Anemia por Deficiencia de Hierro

Descripción General

Definición

La anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types se define como un nivel de hemoglobina que está 2 desviaciones estándar por debajo de la media por edad, sexo y etnia. Debido a que el hierro es un componente fundamental de la hemoglobina, una deficiencia de este mineral puede provocar una disminución de la producción de hemoglobina y anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types.

Epidemiología

• La causa más común de anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum todo el mundo (50% de todas las anemias)
• Más frecuente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria países en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum desarrollo
• Del 5%–10% de las mujeres que menstrúan se ven afectadas.
• Los LOS Neisseria lactantes (6–24 meses) que consumen leche de vaca tienen una mayor incidencia de deficiencia de hierro porque el consumo de leche de vaca conduce a un aumento de las pérdidas gastrointestinales de hierro.
• Más común en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum familias con bajos ingresos/nivel socioeconómico más bajo

Etiología

• Absorción disminuida
  • Dietas restringidas
    • Dietas veganas/vegetarianas bajas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hierro
    • Dietas ricas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum productos lácteos (e.g., un bebé con leche de vaca)
  • Malabsorción:
    • Producción insuficiente de ácido gástrico que normalmente facilita la absorción de hierro (e.g., pacientes con inhibidores de la bomba de protones (IBP))
    • Enfermedad celíaca
    • Enfermedad inflamatoria intestinal
    • Después de gastrectomía/resección del intestino delgado
• Mayor pérdida
  • Hemorragia (e.g., traumatismo, menorragia, cáncer, úlcera péptica)
  • Hemólisis
  • Parásitos gastrointestinales
  • Hemorragia digestiva baja crónica
  • Hemosiderosis Hemosiderosis Conditions in which there is a generalized increase in the iron stores of body tissues, particularly of liver and the mononuclear phagocyte system, without demonstrable tissue damage. The name refers to the presence of stainable iron in the tissue in the form of hemosiderin. Cellular Accumulations urinaria/pulmonar
• Aumento de la demanda
  • Durante el embarazo, aumento de la demanda debido a la expansión del volumen sanguíneo materno/necesidades fetales
  • Tratamiento con eritropoyetina en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el contexto de la ERC
• Deficiencia funcional
  • Visto en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum enfermedades crónicas
  • Los LOS Neisseria macrófagos no liberan a la circulación el hierro procedente de la degradación de la hemoglobina antigua.
  • Debido a la inflamación crónica y la producción de hepcidina.

Fisiopatología

• El metabolismo del hierro es un equilibrio estrechamente regulado de absorción, uso y excreción.
• Necesidades normales de hierro: 0,5–1 mg/día
  • Mujeres durante el periodo menstrual: 1–2 mg/día
  • Mujeres embarazadas: 3–5 mg/día
• Síntesis de hemo:
  • Implica una combinación de hierro ferroso (Fe²⁺) con protoporfirina
  • La disminución del hierro biodisponible da como resultado una deficiencia de la síntesis de hemo y de la capacidad de transporte de oxígeno.
  • Los LOS Neisseria niveles bajos de Fe²⁺ desencadenan la eritropoyesis y la regulación positiva de los LOS Neisseria receptores de transferrina en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria eritrocitos para mejorar la entrega de hierro a los LOS Neisseria tejidos.
• Etapas del agotamiento del hierro:
  • Homeostasis Homeostasis The processes whereby the internal environment of an organism tends to remain balanced and stable. Cell Injury and Death normal del hierro
  • Deficiencia de hierro sin anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types:
    • Las reservas de hierro se agotan, pero se obtiene suficiente hierro de la descomposición de la hemoglobina vieja para hacerla nueva.
    • No se evidencia anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types, pero el individuo es vulnerable a ella.
  • Deficiencia de hierro con anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types
• Cuando el suministro de Fe²⁺ disminuye, los LOS Neisseria siguientes procesos también se ven afectados:
  • La ferritina, la forma de almacenamiento del exceso de hierro en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el cuerpo, disminuye.
  • La transferrina, una proteína que se une al AL Amyloidosis hierro en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la sangre, aumenta.

