Iron is one of the elements without which the human body is not able to fully function. Nevertheless, there is a risk of violation of its reserves due to the influence of various factors and processes. One of the most common problems is iron deficiency anemia (IDA). It can develop in both children and adults, and even pregnant women are at risk. Given the destructive potential of this disease, it is worth learning more about it.
What is iron deficiency anemia?
Before studying sideropenic syndrome in iron deficiency anemia, it is necessary to touch on the essence of the problem associated with the lack of this trace element. Anemia of this type is a pathological condition that is characterized by a decrease in the level of hemoglobin in the blood due to a noticeable deficiency of iron in the body. The deficiency itself appears directly due to a violation of its intake and assimilation, or due to pathological losses of this element.
Iron deficiency anemia (aka sideropenic) differs from most other anemias in that it does not cause a decrease in red blood cells. ATin most cases, it is detected in women of reproductive age, pregnant women and children.
Causes of disease
Initially, it is worth identifying risk factors that may cause iron deficiency. Increased iron expenditure followed by anemia can be caused by repeated pregnancy, heavy menses, lactation, and rapid growth during puberty. Older people may have impaired iron utilization. Also, in old age, the number of diseases that cause anemia (intestinal diverticulosis, renal failure, oncopathology, etc.) increases significantly.
Worrying about such a problem as iron deficiency is also worthwhile when the absorption of this element at the level of erythrokaryocytes is disturbed (due to insufficient intake of iron along with food). As a reason for the development of iron deficiency anemia, it makes sense to consider any diseases that lead to blood loss. These can be tumor and ulcerative processes in the gastrointestinal tract, endometriosis, chronic hemorrhoids, etc. In rare cases, there may be blood loss from the Meckel diverticulum of the small intestine, where a peptic ulcer develops due to the formation of peptin and hydrochloric acid.
The causes of iron deficiency anemia can be associated with glomic tumors in the lungs, pleura and diaphragm, as well as in the mesentery of the intestine and stomach. These tumors, which have a direct connection with the trailing arteries, can ulcerate and become a source of bleeding. Factblood loss is sometimes established in the case of acquired or hereditary pulmonary siderosis, which is complicated by hemorrhage. As a result of this process, iron in the human body is released, followed by its deposition in the lungs in the form of hemosiderin without the possibility of subsequent utilization. Loss of iron in the urine may be due to a combination of diseases such as chronic glomerulonephritis and acquired hemosiderosis of the lungs, which is an autoimmune nature.
Sometimes the causes of iron deficiency anemia associated with the loss of iron along with the blood are directly related to the influence of helminths, which, penetrating into the intestinal wall, cause damage to it and, as a result, microblood loss that can lead to the development of IDA. The risk of this type of anemia is real for those donors who donate blood frequently. And as another cause of blood loss worthy of attention, one can determine the hemangioma of the internal organs.
Iron in the human body can be poorly absorbed due to diseases of the small intestine, which occur together with malabsorption syndrome in intestinal dysbacteriosis and resection of part of the small intestine. Previously, quite often it was possible to meet the opinion that atrophic gastritis, which has a reduced secretory function, should be considered as the real cause of iron deficiency anemia. In fact, such a disease can only have an auxiliary effect.
Latent iron deficiency (hidden, without clinical signs) maybe detected at the biochemical level. Such a deficiency is characterized by the absence or a sharp decrease in the deposits of this trace element in bone marrow macrophages, which can be detected using special staining. It is worth repeating that at this stage, the loss of iron can only be recorded in the laboratory.
Another sign of deficiency is a decrease in serum ferritin.
Symptoms of iron anemia
To make the symptoms more clear, it makes sense to divide the process of iron deficiency into 3 stages.
Speaking of the first stage, it is worth noting that it is not accompanied by clinical signs. It can be detected only by determining the amount of absorption of radioactive iron in the gastrointestinal tract and the amount of hemosiderin, which is contained in bone marrow macrophages.
The second stage can be described as a latent iron deficiency. It manifests itself through a decrease in exercise tolerance and significant fatigue. All these signs clearly indicate a lack of iron in the tissues due to a decrease in the concentration of iron-containing enzymes. In this state, two processes occur simultaneously: a decrease in the level of ferritin in erythrocytes and blood serum, as well as insufficient saturation of transferrin with iron.
The third stage should be understood as the clinical manifestation of IDA. The main symptoms of this period include trophic skin disorders,nails, hair, sideropenic signs (fatigue and general weakness), increasing muscle weakness, shortness of breath and signs of cerebral and heart failure (tinnitus, dizziness, pain in the heart, fainting).
