The most common global cause of iron deficiency anemia is malnutrition or malabsorption. Meat, eggs and leafy-greens describe the types of foods containing iron, which are necessary to prevent anemia. Malabsorption due to parasitism, celiac disease or inflammatory bowel disease may lead to decreased iron absorption. Because dietary iron requires gastric acid to be absorbed, certain bariatric surgeries that reduce available acid may cause an iron deficiency anemia.
Hemorrhage is a cause of iron deficient anemia, due to the amount of iron contained in the blood. Menorrhagia (increased blood loss during menstruation), colorectal cancers and ulcers are other common caused of blood loss which may lead to iron deficiency anemia. Intestinal parasites may also contribute to hemorrhage. Patients IDE stemming from hemorrhage actually have an increased reticulocyte count.
Lab results in patient with iron deficiency anemia show a microcytic, hypochromic anemia. This means that the mean corpuscular volume is less than 80 (MCV <80) and that the cells are paler than usual. Typically the cells have central pallor.
As the body's stores of iron are depleted, a CBC blood test will show a decreased RBC count. This occurs because there is not enough iron to properly complete the final step in heme synthesis.
Reticulocytes are immature blood cells, which are a small component of the blood that develop and mature in the bone marrow. The reticulocyte count is decreased in iron deficient anemia as hematopoesis is interrupted. It should be noted that with hemorrhage, reticulocyte count is actually increased.
Ferritin is a protein which stores iron. For lab purposes, it is an important indicator for how much stored iron is present. Thus in iron deficient anemia, ferritin levels are decreased.
The red cell distribution width (RDW) measures the variation of blood cell volume in an obtained sample. Varying sizes of blood cells is a hallmark of iron deficiency anemia and helps distinguish between this disease and thalassemia (as both are hypochromic and microcytic).
Blood smears in these patients show a variation in blood cell shape (poikilocytosis).
Patients with iron deficiency anemia show blood cells of differing sizes (anisocytosis).
Red blood cells in iron deficiency anemia show pallor on the inside of cells.
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