iron-deficiency anemia Abbreviation: IDA
Anemia resulting from a greater demand on stored iron supplies than can be provided. The erythrocyte count may sometimes be normal, but there is insufficient hemoglobin. Erythrocytes are hypochromic and show poikilocytosis. IDA is present in about 8% of men and 14% of women ages 3 to 74 years in the U.S.
IDA is caused by inadequate iron intake, malabsorption of iron, blood loss, pregnancy and lactation, intravascular hemolysis, or a combination of these factors.
Chronically anemic patients often complain of fatigue and dyspnea on exertion. Iron deficiency resulting from rapid bleeding, may produce palpitations, orthostatic dizziness, or syncope.
Laboratory studies reveal decreased iron levels in the blood, with elevated iron-binding capacity and a diminished transferrin saturation. Ferritin levels are low. The bone marrow does not show stainable iron.
Additional Diagnostic Studies
Adult nonmenstruating patients with IDA should be evaluated to rule out a source of bleeding in the gastrointestinal tract.
Dietary iron intake is supplemented with oral ferrous sulfate or ferrous gluconate (with vitamin C to increase iron absorption). Oral liquid iron supplements should be given through a straw to prevent staining of the teeth. Iron preparations cause constipation; laxatives or stool softeners should be considered as concomitant treatment. When underlying lesions are found in the gastrointestinal tract, e.g., ulcers, esophagitis, cancer of the colon, they are treated with medications, endoscopy, or surgery.
Parents should be warned to keep iron preparations away from children because three or four tablets may cause serious poisoning.
a reduction below normal in the number or volume of erythrocytes or in the quantity of hemoglobin in the blood. Clinically it is manifested by weakness, exercise intolerance, hyperpnea which is only moderate, pallor of mucosae, tachycardia and a large increase in the intensity of the heart sounds. There are often accompanying signs related to the site of blood or hemoglobin loss.
a form of anemia generally unresponsive to specific antianemia therapy. It is often chronic, accompanied by granulocytopenia and thrombocytopenia, in which the bone marrow is usually acellular or hypoplastic. It may, however, be rapidly fatal. The term is actually all-inclusive and most probably encompasses several clinical syndromes. See pure red cell aplasia
autoimmune hemolytic anemia
immune-mediated hemolytic anemia, which occurs in many species, particularly dogs, in which autoantibodies directed against red blood cells are produced. Different classes of immunoglobulins may be involved giving rise to differing clinical syndromes. Signs include pallor, lethargy, splenomegaly, and sometimes icterus, bilirubinuria and hemoglobinuria. There may also be an accompanying thrombocytopenia with bleeding tendencies. Diagnosis is based on a positive Coombs test.
blood loss anemia
see hemorrhagic anemia (below).
anemia of chronic disease
see anemia of inflammatory disease (below).
cold antibody anemia
an immune-mediated hemolytic anemia in which the antibody is maximally active at temperatures below 98.6°F (37°C). See also cold agglutinin
cold (or cold water) anemia
a disease of cattle, especially calves, housed in warm barns and given near freezing water to drink. Dyspnea and the passage of red urine occur several hours after a large drink.
immunoglobulin-mediated anemia that gives a positive reaction to Coombs tests, indicating the presence of immunoglobulins on the red cell surface. See also autoimmune hemolytic anemia (above), alloimmune
hemolytic anemia of the newborn.
drug-induced hemolytic anemia
some drugs such as quinine, quinidine, para-aminosalicylic acid, phenacetin, penicillin, insecticides, chlorpromazine, sulfonamides and dipyrone may be directly injurious to red cells or act to initiate an immune response in which red cells are destroyed.
familial nonspherocytic anemia of Basenji dogs
an inherited pyruvate kinase deficiency causes a hemolytic anemia with shortened red cell life span. In early stages, the disease is characterized by very active erythropoiesis but eventually, usually by the second or third year of life, a terminal myelofibrosis and osteosclerosis develops. The disease is inherited as an autosomal recessive trait.
see microangiopathic anemia (below).
Heinz body anemia
hemolytic anemia resulting from oxidation of globin and formation of Heinz bodies, which are seen in blood smears as dark refractile intracytoplasmic bodies and stain with new methylene blue. Some common causes are ingestion of onions and plants in the Brassicaeae family, phenazopyridine, methylene blue and acetaminophen (paracetamol). Cats are particularly susceptible to Heinz body
is caused by loss of whole blood. If this is very rapid hypovolemic shock develops. At a slower rate there is anemic anoxia and the animal is suffering from anemia. Called also blood loss anemia.
anemia in which the decrease in hemoglobin is proportionately much greater than the decrease in number of erythrocytes.
anemia due to incapacity of blood-forming organs, i.e. inactivity of the bone marrow. See also aplastic anemia (above).
idiopathic immune anemia
see autoimmune hemolytic anemia (above).
anemia of inflammatory disease
a nonregenerative, usually mild, anemia that occurs in association with malignancy or chronic infection. Although other causes of anemia such as hemolysis and blood loss may also occur with these conditions, there is altered iron metabolism with decreased serum iron and iron-binding capacity but with increased iron storage that results in decreased erythropoiesis.
a form characterized by low or absent iron stores, low serum iron concentration, low transferrin saturation, elevated transferrin (iron-binding capacity), low hemoglobin concentration or hematocrit, and hypochromic, microcytic red blood corpuscles, and thrombocytosis. See also iron
isoimmune hemolytic anemia lizard viral anemia
produces inclusion bodies in erythrocytes, commonly mistaken for protozoan parasites.
anemia in which the erythrocytes are much larger than normal. The MCV (mean corpuscular volume) and MCH (mean corpuscular hemoglobin) are increased and the MCHC (mean corpuscular hemoglobin concentration) is normal.
anemia characterized by the presence of megaloblasts in the bone marrow and macrocytic erythrocytes. It occurs in vitamin B12, cobalt and folic acid deficiencies and in some myeloproliferative disorders in cats.
anemia due to fragmentation of erythrocytes in blood vessels whose endothelium has been badly damaged, usually by an infectious disease such as septicemias, disseminated intravascular coagulation and salmonellosis. Called also fragmentation anemia.
anemia characterized by decrease in size of the erythrocytes.
myelopathic anemia, myelophthisic anemia
anemia due to destruction or crowding out of hematopoietic tissues by space-occupying lesions, neoplasms and fibrosis.
one occurring without an appropriate erythropoietic response by the bone marrow.
that in which the hemoglobin content of the red cells as measured by the MCHC and MCH is within the normal range.
the anemia in which the red blood cells are normal in size.
anemia due to a deficiency of an essential substance in the diet, which may be caused by poor dietary intake or by malabsorption; called also deficiency anemia. See also pyridoxine
, vitamin b12
, folic acid
hemorrhagic anemia due to blood loss caused by blood-sucking parasites such as fleas, hookworms and Haemonchus contortus.
see pernicious anemia.
the anemia which occurs as part of a natural event, e.g. in neonates.
primary immune anemia
see autoimmune hemolytic anemia (above).
regenerative anemia, responsive anemia
associated with active erythropoiesis with increased numbers of reticulocytes, nucleated red blood cells, anisocytosis and polychromasia in the peripheral blood.
anemia in which the red cells have a bizarre spiculated shape and are destroyed prematurely, primarily in the spleen; it is an acquired form occurring in severe liver disease, and represents an abnormality in the cholesterol content of the red cell membrane.
see nonregenerative anemia (above).