When the body's hemoglobin synthesis is disturbed, iron deficiency occurs. This leads to various physiological pathologies indicating anemia and sideropenia. Studies have shown that more than two billion people in the world suffer from this form of the disease of varying severity. Most often, children who are breastfeeding mothers are exposed to it. Diagnosis of iron deficiency anemia is carried out in the clinic, after which treatment is prescribed. The doctor selects a diet and drugs depending on the age and well-being of the patient, based on laboratory tests
Reasons for appearance
The main risk group is women of childbearing age. This is due to the low supply of iron in the body, which is three times less than in men. The disease develops in 85% of pregnant women and 45% of young girls and boys. Often occurs in children who are malnourished. Diagnosis of iron deficiency anemia– this is an important point that allows you to assess the risk of complications in time.
Micronutrient deficiency is experienced by patients who need an increased dose. These are children, adolescents, lactating and pregnant women. If the diet is unbalanced, irregular, some important foods are missing, there is a lack of iron intake in the body. Among the main sources are meat, fish and liver. You need to eat peas, soybeans, spinach, eggs, beans, prunes, buckwheat, black bread.
There are several reasons why illness occurs. This is due to the absorption processes that are disturbed in the body. Diagnosis of iron deficiency anemia will reveal chronic blood loss, hemoglobinuria, and violations of iron transport. If you lose 5-10 ml of fluid every day, the figure will be 250 ml per month. If the cause is not determined in time, anemia develops.
The disease occurs with heavy menstruation, uterine bleeding, hemorrhoids and anal fissures. In children, it occurs with helminthiases, hemosiderosis of the lungs, diathesis. In donors who often donate blood, and patients on hemodialysis. Problems are caused by chronic enteritis, gastric resection, gastrectomy.
Development of IDA and degree
Laboratory diagnosis of iron deficiency anemia involves identifying problems, whether they manifest themselves or not. Hidden forms may not bother the patient, so he does not know about his state of he alth. There are several forms of disease development:
- The patient is notcomplains of he alth, and the study reveals a deficiency of ferritin.
- Mobilization of transport and tissue iron occurs. Hemoglobin is synthesized. Characterized by muscle weakness, dizziness, signs of gastritis, skin dries. Examination shows low transferrin saturation.
- The patient feels unwell, hemoglobin is low, then the number of red blood cells decreases.
There are several degrees of anemia according to the content of hemoglobin. After taking a blood sample, the presence of iron with an indicator of 90 g / l is detected if the disease is just beginning to develop. An indicator of 70-90 g / l will indicate the average form. If the patient feels unwell, the form is severe, and the results of the hemoglobin will be below 70 g / l.
When a disease is determined through laboratory tests, the results do not always match the clinical manifestations of the disease. In the classification, the first degree is characterized by the absence of poor he alth, so the patient may not be aware of the state of the blood. The second degree is manifested by dizziness and weakness. With the onset of the third type, a person becomes disabled. At the next stage - a state before a coma. The last one is fatal.
The norm differs depending on age and gender. In newborns, it is 150-220 g / l, and in one month - 110-170 g / l. From two months to two years - 100-135 g / l. Up to 12 years - 110-150 g / l. In adolescents - 115-155 g / l. For women, this figure will be 120-140 g / l, and for adultsmen – 130-160 g/l.
What you need to know about the disease
The etiology, pathogenesis, clinic, diagnosis and treatment of iron deficiency anemia are determined by a hematologist. However, depending on the type of disease, another specialist may be competent. Most often, they turn to a therapist, who will prescribe an examination, identify the cause of a decrease in hemoglobin. If knowledge is not enough, he will refer you to a hematologist.
Almost all types of anemia are deficient in iron, vitamin B12 and folic acid. The therapist will prescribe treatment, select a diet, prescribe iron supplements and the necessary vitamins. When the disease develops against the background of the pathology of the blood system, a narrow specialist will be needed.
In the absence of complications, it is not difficult to determine the disease. Often it is confirmed during examinations for another reason. A general blood test is taken, where a decrease in hemoglobin is detected by the characteristic content of red blood cells. This is the reason for the laboratory diagnosis of iron deficiency anemia of the following stages:
- Hypochromic look.
- The nature of anemia.
- Causes of IDA.
When interpreting, the doctor pays attention to the color of the blood, erythrocytes. It is important to correctly recognize the disease, since in some cases iron preparations cannot be prescribed. This will lead to an overload of the body with a substance.
Iron deficiency anemia is diagnosed in the following cases:
- Anemia due to an enzyme defect with a hereditary characteristic orafter taking certain types of medications.
