NUTRITIONAL DEFICIENCY ANEMIAS

By Satish S

1)IRON DEFICIENCY ANEMIA 2)VITAMIN DEFICIENCY ANEMIA

IRON DEFICIENCY ANEMIA

INTRODUCTION
Most common nutritional deficiency worldwide Prevalent among females Total body Iron : Males - 6 gm Females - 2 gm Dietary forms of Iron

METABOLISM
Forms of Iron Storage Form Functional Form

ABSORPTION OF IRON

TRANSPORT OF IRON

REGULATION OF IRON ABSORPTION

Regulated via enzyme: Hepcidin

ETIOLOGY OF I.D.A
Inadequate Iron Intake Infants Low Socio Economic Status Increased requirement Children, pregnant women, lactating mothers Increased loss Chronic bleeding, External Hemorrhage Impaired absorption Chronic Diarrhea, Crohn Disease

PATHOGENESIS OF I.D.A

MORPHOLOGY
Bone Marrow Picture Mild to moderate increase in erythroid precursors Disappearance of stainable iron from macrophage Peripheral Blood Picture

Normal

I.D.A

CLINICAL FEATURES

VITAMIN B 12 DEFICIENCY ANEMIA

INTRODUCTION
Required for DNA synthesis As a co factor for Thymidine Synthesis Deficiency Defective maturation of RBC WBC Platelet Diet in non-veg

METABOLISM OF B 12

ETIOLOGY
DECREASED INTAKE Strict vegetarians IMPAIRED ABSORPTION Pernicious Anemia Gastrectomy patients Loss of Pancreas Ileal resection Competitive parasitic uptake

PATHOGENESIS OF PERNICIOUS ANEMIA 3 ANTIBODIES : 1, 2 ,3

AB 1

AB 2

Vit B12

I.F

I.F VIT B 12 COMPLEX

COMPLEX RECEPTOR

ANTIBODY 3

MORPHOLOGY
Bone Marrow Picture

Band Forms

Megaloblastic changes are seen in all stages of erythropoiesis Nuclear cytoplasmic asynchrony

Peripheral Blood smear

Macro ovalocytes - Hyperchromic

Megaloblasts

Hypersegmented neutrophil

CLINICAL FEATURES
Pernicious Anemia

Atrophy of gastric mucosa

ANEMIA OF FOLATE DEFICIENCY

Sources: Green vegetables, fruits, liver Etiology: Decreased intake Impaired absorption Increased loss Increased requirement Impaired utilization Folic acid antagonist

RICH GET RICHER !

POOR GET POORER !

HAVE WE ATTAINED THE REAL FREEDOM ?

NO !

JAI HIND !