Sideropenic symptoms during the third stage include the desire to eat chalk - geophagia, dysuria, urinary incontinence, craving for the smell of gasoline, acetone, etc. As for geophagy, in addition to iron deficiency, it may indicate a lack of magnesium and zinc.
When describing the general signs of iron deficiency, you need to pay attention to symptoms such as weakness, loss of appetite, syncope, palpitations, headaches, irritability, low blood pressure flickering "flies" before the eyes, poor sleep at night and drowsiness during the day, a gradual increase in temperature, decreased attention and memory, as well as tearfulness and nervousness.
Influence of sideropenic syndrome
It is important to understand that iron is a component of many enzymes. For this reason, when its deficiency occurs, the activity of enzymes decreases and the normal course of metabolic processes in the body is disturbed. Thus, sideropenic syndrome is the cause of many symptoms:
- Skin changes. When iron deficiency occurs, you may notice flaking and dry skin, which cracks over time. The occurrence of cracks is possible on the palms, in the corners of the mouth, on the feet and even in the anus. Hair with this syndrome turns gray early,become brittle and actively fall out. Approximately a quarter of patients are faced with brittleness, thinning and transverse striation of the nails. Tissue iron deficiency is actually the result of a lack of tissue enzymes.
- Changes in the muscular apparatus. Iron deficiency leads to a lack of enzymes and myoglobin in the muscles. This leads to rapid fatigue and weakness. In adolescents, as well as in children, a lack of iron in enzymes provokes a delay in physical development and growth. Due to the fact that the muscular apparatus is weakened, the patient feels an imperative urge to urinate, difficulty with holding urine during laughter and coughing. Girls with iron deficiency often have to deal with bedwetting.
Sideropenic syndrome also leads to changes in the mucous membranes of the intestinal tract (cracks in the corners of the mouth, angular stomatitis, increased susceptibility to caries and periodontal disease). There is also a change in the perception of smells. With a similar syndrome, patients begin to like the smell of shoe polish, fuel oil, gasoline, gas, naphthalene, acetone, damp earth after rain, and varnishes.
Changes also affect taste sensations. We are talking about a strong desire to taste such non-food products as tooth powder, raw dough, ice, sand, clay, minced meat, cereals.
With a disease such as sideropenic syndrome, the mucous membranes of the lower and upper layers of the respiratory tract change. Such changes lead to the development of atrophic pharyngitis and rhinitis. The vast majority of people withiron deficiency, blue sclera syndrome appears. As a result of a violation of lysine hydrocollation, a failure occurs in the process of collagen synthesis.
With a lack of iron, there is a risk of changes in the immune system. We are talking about lowering the level of certain immunoglobulins, B-lysines and lysozyme. There is also a violation of the phagocytic activity of neutrophils and cellular immunity.
With such a problem as sideropenic syndrome, the appearance of dystrophic changes in internal organs is not excluded. These include secondary anemic sideropenic myocardial dystrophy. It manifests itself by strengthening the first tone at the apex of the heart and expanding the border of percussion dullness.
With iron deficiency, the condition of the digestive tract can also change. These are symptoms such as sideropenic dysphagia, dryness of the esophageal mucosa and, possibly, its destruction. Patients begin to feel difficulty in the process of swallowing in the evening or in a state of overwork. Perhaps a violation of tissue respiration, leading to a gradual atrophy of the gastric mucosa, in which atrophic gastritis develops. Sideropenic syndrome can also lead to a decrease in gastric secretion, which can result in achilia.
Why does iron deficiency anemia develop in pregnant women?
In women who are carrying a child, iron deficiency may be due to the appearance of extragenital and gynecological diseases before pregnancy, as well as a high need for iron during fetal development.
Many factors canaffect the occurrence of diseases such as anemia. Iron deficiency in pregnant women usually develops for the following reasons:
- the chronic extragenital diseases mentioned above (heart defects, duodenal and gastric ulcers, atrophic gastritis, kidney pathology, helminthic invasions, liver diseases, diseases accompanied by nosebleeds, and hemorrhoids);
- exposure to a woman's body of various chemicals and pesticides that can interfere with the absorption of iron;
- congenital deficiency;
- impaired iron absorption (chronic pancreatitis, enteritis, resection of the small intestine, intestinal dysbacteriosis);
- malnutrition, which is not able to ensure the supply of this trace element to the body in the required amount.
Iron deficiency in children
Throughout the entire period of pregnancy, the formation of the basic composition of this microelement in the blood occurs in the child's body. However, in the third trimester, one can observe the most active intake of iron through the placental vessels. In a full-term baby, the normal level of its content in the body should be 400 mg. At the same time, for those children who were born prematurely, this indicator does not rise above 100 mg.
