Week 7 Discussion Iron Deficiency Anemia Iron deficiency anemia (IDA) is a microcytic-hypochromic anemia that occurs worldwide and is the most common type of anemia (Schwartz, McCance, & Rote, 2017). Absolute and functional IDA are the two main types. Absolute IDA occurs when total body iron stores are low or depleted and functional IDA has normal iron stores but the supply to the bone marrow is insufficient (Lopez, Cacoub, Macdougall, & Peyrin-Biroulet, 2016). Iron is an important element of hemoglobin and myoglobin (Lopez et al., 2016). Iron is required for numerous cellular mechanisms such as enzymatic processes, DNA synthesis, and mitochondrial energy generation (Lopez et al., 2016). Schwartz et al. (2017) describe three overlapping stages for IDA development. The first stage involves the depletion of the body’s iron stores for red blood cell (RBC) production and hemoglobin synthesis. However, the production of red cells and the hemoglobin content remain normal (Schwartz et al., 2017). In the second stage, iron- deficient red cell production begins due to the inadequate iron transported to the bone marrow (Schwartz et al., 2017). The deficient red cells enter circulation to replace the standard, old red blood cells, signaling stage III development (Schwartz et al., 2017). Compensatory changes occur when iron becomes deficient and the oxygen-carrying capacity of blood causes the tissue to become hypoxic (Schwartz et al., 2017). Increased production of erythropoietin and a decrease in the production of hepcidin takes place (Schrier & Auerbach, 2018). Hepcidin is a small peptide that helps control the availability of iron to tissues (Lopez et al., 2016). Symptoms vary depending on the severity of IDA and the milder the anemia the easier it is for the body to compensate (Schwartz et al., 2017). Pale skin, conjunctivae, and nail beds are some of the first symptoms to occur, along with fatigue, dyspnea on exertion evolving to shortness of breath at rest, vertigo, syncope, headache, tachycardia, and development of a cardiac systolic flow murmur (Lopez et al., 2016). Epithelial cells begin to become affected and rapid turnover produces dry, rough skin, dry and damaged hair, moderate alopecia, and koilonychia (Lopez et al., 2016). Glottis is seen in severe cases and can determine how long the iron deficiency has occurred (Lopez et al., 2016). An esophageal web may form due to an accumulation of mucous and inflammatory cells that has the potential to turn cancerous (Schwartz et al., 2017).
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- Fall '17
- keisha lovence
- Hematology, Hemoglobin