Iron deficiency anaemia- Diagnosis

Symptoms & Signs:

                -Certain clinical conditions carry an increased likelihood of the disease.,Pregnancy, adolescence, periods of rapid growth, and an intermittent history of blood loss of any kind should alert the clinician of the same. 

                 -A cardinal rule is in an adult male it is due to gastrointestinal blood loss until proven otherwise. 

                  -Signs depend on the severity and chronicity of the disease in addition to the usual signs—fatigue, pallor, and reduced exercise capacity.

                  -Cheilosis (fissures at the corners of the mouth) and koilonychia (spooning of the fingernails) are signs of advanced deficiency.

                  -The diagnosis is typically based on laboratory results.

Laboratory diagnosis:

                     -The serum iron level represents the amount of circulating iron bound to transferrin. The TIBC (Total iron binding capacity)is an indirect measure of the circulating transferrin. The normal range for the serum iron is 50–150 micro gm/dL; the normal range for TIBC is 300–360micro gm/dL.
                      -In the disease- serum iron is < 30micro gm/ dL &
                                                                     -   TIBC is >360 micro gm/dL
                      -Transferrin saturation, which is normally 25–50%, is obtained by the following formula: serum iron x 100 ÷ TIBC. the disease is associated with saturation levels below 18%.
                      -Adult males have serum ferritin values averaging about 100 micro gm/L, while adult females have levels averaging 30micro gm/L. As iron stores are depleted, the serum ferritin falls to <15 micro gm/L. Such levels are diagnostic of absent body iron stores.
                      -Peripheral smear will show hypochromic RBC & microcytosis