologic values to replenish iron value* Requirement of iron in anemia= 2.21 x body weight x Hb deficit **** The average iron absorption in adult male is 6% in female 12% but in iron deficiency can increase iron absorption is about 20% for meat iron and 5-10% for vegetarian diet. Therefore 300 mg of elemental iron given only 30 mg will be absorbed, with rise of hemoglobin iron absorption is decreased and erythropoietin stimulation also decreases ***
Corpuscular volume is reduced
Mchc increased
Increased total iron binding capacity
S.ferritin reduced
Blood