Question

Compare and contrast the metabolic causes and clinical diagnosis of i) iron-dependent anaemia and ii) iron-independent anaemia.

Answer 1

Ans:

Iron-dependant anaemia

Iron-independant anaemia

Causes: If iron intake is limited or inadequate due to poor dietary intake, anemia may occur as a result. This is called iron dependant anemia. Iron dependant anemia can also occur when there are stomach ulcers or other sources of slow and chronic bleeding like colon cancer, uterine cancer, intestinal polyps, hemorrhoids etc. Diagnosis: A serum ferritin level is obtained in patients with anemia. Ferritin gives iron stores and is the most accurate test to diagnose iron dependant anemia. Although levels below 15 ng per mL are consistent with a diagnosis, using a cutoff of 30 ng per mL improves sensitivity from 25 to 92 percent, and specificity remains high at 98 percent. In patients with chronic inflammation, iron deficiency anemia is likely when the ferritin level is less than 50 ng per mL (112.35 pmol per L).7 Ferritin values greater than or equal to 100 ng per mL generally exclude iron dependent anemia.

Causes: Iron independent anaemia may occur due to vitamins deficiency, sickle cell disorder, thalassemia, autoimmune disease, exposure to toxic chemicals etc. Diagnosis: Complete blood count (CBC) test, and tests to detect vitamin B12, folates, reticulocyte count, bilirubin etc.