It is also important to take into account the fact that mother's milk contains enough of this trace element to replenish the reserves of the child's body before the age of 4 months. So if it's too soon to stopbreastfeeding, the child may develop an iron deficiency. The causes of IDA in children may be associated with the prenatal period. We are talking about various infectious diseases of the mother during pregnancy, with late and early toxicosis, as well as hypoxia syndrome. Factors such as multiple pregnancies in fetal transfusion syndrome, chronic iron deficiency anemia during pregnancy, and uteroplacental bleeding may also affect iron depletion.
In the intranatal period, the danger is massive bleeding during delivery and premature ligation of the umbilical cord. As for the postpartum period, at this stage, iron deficiency can be the result of an accelerated growth rate of the child, early feeding with whole cow's milk and diseases that are accompanied by a violation of the absorption function of the intestine.
IDA blood test
This diagnostic method is necessary in order to determine the low level of hemoglobin and red blood cells. It can be used to identify hemolytic and iron deficiency anemia by fixing the morphological characteristics of erythrocytes and erythrocyte mass.
In the case of IDA, a biochemical blood test will necessarily show a decrease in the concentration of serum ferritin, an increase in TI, a decrease in the concentration of serum iron and a significantly lower saturation of this microelement of transferrin compared to the norm.
It is important to know that you should not drink alcohol the day before the test. Not worth iteat 8 hours before the diagnosis, only clean water without gas is allowed.
Differential Diagnosis
In this case, a medical history can significantly help in making a diagnosis. Iron deficiency anemia often develops along with other diseases, so this information will be extremely useful. As for the differential approach to the diagnosis of IDA, it is carried out with those diseases that can cause iron deficiency. At the same time, thalassemia is characterized by clinical and laboratory signs of erythrocyte shemolysis (an increase in the size of the spleen, an increase in the level of indirect bilirubin, hypochromic anemia, reticulocytosis, and high levels of iron in the depot and blood serum).
Treatment Methods
In order to overcome such a problem as a lack of iron in the blood, it is necessary to correctly approach the recovery strategy. An individual approach should be shown to each patient, otherwise it is difficult to achieve the desired level of effectiveness of therapeutic measures.
With such a problem as iron deficiency in the body, treatment primarily involves the impact on the factor that provokes the occurrence of anemia. Correction of this condition with the help of medications also plays an important role in the recovery process.
Attention should also be paid to nutrition. The diet of patients with IDA should include foods that contain heme iron. These are rabbit meat, veal, beef. Do not forget about amber, lemon andascorbic acid. Iron deficiency can be corrected by dietary fiber, calcium, oxalate, and polyphenols (soy protein, tea, coffee, chocolate, milk).
Concerning the topic of drug treatment in more detail, it is worth noting that iron preparations are prescribed in a course of 1.5 to 2 months. After the level of Hb is normalized, maintenance therapy is indicated with a half dose of the drug for 4-6 weeks.
Iron-containing drugs for anemia are taken at the rate of 100-200 mg / day. After the dosage is reduced to 30-60 g (2-4 months). The following drugs can be attributed to the most popular: "Tardiferon", "M altofer", "Totema", "Ferroplex", "Sorbifer", "Ferrum Lek". As a rule, medication is taken before meals. The exception is patients diagnosed with gastritis and ulcers. The above medicines should not be washed down with products that can bind iron (milk, tea, coffee). Otherwise, their effect will be nullified. It is worth initially being aware of the harmless side effect that iron-containing drugs can produce in case of anemia (meaning the dark color of the teeth). You should not be afraid of such a reaction. As for the unpleasant consequences of drug treatment, gastrointestinal disorders (constipation, abdominal pain) and nausea may occur.
The main way to administer drugs for iron deficiency is by mouth. But in the case of the development of intestinal pathology, in which the absorption process is disturbed, parenteralintroduction.
Prevention
In the vast majority of cases, with the help of drug treatment, doctors manage to correct iron deficiency. Nevertheless, the disease can recur and develop again (extremely rare). To avoid such a development of events, prevention of iron deficiency anemia is necessary. This means annual monitoring of the parameters of a clinical blood test, the rapid elimination of any causes of blood loss and good nutrition. For those who are at risk, the doctor may prescribe the necessary medications for preventive purposes.
Obviously, the lack of iron in the blood is a very serious problem. Any medical history can confirm this. Iron deficiency anemia, no matter what the patient is, is a prime example of a highly devastating disease. Therefore, at the first symptoms of a lack of this microelement, it is necessary to consult a doctor and undergo a course of treatment in a timely manner.
