You are on page 1of 13

IRON DEFICIENCY ANEMIA

Definition Iron deficiency anemia is the common anemia found in the developing country. Iron deficiency anemia is caused by abnormality in eritropoesis in maturation step. Iron is important in hemoglobin making. Iron absorbed in duodenum in Ferro (fe+2) form and excreted though hair, nail, urine and des uamation intestinal epithelial. In the body iron is save in feritin form and haemosiderin form in reticular endothelial system, such as! liver, spleen and bone marro". In the plasma iron binding "ith protein "hich call transferin. #en need $%2 mg iron every day and "oman and child need &,'%$ mg more than man. (here are ) grade before iron deficiency anemia, they are! $. Iron depletion 2. Iron deficiency ). Iron deficiency anemia Etiology Iron deficiency anemia cause by ! $. *ecreased iron intake. 2. +bnormality in absorption. it is happen at post intestinal surgery and patient "ith malabsorbtion syndrome.

hiatus hernia.). (he symptoms of anemia are!          (ired Fatigue /eakness 0ead ache *yspnea 1ale 2lossitis 3tomatitis 4oilonychias Laboratory Finding $. neoplasm and parasite intestinal. gastritis. Increased iron utili.hronic bleeding.ation iron utili. 5ed blood cell morphology .ation increase in post natal gro"th spurt and adolescent gro"th spurt Clinical Manifestation . -. as specially ankilostoma. chronic bleeding common cause by peptic ulcers.linical manifestation of iron deficiency anemia cause by basic disease manifestation and anemia manifestation it self. . hemorrhoid.

+hmad #uchtar 6ukittingi on #arch $&th . 2&&) "ith! Chief Co"plain#  7ausea and vomit since 2 days ago !resent Illness $istory#  7ausea and vomit since 2 days ago. if patient eat. he "ill vomit all thing "as he eat. . (herapy of anemia is !     5est 0igh calorie and high protein diet 3ulfa ferosus (ransfusion CA E RE!ORT + male patient age $) years old "as admitted to internal medicine department of general hospital *5. Iron serum concentrate decrease and iron binding capacity increase ). Feritin serum concentrate decrease Therapy (herapy of iron deficiency anemia consist of therapy of anemia it self and therapy of basic diseases. 0aemosiderin bone marro" decrease -. #ikrositer hipokrom 2.

head ache. he live "ith his aunty and there he eat irregularly  (here are no bleeding story  (here is no abnormality in defecation and urinate !re%io&s Illness tory#  1atient didn9t have this illness before The Fa"ily Illness tory#  7one of family members had disease like this !hysical E'a"ination (!E) # *ital ign # 2eneral appearance ! moderate illness . pain at left side of abdominal.& mmhg ! .<o. and vomited if he eat.onsciousness 6lood pressure 1ulse rate 5espiratory rate (emperature 6ody height ! compos mentis cooperative ! $$&:. 2 days ago patient abdomen kicked by his brother and made patient unconscious. +fter conscious patient feel nausea. ! $). "eakness since 2 "eeks ago  3ince 8 months ago.2x:minutes ! 2&x:minutes ! )8. cm .  1ale since 2 "eeks ago  Fatigue.

mouth and nose ! (here is no abnormality Nec+ # @A1 '%2 cm02B (hyroid gland ! 7o enlargement Chest # Cung and heart are no abnormality Abdo"en # I 1a 1er + E'tre"ities # 5F 51 ! +:+ ! %:% ! 7o s"ollen ! Civer "as not palpable.<& ( normal ) Ly"ph node ! 7o enlargement $ead# +yes ! +nemic con>unctiva and sclera not icteric ?ars. spleen palpable (3%$) ! (ympani ! 1eristaltic sound (+) normal ?dema ! %:% .6ody "eight 6#I +in # 1ale .yanosis ! (+) ! (%) ! )8 kg ! $=.

2 mg:dl .' D ! +.&&& :mm) ! $' vol D ! 2. mikrositik hipokrom ! $<2..).' mm : hour ! &:2:):--:-=:) ! 2.2 mg:dl ! 88&&:mm) ! $$.8.Laboratory Finding .&&&:mm) ! =.< mg:dl ! &.ount ?rythrocyte 0aematocrit 5etikulocyt 56.)& gr:dl ! ). mg:dl ! &.lood # 0b Ceukocyte C?* *iff.&&&. . mg:dl ! $=.'2 gr:dl ! $. morphology (rombosit (otal protein +lbumin 2lobulin (otal bilirubin 6ilirubin I Ereum 4reatinin -rine # 6ilirubin Erobilin 1rotein 5eduksi ! (%) ! (+) ! (%) ! (%) ! 8.= gr:dl ! -.

1ost abdominal trauma Differential Diagnosis Therapy # % % % % % % % % 6ed rest 0igh calories and protein diet 3ulfa ferosus )F$ tab: day +s. (halasemia .or+ing Diagnosis ! $.rystal Bval fat bodies ! &%$ ! $%2 ! (+) ! (%) ! (%) Fesses # ?rythrocyte Ceukocyte +nkilostoma egg ! (%) ! (%) ! (%) . Co" intake 2. Iron deficiency anemia ec.3ediment ! ?rythrocyte Ceukocyte ?pitel . Folat )F$ tab: day 6. complex )F$ tab:day +ntacid F$ tab: day Ailapon F$ tab:day 6lood transfusion ! $.

