内科学 缺铁性贫血(英文)

Irondeficiencyanemia

1CONTENTSINTRODUCTIONETIOLOGY/PATHOGENESISMANIFESTATIONSLABORATORYFINDINGSDIAGNOSIS&DIFFERENTIALTREATMENTCASEREPORT2Irondeficiencyanemia(IDA)Theanemiacausedbyinsufficientdietaryironuptake,bleeding,etal,inwhichtheironstorageandhemoglobinsynthesisdecreased.Irondeficiencyistheleadingcauseofanmeiaworldwide.hemoglobinhemeglobinFe++protoporphyrin3Serumiron4CausesDecreaseofintakeBloodlossIncreaseofneedsDietarydeficiencygastrointestinalpregnancyGastricdiseaseulcerbabycancerhookworm

diseasehaemorrhoidsmenstruationhemolysis5MANIFESTATIONSMANIFESTATIONSPrimarydiseaseanemia6Menifestationofanemia1,commonmenifestation:pale,weak,dizzy,tinnitus,palpitation2,specialmenifestation:7Tests---morphology---bloodMCV<80flMCH<26pgMCHC<32%8Tests---morphology---bonemarrow9Tests---ironmetabolismSerumironTotalironbindingcapacity,TIBCTransferrinsatuationSerumferritinFEP(freeerythrocyteprotoporphyrin)10DIAGNOSISThreestages1,irondepletion:serumferritin,serumironnormal2,latentirondeficiencyserumiron,serumferritin,FEP,TIBC,HBnormal3,IDA11DIFFERENTIAL1,thalassemia2,anemiaofchronicdiseaseserumiron,serumferritin,TIBCnormal,ringedsideroblast3,ringedsiderblastanemiaringedsideroblast,>15%12treatmentTreatmentofprimarydiseaseIronsupplementation(TargetHb-presentHb)*kg*0.33(TargetHb-presentHb)*kg*0.24+50013TreatmentresponseRet:d7-10Hemoglobin:week2Hemogolbin:1-2monthlaternormalFerritin:continuesupplement3months14CasereportA20-year-oldfemalepresentedwithfatigue,paleinAugust2014.ShewasadmittedtoThe1stAffiliated,GMU.Physicalexaminationfoundthatnosternumtendernessandnoenlargementofliverandspleen.15TESTShepresentedwithandecreasedleukocytecountof2.5×109/L,anaemiawithhaemoglobinof54g/l，RBCcountof3.4×1012/L,MCV55.9fL，MCH:15.9pg，MCHC:284g/L.Plateletcountof343×109/L.Serumiron6.2umol/L，TIBC:89.1umol/LSerumferritin:18.94ng/mLCD55/59normal,thalassemiagenetestnormal1617dianosisIronDeficiencyAnemiaWhatwasthecauseofIDA?decreaseofintake:sheeatedlittlemeat.bloodloss:hermenstruationwasnormal.

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18treatmentChangethewayofdietTreattheerosionofstomachInfusionIronsupplementation

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