Iron deficiency anemia

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Iron deficiency anemia is the most common cause of anemia worldwide. Although it occurs in both developed and undeveloped countries, the causes are different. In developed countries, the causes are usually due to pregnancy or chronic blood loss due to gastrointestinal ulcers or neoplasm. In undeveloped countries, hookworm infections accounts for most cases of iron-deficiency anemia.

Acute or chronic blood loss is another cause of anemia. With hemorrhage, red cells are lost and hypovolemia causes the kidney to retain water and electrolyte as compensation. Retention of water and electrolyte restores the blood volume, but the concomitant dilution of the blood causes a further decrease in the red cell count, hemoglobin concentration, and hematocrit. Chronic bleeding in compensated by erythroid hyperplasia, which eventually depletes iron stores. Thus, chronic blood loss results in iron-deficiency anemia.

The last category, increased rate of red cell destruction, includes the Rh factor and sickle cell anemia. The Rhesus (Rh) blood group antigens are involved in maintaining erythrocyte structure. Patients who lack Rh antigens (Rh null) have severe deformation of the red cells.

References:

• Harrison’s Principles of Internal Medicine, 17th edition.
• Davidson’s Principles and Practice of Medicine, 20th Edition
• Medical physiology, Lippincott Williams & Wilkins 3rd edi.

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