However, menstrual blood loss may be five times the average. Any additional iron required for daily red cell production comes from the diet. Three pathophysiologic mechanisms have been identified: At this point a certain amount of the transferrin receptor protein may be released into circulation and can be measured as soluble transferrin receptor protein.
Reticuloendothelial cells retain iron from senescent RBCs, making iron unavailable for hemoglobin Hb synthesis. Normally, an adult male will need to absorb at least 1 mg of elemental iron daily to meet needs, while females in the childbearing years will need to absorb an average of 1.
In general, there is no regulation of the amounts of nutrients absorbed from the gastro intestinal tract.
It is characterized by a microcytic or normocytic anemia and low reticulocyte count. Iron absorption Iron absorption takes place largely in the proximal small intestine and is a carefully regulated process.
Diagnosis generally requires the presence of a chronic inflammatory condition, such as infection, autoimmune disease, kidney disease, or cancer. The molecular mechanism underlying this relationship is not known. Absorption of these two forms of iron occurs by different mechanisms.
Iron supplements are required to ensure an adequate response to EPO. If anemia of chronic disease is suspected, serum iron, transferrin, reticulocyte count and serum ferritin are measured. However, to achieve a maximum proliferative erythroid marrow response to anemia, additional iron must be available.
Iron may also enter the body through red-cell transfusions or injection of iron complexes. Transferrin Tf is a bilobed glycoprotein with two iron binding sites.
Chronic aspirin use may cause it even without a documented structural lesion. Generalized weakness, exercise intolerance, dyspnea, palpitations, history of blood loss during menstruation, tachycardia and low Hb, all are suggestive of iron deficiency anemia.
Next, ferrous ion is transported across the lumen cell surface by a transporter called divalent metal transporter 1 DMT1 that can transport a number of other metal ions including copper, cobalt, zinc, and lead.
Iron bioavailability is affected by the nature of the foodstuff, with heme iron e. When iron stores are high, Haemosiderin predominates.
Iron stores provide a source of iron when physiologic demand is high, e. During the last two trimesters of pregnancy, daily iron requirements increase to 5—6 mg.
However, serum ferritin may be falsely elevated as an acute-phase reactant. Should a patient develop evidence of meningoccocus, eculizumab therapy should be stopped. Frequent blood donors may also be at risk for iron deficiency.
The patient has evidence of a thrombotic microangiopathy with anemia, schistocytosis, and elevated LDH. Worldwide, anemia of chronic disease is the 2nd most common anemia.
Iron deficiency is the most prevalent single deficiency state on a worldwide basis. Ferritin is a protein bound, water-soluble, mobilizable storage compound and is the major source of storage iron.
Etiology Anemia of chronic disease occurs as part of a chronic inflammatory disorder, most often chronic infection, autoimmune disease especially RAkidney disease, or cancer; however, the same process appears to begin acutely during virtually any infection or inflammation, including trauma or post-surgery.
Serum iron and transferrin are typically decreased, while ferritin is normal to increased.Hematology Review _ Case Studies - Download as Powerpoint Presentation .ppt), PDF File .pdf), Text File .txt) or view presentation slides online.
Study Flashcards On Hematology: Case Studies at mint-body.com Quickly memorize the terms, phrases and much more.
mint-body.com makes it easy to get the grade you want! Anemia of chronic disorders is produced by blockage of iron release from the storage areas (macrophage) and availability to be used in the synthesis of heme in the /5(1).
teaching cases Case 1: A 73 year old man with fatigue, weight loss, anemia and mild thrombocytopenia for five months. Case 2: A 56 year old man with weight loss and microcytic anemia. Case Study: 32 Year-Old Female with Anemia and Confusion A board-style question with an explanation and a link to a relevant article is a recurring feature of TraineE-News.
The goal of the case study is to clarify specific and timely teaching points in the field of hematology. 6: Case studies Hemeteam is free of charge and advertising, and the author has no conflicts of interest. You may freely use The QxMD Hematology calculator which has many interesting applications.
PATHOPHYSIOLOGY CASES FOR HEMATOLOGY Dr. David Diuguid Section Director. Pathophysiology - Hematology Hematology Page 5 Case 1: No anemia in parents, siblings, or in any of her 8 children. Present illness: 15 years ago she was admitted for the 1st time with a 6-month history of hemoptysis and night sweats.