Iron Deficiency Anaemia

TARGET GROUP: PREGNANT WOMEN

OBJECTIVES

·        To diagnose iron deficiency anaemia (IDA), treat using oral and parenteral iron supplementation

·        To provide ongoing management; will understand why red blood cell transfusion (RBC) may be harmful and is only occasionally required for the treatment of IDA.

SUMMARY

Iron is crucial to biologic functions, including respiration, energy production, DNA synthesis, and cell proliferation. Iron is biologically conserved in several ways including recycling after the degradation of red cells and iron retention in the absence of an excretion mechanism. Because excess iron levels can be toxic, absorption is limited to one to two mg daily, and most of the iron required daily (approximately 25 mg per day) is provided through recycling by macrophages that phagocytose senescent erythrocytes. The latter two mechanisms are controlled by hepcidin, a hormone that maintains total-body iron within normal ranges, avoiding both iron deficiency and excess. The degree of iron store repletion is determined by the rapidity with which iron deficiency develops in the context of blood loss or a substantial reduction in iron absorption. Hepatocytes are thought to be a long-term reservoir for iron and release it more slowly than macrophages. Iron deficiency is defined as the reduction of iron stores that precedes overt iron-deficiency anemia (IDA) or may persist but not progress to IDA. IDA is a serious condition whereby low levels of iron are associated with anemia and the presence of microcytic hypochromic red cells. A recent systematic review of 29 guidelines was published in 2015. These guidelines were developed by professional associations throughout the world including the United States (n = 8), Europe (n = 6), Britain (n = 4), Canada (n = 3), other international organizations (n = 2), France (n = 2), Poland (n = 1), Australia (n = 1), Mexico (n = 1), and Japan (n = 1). Findings from this guideline summary reveal that, for the most part, Iron Deficiency (ID) guideline recommendations are somewhat heterogenous largely because different patient populations were addressed. Recommendations in this guideline were informed by available evidence located as well as the guideline development committees’ expertise, experience and consensus.

REFERENCE        

https://actt.albertadoctors.org/CPGs/Lists/CPGDocumentList/IDA-CPG.pdf