Iron deficiency anemia

Iron-deficiency anemia can be exogenous (alimentary) and endogenous. The first commonly found in children (see Anemia in children). Much more often there are cases of endogenous iron deficiency associated with elevated iron losses (increased sweating when working in hot shops), increased its consumption (during pregnancy, during lactation, or inadequate absorption (enteritis, resection of the stomach, intestines). All iron-deficiency anemia are related to hypochromic.
Chlorosis (chlorinate) - clinical and hematological syndrome, often resulting from the combined effect of the endogenous (increased spending of iron in the period of growth and puberty) and exogenous (malnutrition, chronic infections, such as tuberculosis) factors.
Treatment. Pathogenetic factor of treatment are iron supplements. Inside apply restored iron 1 g in combination with ascorbic acid (0,1-0,2 g) 3-4 times a day. More digestible are organic compounds of iron: lactate iron, glycyrrhizinate iron, carbon saharat iron and ascorbate iron appointed by 2-3 g per day, and tincture malic iron 1 table (or dessert) spoon 3-4 times a day. Effective hemocyanin (0.6 g 3 times a day during meals). The iron treatment should be long-term (not less than 1,5-2 months). When the patient underwent resection of the stomach (bowel) or suffers enteritis shown (only in the hospital) intravenous administration of Verkhovina every day or two 2.5 - 5 ml of the Course of treatment is 10-20 injections. Along with this it is recommended rich in protein and iron in the diet (up to 120 grams of protein per day, mainly meat), limiting fat to 40 g per day. The diet of the patient should contain a sufficient quantity of fresh herbs, fruits, vegetables and other foods rich in vitamins a, b and C. it is Advisable to appoint climatic treatment in mountainous areas (a stimulating effect on the bone marrow has reduced partial pressure of oxygen).

A group of iron-deficiency anemia unites numerous, different etiology of anemic syndrome, the main pathogenetic factor of which is the lack of iron in the body (sideropenia, gemosideros).
Hipposideros in the broad sense of this word means not only anemia on the grounds of violation of hemoglobinopathy. The lack of iron in the body affects in violation of redox processes, poor growth, the emergence of a number of trophic disorders (nail deformity - koilonychia, their fragility, dry skin, hair loss), lesions of the mucous membrane of the tongue (glossitis), esophagus, taste perversion ("pica chlorotica", geophagia) and others Depletion of tissue reserves of iron leads to the breakdown of oxidative processes in the tissues, resulting trophic epithelial disorders of the skin - skin, nails, hair, and mucous membranes.
The reasons for the development of hipposideros can be as exogenous (nutritional iron deficiency)and endogenous. Examples of exogenous iron deficiency can serve as anemia premature infants and nutritional iron deficiency anemia children (see below Anemia in children). In rare cases exogenous iron deficiency can occur in adults in General malnutrition or after a prolonged diet (e.g. milk) with a limited content of iron.
Much more often there are cases of endogenous iron deficiency associated with elevated losses, an increased intake of either insufficient absorption of iron. Iron deficiency may develop on the soil of iron losses on increased sweating (in conditions of tropical heat, working in hot shops), not compensated by sufficient supply exogenous (alimentary) iron. Pathologic States, often accompanied by the development of endogenous iron deficiency, are various, mainly chronic infection (tuberculosis), intoxication (azotemia), hypovitaminosis (especially-hypovitaminosis), hypothyreosis, malignant neoplasms. The mechanism of development of hipposideros in these conditions is complex. To endogenous iron deficiency lead to violations of the process of ionization of iron (achlorhydria, a deficiency of vitamin C) and intestinal absorption (enteritis, bowel resection).
All iron-deficiency anemia are related to hypochromic.
Chlorosis (chlorinate) in the light of modern concepts should not be seen as independent nosological unit but as clinical and hematological syndrome requiring in each case the disclosure of individual etiology. Most often syndrome chlorosis occurs as a result of the combined effect of the endogenous (increased spending of iron in the period of growth and sexual maturation), and exogenous analiziruyutsya factors (malnutrition, chronic infections, such as tuberculosis).
Treatment. Pathogenetic treatment of iron-deficiency anemia is iron supplements. Of iron salts that is inside the body, the most activity has iron, restored by hydrogen, which is administered in capsule and wafers 1 g in combination with ascorbic acid (0,1-0,2 g) 3-4 times a day. Avoid intestinal disorders recommended simultaneously with the iron to make Pancreatin and calcium carbonate (0.5 g), and if chilijskij States - gastric juice or divorced hydrochloric acid and pepsin (1 table spoon). More digestible than the recovered metal iron, are organic compounds in which iron is found in ferrous divalent form. The most effective drugs in this group are: lactate iron, glycyrrhizinate iron, carbon saharat iron and ascorbate iron appointed in the same doses (2-3 g per day), and tincture malic iron in large doses - not drop by drop, and canteens (or dessert) spoons 3-4 times a day. Of the complex preparations greatest application have received hemocyanin (0.6 g 3 times a day during meals). Daily dose of iron entered with hemostimulating, to 0.21,
Oral intake of iron is not always well tolerated. The least effective is the treatment of patients after resection of the stomach or intestines, as well as in patients with chronic diarrhea type enteritis. In these cases it is the treatment of parenteral entered preparation of iron - Verkhovina.
Verkopen injected every day or two 2.5-5 ml; daily dose of the drug in terms of iron is 0.1 g, i.e. 30 times less than the inner reception. However, due to the fact that the drug is injected directly into the blood, iron absorbed completely, leading to a good therapeutic effect. To avoid overdose (development gemosideros) treatment parkovanim and other parenteral entered iron supplementation should be conducted in accordance with the existing regulations. Treatment usually consists of 10-15-20 infusion of 0.1, testimony to the introduction of Verkhovina are: 1) treatment failure regular input per os iron supplementation; 2) intolerance oral preparations; 3) the need for fast regeneration of blood, for example in preparing the patient for surgery when anemic a coma, if it is impossible to produce a blood transfusion; 4) the defeat of the gastrointestinal tract (gastroenteritis, diseases of operated stomach, resected intestines, and so on). Verkopen contraindicated in liver disease, coronary insufficiency, hypertension. Treatment Verkhovina, given the possible (although rare) reactions, should be conducted in a clinical setting.
The course of treatment for iron supplementation should be long-term (at least 1-2 months)until full recovery of the normal pattern of blood and tissue reserves of iron (on condition of the latter is judged by the content of iron in the plasma). When georegistration States of the blood iron treatment should be combined with blood transfusion (erythrocyte mass) and the appointment of vitamins blood - B12, folic acid. The appointment of iron preparations indicated for other manifestations of hipposideros ("iron deficiency") of the body, combined with anemia or observed independently; syndrome sideropenic dysphagia Rossolimo-Bekhterev, koilonychia, the perversion of taste.
In addition to pharmacotherapy of iron-deficiency anemia is recommended stimulating erythropoiesis, rich in protein and iron in the diet (up to 120 grams of protein a day, mainly in the form of meat); on the contrary, fats should be limited (not more than 40 g per day). The diet of the patient should contain a sufficient quantity of fresh herbs, fruits, vegetables and other foods rich in vitamins a, B1, B2, B12 and C. Patients georegistration anemia appropriate to send to climatic treatment in a mountainous area, as lowering the partial pressure of oxygen stimulates the bone marrow.