#. /eakness (+) 7ausea (%). 6p .on>unctiva anemic +bdomen %I % 1al % 1er %+ . Iron *eficiency +nemia ec. 3usp. moderate . ( )8. spleen palpable at 3%$ ! (ympani ! 1eristaltic 3ound (+) 7ormal ! $.D ! ! 7o 3"ollen ! Civer not palpable. Aomit (%) 1ain at left side abdomen (%) 0ead ache (%) 1ale (+) !E ! 2+ . 55 2&x:i . 6lood.& 15 .!lanning E'a"ination # % % % % % % Follo/ -p # March 01th 2 3445 A ! Fatigue (+). C. .&x:i . $$&:. Co" Intake .<o. urine and fesses routine examination 5ed blood cell morphology Iron serum concentration Iron binding capacity 6one marro" biopsy Feritin serum concentrate 3kin ! pale (+) .

3kin ! pale (+) . 55 $=x:i . 6p . 55 $=x:i . 3usp.o.on>unctiva anemic +bdomen %I % 1al % 1er %+ . $$&:. /eakness (+) 1ale (+) !E ! 2+ .& 15 . Iron *eficiency +nemia ec. C. 3kin ! pale (+) .=o. /eakness (+) 1ale (+) !E ! 2+ .8x:i .ontinue March 34th 2 3445 A ! Fatigue (+). . spleen palpable at 3%$ ! (ympani ! 1eristaltic 3ound (+) 7ormal ! $.#. Co" Intake ! . 6p . other ! continue March 06th 2 3445 A ! Fatigue (+). . ( ). moderate .on>unctiva anemic +bdomen ! . C.#. $$&:.& 15 .2x:i .D T$ ! ! 7o 3"ollen ! Civer not palpable. moderate . ( )8.T$ ! 3top antacid and vilapon.

55 2&x:i . Iron *eficiency +nemia ec. Co" Intake ! . .=o. moderate . spleen palpable at 3%$ ! (ympani ! 1eristaltic 3ound (+) 7ormal ! 0b ! . $$&:.ontinue March 30th 2 3445 A ! Fatigue (+).& 15 . 6p . Iron *eficiency +nemia ec.%I % 1al % 1er %+ .#.ontinue March 33th 2 3445 A ! Fatigue (+). ( )8. 3usp..2x:i . C.D T$ ! 7o 3"ollen ! Civer not palpable. /eakness (+) 1ale (+) !E ! 2+ .D T$ ! ! 7o 3"ollen ! Civer not palpable.on>unctiva anemic +bdomen %I % 1al % 1er %+ LF . /eakness (+) . Co" Intake ! .= mg:dl ! $. 3kin ! pale (+) . spleen palpable at 3%$ ! (ympani ! 1eristaltic 3ound (+) 7ormal ! $.

ontinue March 37th 2 3445 A ! Fatigue (+).D T$ ! $.#.=o. $$&:.& 15 . 55 2&x:i . ( ). Ceococyte (%) . moderate .& 15 =-x:i .on>unctiva anemic +bdomen %I % 1al % 1er %+ LF ! Fesses ! ! 7o 3"ollen ! Civer not palpable.#. moderate . 3kin ! pale (+) .1ale (+) !E ! 2+ .o. 6p . 6p . $$&:. . 55 2&x:i . Co" Intake ! . spleen palpable at 3%$ ! (ympani ! 1eristaltic 3ound (+) 7ormal !% +nkilostoma egg (%) % ?rythrocyte (%). ( )8. /eakness (+) 1ale (+) !E ! 2+ . . C. 3kin ! pale (+) .on>unctiva anemic +bdomen ! . C.2x:i . Iron *eficiency +nemia ec.

C.D T$ ! ! 7o 3"ollen ! Civer not palpable.%I % 1al % 1er %+ . $$&:.D T$ ! 7o 3"ollen ! Civer not palpable. spleen palpable at 3%$ ! (ympani ! 1eristaltic 3ound (+) 7ormal ! 0b ! $&. Iron *eficiency +nemia ec. .2x:i .& 15 .ontinue March 38th 2 3445 A ! fatigue (+) 1ale (+) !E ! 2+ . ( )8.ontinue . 6p . spleen palpable at 3%$ ! (ympani ! 1eristaltic 3ound (+) 7ormal ! $.8o.#. Co" Intake ! . moderate . Iron *eficiency +nemia ec. skin pale (+) con>unctiva anemic abdomen %I % 1al % 1er %+ LF . 55 $=x:i . Co" Intake ! .' mg:dl ! $.

&&&. #ikrositik 0ipokrom . morphology ! +.&&&:mm) ! $' volD ! 2.DI C- ION /e diagnosed this patient as iron deficiency ec.' D 3kin +yes ! 1ale (+) ! . patient live "ith his aunty and there he eat irregularly 1hysical examination !   Caboratory fining ! 6lood !      0b ?rythrocyte 0aematocryte 5etikulocyte ! 8.on>ungtiva anemic 56. Co" intake ! +namnesis !    1ale since 2 "eeks ago Fatigue and "eakness since 2 "eeks ago 3ince 8 ounths ago.2 mg:dl ! 2.