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Iron Deficiency Anemia: Imran Shahzad Anjum, MD
Iron Deficiency Anemia: Imran Shahzad Anjum, MD
Imran Shahzad
Anjum,MD
Iron in human body
Total Iron in human body averages 4 to 5 grams which is
distributed as:
1. 65% in form of Hb.
2. 4% in form of mayoglobin.
3. 1% in form of heme compunds whcih promote intracelluar
oxidation.
4. 0.1% is combined with protein transferrin in blood plasma.
5. 15%−30% stored for later use,mainly in reticuloendothelial
system of bone marrow and liver parenchymal cells,
principally in form of ferritin
Iron transport & metabolism
Bilirubin
excreted Fereitin hemosiderin
Macrophages heme
Degrading hemoglobin Free Fe enzymes
Free Fe (Tissue:liver & RNC of BM)
Hemoglobin Transferrin−Fe
Red cells
+ −
hepcidin:25−amino acids peptide
hormone secreted by liver
− +
ferroportin: sole known cellular Fe
export channel
− +
Iron efflux into plasma from macrophages,
heptocytes
& intestinal enterocytes
Body Iron supply & storage
Iron deficiency
Fe Fe
1. Serum ferritin
deficiency overload
2. Serum iron &TIBC
3. Transferrin saturation
4. RBC protoporphyrin
BM Q. 5. Serum level of TRP
MRI
Aspirate& Flebotomy
Non−inv
biopsy Liver biopsy
Stages of Iron deficiency
serum TRP is less affected by inflammation, its measurement usually can determine
whether iron store are absent.
Differential diagnosis of microcytic
hypochromic anemia