Presentación Clínica

Signos y síntomas

• Palidez
• Fatiga
• Dificultad para respirar
• Aturdimiento
• Síncope
• Coiloniquia (uñas quebradizas en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum forma de cuchara)
• Cabello quebradizo
• Síndrome de pica Pica Pica is an eating disorder characterized by a desire or recurrent compulsion to eat substances that are nonnutritive and not food. These compulsions and ingested substances are inappropriate for age or culture. Pica (antojo de artículos no alimentarios: tierra, hielo, pintura, etc ETC The electron transport chain (ETC) sends electrons through a series of proteins, which generate an electrochemical proton gradient that produces energy in the form of adenosine triphosphate (ATP). Electron Transport Chain (ETC).)
• Síndrome de pierna inquieta
• Alteraciones del estado de ánimo: irritabilidad, capacidad de atención más corta

Síndrome de Plummer-Vinson

• Disfagia: solo a sólidos, debido a redes esofágicas
• Glositis: lengua roja y carnosa
• Queilitis
• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types por deficiencia de hierro

Diagnóstico

El diagnóstico de anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types es clínico, pero para calificarla aún más como anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types por deficiencia de hierro, es necesario realizar pruebas de laboratorio.

• Hemograma
  • Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types microcítica hipocrómica
  • ↓ Hb Hb The oxygen-carrying proteins of erythrocytes. They are found in all vertebrates and some invertebrates. The number of globin subunits in the hemoglobin quaternary structure differs between species. Structures range from monomeric to a variety of multimeric arrangements. Gas Exchange
  • ↓ VCM ( < 70)
  • ↓ HCM HCM Hypertrophic cardiomyopathy (HCM) is the most commonly inherited cardiomyopathy, which is characterized by an asymmetric increase in thickness (hypertrophy) of the left ventricular wall, diastolic dysfunction, and often left ventricular outflow tract obstruction. Hypertrophic Cardiomyopathy (< 25)
  • ↑↑ Ancho de distribución eritrocitaria
  • Trombocitosis: ↑ plaquetas
• Estudios de hierro:
  • ↓ Hierro
  • ↓↓ Ferritina
  • ↑↑ Capacidad total de fijación de hierro
  • ↑ Transferrina
  • ↓↓ Saturación de transferrina
• Frotis de sangre periférica
  • Microcitosis y eritrocitos hipocrómicos
  • Anisocitosis
  • Células diana
  • Células de lápiz
• Aspiración de médula ósea
  • Estándar de oro (pero rara vez se hace HACE Altitude Sickness)
  • Tinción con azul de prusia: disminución del hierro en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria eritroblastos
• Encuentre la causa subyacente: estudio gastrointestinal en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum hombres o mujeres posmenopáusicas
• 1 de los LOS Neisseria siguientes hallazgos es necesario para el diagnóstico:
  • Fertina sérica < 30 ng/mL
  • Saturación de transferrina < 19%
  • La anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types se resuelve con suplementos de hierro.
  • Aspirado de médula ósea sin hierro teñido

Tratamiento

Tratar la causa subyacente

• Disminuir la ingesta de leche de vaca en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el lactante.
• Suspender los LOS Neisseria medicamentos que interfieren.
• Tratar la enfermedad inflamatoria intestinal.

Suplementación

• Oral
  • Sulfato ferroso/gluconato ferroso/fumarato ferroso
  • Duración: 3–6 meses
  • Mejora la absorción con jugo ácido (reduce el pH pH The quantitative measurement of the acidity or basicity of a solution. Acid-Base Balance)
• Intramuscular/intravenoso: indicado en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum quienes no toleran la vía oral o presentan malabsorción
• Transfusión de sangre: para pacientes severamente anémicos con taquicardia basal

Verificación de respuesta

Los LOS Neisseria reticulocitos deben aumentar en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum 1 semana.

Diagnóstico Diferencial

• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types de enfermedad crónica: anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types resultante de una enfermedad crónica que se presenta con atrapamiento de hierro en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum macrófagos o en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum ferritina. Se observa con mayor frecuencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la insuficiencia renal crónica debido a la falta de producción de eritropoyetina. La capacidad total de unión al AL Amyloidosis hierro es baja y los LOS Neisseria niveles de hepcidina aumentan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum estos casos.
• Anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types sideroblástica: forma de anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la que los LOS Neisseria niveles de hierro son normales, pero el hierro no se puede incorporar a la molécula de hemo. Las causas de la anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types sideroblástica incluyen envenenamiento por plomo, deficiencia de vitamina B ₆ e isoniazida.
• Talasemia: hemoglobinopatía hereditaria que cursa con un cuadro clínico similar al AL Amyloidosis de la anemia Anemia Anemia is a condition in which individuals have low Hb levels, which can arise from various causes. Anemia is accompanied by a reduced number of RBCs and may manifest with fatigue, shortness of breath, pallor, and weakness. Subtypes are classified by the size of RBCs, chronicity, and etiology. Anemia: Overview and Types ferropénica. Sin embargo, los LOS Neisseria estudios de hierro son normales en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la talasemia y, por lo tanto, la suplementación con hierro puede ser perjudicial.