Hypochromic microcytic anemia

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  1. Etiology-3 categories: decreased red blood cell (RBC) production, increased RBC destruction, and blood loss.
  2. Symptoms: fatigue, weakness, irritability, headache, dizziness- especially postural, vertigo, tinnitus, syncope dyspnea, especially with increased physical activity (exercise intolerance) chest pain, palpitations, difficulty sleeping or concentrating, thirst, anorexia, decreased urine output/bowel irregularity, decreased libido or impotence.

Four causes

  • iron deficiency – due to increased demand for iron, increased loss (bleeding) or decreased iron uptake
    • labs: increased total iron binding capacity, low serum ferritin, increased protoporphyrin (an intermediate in the pathway of heme synthesis)
  • chronic inflammatory disease with inadequate iron supply to the erythroid marrow
    • usually presents as normocytic and normochromic, normal ferritin and total iron binding capacity
  • thalassemias
    • defect in globin chain synthesis – often have normal or elevated serum iron values and transferrin saturation
  • myelodysplastic syndromes
    • serum iron values are normal; due to impaired hemoglobin synthesis with mitochondrial dysfunction
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