IRON PREPARATIONS

MESREYA SUHANA
14M076
 CONTENTS

Iron absorption, storage and

transport
Factors influencing iron
absorption
Iron deficiency anaemia
*causes
*clinical feature
Iron absorption

 The average daily diet contains 10 -20mg of iron,out of

which 5-10% are absorbed
 Absorption occurs at duodenum and proximal jejunum
DIETARY IRON

HAEME NON-HAEME
(better absorbed)
 HAEME FORM:
 Absorption occurs with the aid of HAEME CARRIER PROTEIN
1(HCP1)

NON HAEME FORM:

 They are in ferric form which dissociates from the complexes and
reduced to ferrous form which is then absorbed
FERRIC form FERROUS Form
(ferric reductace)
DIVALENT METAL TRANSPORTER 1(DMT1) in luminal
membrane carrys ferrous iron into mucosal cell

 Iron released from the haeme in mucosal cell transported across

basolateral membrane by another iron transporter
FERROPROTEIN and HEPHASTIN
 Iron transport and storage
 Oxidised to FERRIC form and complexed with APOFERRITIN to
form FERRITIN(storage form of iron)
Iron is stored in reticuloendothelial cells(liver, spleen, bone
marrow)

 Transported to plasma
* convert to FERRIC form and complexed with glycoprotein
TRANSFERRIN -Tf(transport form of iron)
*Iron is transported inside erythropoietic and other cells through
attachment of transferrin to specific membrane bound glycoprotein
that functions as TRANSFERRIN RECEPTOR(TfR)
 Factors facilitating iron absorption:
*gastric secretion
*reducing substances- ascorbic acid , citric acid ,amino
acids
*meat

 Factors impending iron absorption:

*antacids *Phosphates
*Phytates *Tannates
*Tetracycline *milk
*pancreatic secretion
 Iron deficiency anaemia
CAUSES:
Diminished intake of iron:Faulty dietary habit, vomiting
in pregnancy, loss of appetite
Faulty absorption due to intestinal infestation and intake
of antacids
Iron loss: repeated pregnancies at short interval
excessive blood loss during menstruation
chronic blood loss
Increased demand during pregnancy
CLINICAL FEATURE:
*Weakness *fatiguability
*palpitation *dyspnoea on exertion
*anorexia and indigestion

ON EXAMINATION:
*pallor *koilonychia
*atrophic glossitis *angular stomatitis
 LABORATORY FINDINGS:

 BLOOD PICTURE:
*haemoglobine-reduced
mild:8-10g%
moderate:7-8g%
severe:<7g%
*RBC count –reduced
*WBC ,Platetets and Reticulocyte counts normal

 RBC INDICES:
*MCV ,MCH ,MCHC are reduced

 PERIPHERAL BLOOD SMEAR:

* Red cells are MICROCYTIC and HYPOCHROMIC
*there is ANISOCYTOSIS and POIKILOCYTOSIS
*TARGET CELLS are also present
 BONE MARROW FINDINGS:
*marrow cellularity is increased due to ERYTHROID HYPERPLASIA
*NORMOBLASTIC ERYTHROPOIESIS with predominance of small
polychromatic normoblasts
*MARROW IRON: shows deficient reticuloendothelial iron stores and
absence of siderotic iron granules from developing normoblasts

 BIOCHEMICAL FINDINGS:
*serum iron level- low
*serum ferritin- low
*total iron binding capacity –increased
*serum transferrin receptor protein- increased