- With thalassemia associated with a violation of the protein part of hemoglobin. Characterized by an enlarged spleen, elevated bilirubin.
- Anemia due to chronic diseases. The group includes inflammatory diseases of an infectious nature. This includes sepsis, tuberculosis, malignant tumors, rheumatoid arthritis.
Identification of the causes of the disease
To avoid errors in the diagnosis, differential diagnosis of B12- and iron deficiency anemia is carried out, adhering to the rules and recommendations. This will allow you to prescribe timely effective treatment. Here are some research rules:
- First examination, then treatment. If the patient was taking iron, the readings will not reflect the true amount of the substance in the blood. You can conduct a study 7-10 days after the drug is discontinued.
- Use special tubes that are washed with distilled water. Dry in special cabinets.
- Bathophenanthralin acts as a reagent. It makes the method as accurate as possible.
- Blood is taken in the morning when iron levels are higher.
Women need to know that the accuracy of diagnosing an iron deficiency anemia clinic is affected by the menstrual cycle, oral contraceptive use and pregnancy.
Diagnostic measures
To identify the problem, you will need to interview the patient. After that, laboratory blood tests are carried out. In some cases, a bone marrow puncture is prescribed, since the methodis the most informative. When it is necessary to establish the cause of the development of the disease, examine the feces for occult blood. A positive result is diagnosed as a tumor, peptic ulcer, or Crohn's disease.
Diagnosis of iron deficiency anemia in adults takes place in the presence of several specialists. They invite an endocrinologist, a gastroenterologist, a surgeon, a gynecologist and an oncologist. They will help to establish the true causes of the disease and prescribe effective therapy.
Diagnosis of iron deficiency anemia is based on determining the clinical picture and changing laboratory tests. With IDA, the hemoglobin content in the erythrocyte decreases. With a norm of 27, the indicator is 20-23 pg. The zone of central enlightenment differs. It increases, which in the ratio gives the result not in the norm of 1:1, but 2:1 or 3:1.
The size of erythrocytes decreases, they become different shapes. If there is no blood loss, the number of leukocytes and reticulocytes is preserved. The number of siderocytes - erythrocytes with iron granules - decreases. To improve the identification of the quality of the check, automatic devices are used.
Identification of disease in babies
Diagnosis of iron deficiency anemia in children is carried out in the laboratory. Small patients do a microscopic examination of the blood. Signs are low levels of red blood cells and hemoglobin, hypochromia, the presence of red blood cells of different sizes. If the case is complicated, they do blood biochemistry. Confirmation of the disease is a decrease in serum iron andtransferrin.
After diagnosing iron deficiency anemia in children, nutrition needs to be adjusted. Severe and moderate degree involves diet therapy and drug treatment. With its help, iron reserves are restored. After birth, the baby receives iron only through nutrition, so it is believed that natural feeding, timely administration of juices helps to maintain the required amount of the substance in the norm.
When breastfeeding, the absorption of the beneficial substance is at the level of 70%, and with artificial feeding - no more than 10%. Children with anemia are introduced complementary foods from the 5th month. The diet should include cereals and mashed potatoes with a high iron content. Meat is introduced from six months.
In newborns, deficiency occurs if the pregnant mother had problems. Children are selected medications based on age. Doses can be small and medium - from 10 to 45 mg. Most often it is drops or syrup. Chewable tablets are given to young children.
Research
Patients are offered various methods for diagnosing iron deficiency anemia. The anamnesis is studied with the clarification of the place of residence. The doctor is interested in a hobby, whether the patient goes in for sports. Is there fatigue and weakness, what medications does she take. Nutrition is important, as anemia develops in the absence of foods that contain iron in the diet.
Women talk about having abortions, how many births there were. It is important to indicate the regularity of menstruation. Are there blood loss from injuries, ulcers, fibroids. Presentwhether diseases of the stomach. To diagnose iron deficiency anemia, it is necessary to tell the specialist whether there were sharp fluctuations in weight up or down. Indicate the presence of transferred infectious diseases. Some become brittle nails, hair turns gray at an early age. With B12-anemia, there is a burning sensation of the tongue. In some patients, anemia occurs against the background of cholelithiasis, diseases of the excretory system.
The next method is a physical examination. Examine the skin, mucous membranes to highlight pigmentation and jaundice. Angiomas, bruises can be located on the surface. Enlarged lymph nodes indicate an inflammatory or malignant process. Checking the digestive tract occurs with palpation of the liver and spleen to determine their enlargement.
Differential diagnosis of B12- and iron deficiency anemia occurs with a blood test. The patient passes a general analysis, which is necessary to study all cells, determine their volume in the liquid part of the blood. Biochemical analysis allows you to evaluate the work of internal organs and body systems. Feces for occult blood will show the presence of bleeding in the gastrointestinal tract.
