Iron deficiency anaemia
Characteristically, a full blood count will show a microcytic anaemia. A blood film may show hypochromic red blood corpuscles. Haematinics will show low serum iron, low ferritin and raised total iron binding capacity (TIBC).
It is often caused by chronic, insidious losses rather than acute, large volume bleeds. Common sites including the upper and lower GI tracts.
Symptoms and signs iron deficiency
There is evidence that iron deficiency produces symptoms independent of those due to haematologically demonstrated anaemia. Iron loss due to bleeding will present more often with anaemia and its symptoms, but any cause of chronic iron deficiency including blood loss might present with the symptoms that can be independent of demonstrable anaemia. Tissues with high cell turn over such as the skin and mucosa will be affected by subacute or chronic iron deficiency. Some of the associations are complex with for example equivocal evidence that correcting demonstrated iron deficiency associated with restless legs syndromes reduces symptoms as effectively as treating the symptoms in their own right.
- Pallor (45-55% presentations)
- Fatigue (44% of presentations)
- Headaches (63% of presentations)
- Alopecia (30% of presentations)
- Atrophic glossitis (27% of presentations)
- Restless legs syndrome (24% of presentations)
- Heart murmur (10% of presentations)
- Tachycardia (9% of presentations)
- Dry skin
- Rough skin
- Dry hair
- Damaged hair (see also alopecia above)
- Neurocognitive dysfunction
- Haemodynamic instability (2% of presentations)
- Syncope (0.3%)
- Plummer-Vinson syndrome (the most effective treatment is iron !)
Set out in BSG guidelines.
- Full blood count
- ↑ Bergsjø P, Evjen-Olsen B, Hinderaker SG, Oleking'ori N, Klepp KI. Validity of non-invasive assessment of anaemia in pregnancy. Tropical medicine & international health : TM & IH. 2008 Feb; 13(2):272-7.(Link to article – subscription may be required.)
- ↑ [www.bsg.org.uk/pdf_word_docs/iron_def.pdf BSG 2005 Guidelines on Investigation of Iron Deficiency Anaemia]