Lecture 1

Microcytic Anemia o < 80 MCV Sideroblastic anemia Iron deficiency Anemia chronic inflammation Iron-related Disorders o Iron deficiency anemia (IDA) o Anemia of chronic inflammatory disease (ACD) o Sideroblastic anemias Hereditary sideroblastic anemia Acquired sideroblastic anemia Lead poisoning (porphyrias) o Hemochromatosis o Acute blood loss Iron o 70% is in hemoglobin o 25% is in storage as ferritin and hemosiderin o Rest is in cytochromes, enzymes o Iron Function Interacts reversibly with oxygen and functions in electrontransfer reactions (as ferrous) o The body is very efficient at recycling iron, daily need is only about 1 mg per day from loss through shedding of epithelial cells. o Menstruating women lose 2x as much o Too much iron in the body is toxic

Iron Metabolism o Depends on: Iron intake & bioavailability Ingestion - 90% iron salts, 10% heme iron from meat (but iron is more readily used from meat) Absorption heme iron (Hb & myoglobin in meat) is readily absorbed, iron in vegetables is mostly ferric, which is only absorbed if it is converted to ferrous (Fe++) Need (iron losses) Decreased iron stores and increased erythropoiesis increases absorption. o