The specialist selects methods for determining the disease according to several criteria for diagnosing iron deficiency anemia. In addition to examination, questioning and testing, they prescribe an X-ray of the lungs, ultrasound, FGSD, colonoscopy and CT.
Therapy
Clinical guidelines for the diagnosis of iron deficiency anemia include determining the causes of the development of the disease, correction, educationright way of life. They help to choose the right treatment, drugs and the way they are administered. Control portability, evaluate the effectiveness of the action.
The main treatment is aimed at eliminating the cause of the disease. If this is not possible due to nosebleeds, pregnancy, iron therapy is used.
The following drugs are isolated:
- "Hemofer prolongatum". Drink a tablet one hour before meals or two after it. The course of treatment is six months. Then they normalize the level of iron and take the remedy for another 3 months.
- "Sorbifer Durules". Take half an hour before meals with water. Often prescribed to pregnant women. The duration of the course is determined by the dynamics.
- "Ferro foil". Take twice a day half an hour before meals. Therapy lasts 2-4 months, then studies are carried out. If necessary, the rate is increased.
All drugs are available at the pharmacy. They are taken strictly according to the doctor's prescription.
After establishing the clinic and diagnosing iron deficiency anemia, treatment begins immediately. Medicines are taken in a variety of ways. The route of administration differs depending on the situation. Most often prescribed tablets. Intravenous and intramuscular preparations are administered in violation of the absorption of iron by the intestines and in order to quickly replenish the reserves of the substance. Injections will be needed for stomach ulcers, uterine fibroids, hemorrhoids.
When choosing treatment with tablets, the minimum dose is 100mg, maximum - 300 mg. The appointment depends on the amount of iron deficiency in the body. Depletion of stocks, absorbability, portability matters. Do not drink tea, do not take with calcium, antibiotics.
Disease in patients of different ages
When a patient is diagnosed and treated for iron deficiency anemia, they are monitored for side effects. The patient has nausea, constipation, metallic taste in the mouth. Disorders are relieved by lowering the dose of the drug or taking it after a meal.
Depending on the growth rate of hemoglobin determine the duration of therapy. Pharmaceutical companies offer drugs that will help you lead a normal life. Iron-containing complexes contain additional substances in the form of ascorbic acid, fructose and vitamins.
Teenage girls have problems with the appearance of menstrual blood loss. A tablet form is selected with vitamins of groups A, B, C. After recovery, additional courses are necessary for heavy menstruation or minor blood loss.
Pregnant women have problems from the second trimester. Assign drugs with ascorbic acid. The daily dose does not exceed 100 mg. Treatment is carried out before childbirth in order to adjust the amount of the substance not only in the expectant mother, but also in the fetus. This continues for six months from the moment the baby is born.
Women with menorrhagia have long therapy. Select tablets based on tolerance. After normalization, the medication continues for another week. Interruptions in treatment are small, as the diseasequickly depletes iron stores in the body.
In case of malabsorption, the drug is administered by injection intramuscularly or intravenously. Assign no more than 100 mg of the substance per day, so that no adverse reactions occur. In older people, problems arise with chronic blood loss, protein deficiency. This also includes a tumor in the stomach, a combination of IDA and anemia B12.
If the elderly refuse examination, are in serious condition, a trial treatment in the form of iron s alts is prescribed. The correctness of the treatment is monitored by checking the increase in reticulocytes one week after the start of the drug.
Lifestyle when ill
Diet is important. It will help speed up the healing process. Choose foods rich in iron. The diet includes cereals, fruits, vegetables, fish and meat. The maximum amount of the substance is found in rabbit meat, liver and beef meat. From animal products, digestibility is 20%, from fruits - only 5-7%. The substance is well absorbed when using ascorbic and lactic acid.
Buckwheat and apples are considered real pantries. Tea and coffee should be avoided, as drinks interfere with the absorption of the microelement. Experts advise not only relying on proper nutrition, but every year to conduct a course of iron intake for three months. Women from 15 to 50 years of age select a dose of 30 to 60 mg per day - depending on age.
To eliminate anemia, general strengthening loads, physiotherapeuticprocedures. Examination of the gastrointestinal tract is required. It is important to monitor the state of he alth, consult a doctor in a timely manner and take tests.
Adequate approach to anemia is required, as the condition can become dangerous, there will be a threat to the patient's life. You can get rid of the pathology by taking medications. Be sure to find out the cause of bleeding, otherwise the drugs will be ineffective. You can avoid complications if, during the course of treatment, you take tests and monitor hemoglobin and changes in the body.
