STUDY OF IRON DEFFICIENCY

ANAEMIAS, CLINICAL
PRESENTATIONS AND ITS
CORREALTION WITH
HAEMATOLOGICAL AND
BIOCHEMICAL PARAMETRES

DR. PRATIBHA
 Place of study:-
Teerthankar Mahaveer Medical College and
Research centre, Moradabad
Guide:-
Dr. Shyamoli Dutta(professor & HOD,Dept. of
Pathology )
Co- guide:-
Candidate name:-
Dr. Pratibha Srivastava
 INTRODUCTION

Anaemia is defined as an insufficient Red(RBC)

blood cell mass to adequately deliver oxygen to
peripheral tissues
Based on size of the rbc, hematologists categorize
anaemia as normocytic, macrocytic or microcytic.
Iron deficiency anaemia (IDA) can be suspected
when there is decreased haemoglobin level for age
and sex; microcytic hypochromic red blood cells
morphology and reduced red cell indices that are
MCV, MCH, MCHC.
Confirmation of IDA biochemical tests such as
serum ferritin, serum iron, percentage
saturation of transferrin and serum total iron
binding capacity should be done
Bone marrow aspirate stained with Prussian
blue also show presence or absence of iron
storage in the marrow.
 REVIEW OF LITERATURE
Hanumante. NM, Kavinde S , Vaidya M et
al.(2008)2 conducted a pilot study to assess
the iron status and dietary intake of 1-3 year
old apparently healthy toddlers and effect of
eight weeks intervention with liquid oral iron
in an urban slum in Pune, India. Fifty toddlers
with mean age of 2.4 years were evaluated.
Anthropometry, Food Frequency
Questionnaire, a hemogram, and serum
ferritin were measured. Twenty mg of iron
was given to all toddlers.
 Hopkins D, Emett P, Colin S et al (2007)6 from
Bristol, United Kingdom, in an observational
cohort study, investigated the relationship
between iron status in infancy and type of
milk and weaning food consumed. 928 term
infants were included in the study and
hemoglobin and ferritin concentration at 8
and 12 months were assessed in relation to
type and quantity of milk intake at 8 months
 In a survey conducted by Cutts et al in Surkhet, 95%
of children less than 15 years of age were anaemic.
Also 33% of children under 5 years of age, 9% of
children within 5-15 years, 17% of adult women and
4% of adult men had haemoglobin levels under 9
gm/dl. 80% of these people had microcytic
hypochromic blood films inducted by Shrestha PN,
78.4% of children of rural Kathmandu were found to
be anaemic 12.
 Anaemia is the major problem in
india.F.Arnold,M.Kothari et al c In the 2005-
2006 National Health Survey(FFHS-3),Having
the prevalage of anaemia was 70% in children,
55% in females aged 15-49 years,and 24% in
males aged 15-49 years[4].Althrough the
NFHS-3 showed that the prevalence of
anaemia was higher in ruler areas. The aim of
this study is to describe the prevalence of
anemia.
 According to data from National Health and
Nutrition Examination surveys, the prevalence
of hypoferremia in the United States was
about 5% in adult men and 14% in adult
women 13. Anaemia was noted in about 3% of
adult men and in 4 to 6% of adult women. The
latent iron deficiency (hypoferremia without
anaemia) was prevalent in 2% of adult men
and 8 to 10% of adult women
 OBJECTIVE OF STUDY
To study the frequency of iron deficiency anaemia.
To study the clinical presentation of iron deficiency
anaemia.
To correlate the haemoglobin level and biochemical
parameters (serum iron, TIBC, serum ferritin,
percentage saturation of transferrin) in iron
deficiency anaemia.
To correlate the haemoglobin level with
haematological parameters (MCV, MCHC, MCH) in
iron deficiency anaemia.
 METHOD OF COLLECTION OF DATA

SOURCE OF DATA :
All patients clinically anaemic from opd and ipd by various
department of teerthanker mahaveer medical college and
research centre, Moradabad during the period jan 2017 to oct
2018.

METHODS OF COLLECTION OF DATA:

1. CBC-by automated hematology analyzer
2. Peripheral blood smear(thin smear)-to see the general blood
picture
3. Biochemical test:-serum iron, TIBC, serum ferritin,
percentage saturation of transferrin

 DURATION OF STUDY:-
Approximately 2 years .

SAMPLE SIZE:-
Approximately 500 cases expected
The obtained data will be tabulated and
analyzed by appropriate statistical tests.
 INCLUSION CRITERIA
All The patients having low serum iron less
than 55-160microgrm/dl in men and 40-
155microgram/dl in women will be included
for study.

4.EXCLUSION CRITERIA
Patients previously transfused with blood
within 120 days.
Patients already on Iron therapy.
 ETHICAL DECLARATION
Throughout the study, ethical considerations will be
maintained, even if patients refuse to participate in study.

Confidentiality would be ensured.

Written informed consent will be taken from the patients

and /or accompanying nearest relatives. Patients will be
free to drop out at any time .

The Ethical clearance will be taken from the Institutes

Ethical committee before starting this study.
Proforma for the study of frequency of Iron Deficiency Anaemia, its clinical presentation, its correlation
with haematological and biochemical parameters.
Case no: Date:
Name: Age..Yrs. Sex: Male Female
Address.
Occupation: Service Agriculture Business
Others..
Marital status: Unmarried Married
Ward:. Bed No.IP No: OPD No:.
Clinical History
Fatigue Yes No
Irritability Yes No
Palpitation Yes No
Dizziness Yes No
Breathlessness Yes No
Headache Yes No
Faver Yes No
Haematemesis Yes No
Melaena Yes No
Menstrual History Flow:.. duration: Cycle:.
Pregnancy No. Miscarriages No:
Clinical Examination
Anaemia Present Absent
Flattening of nail Present Absent
Koilonychia Present Absent
Pulse:/min B. P.:../..mmHg
Hepatomegaly Present Absent
Splenomegaly Present Absent
 References
1.INAG/WHO/UNICEF. Guidelines for the use of iron supplements to prevent
and treat iron deficiency anemia. International nutritional anemia
consultation group/WHO/ United Nations childrens fund. Stoltzfus RJ,
Dreyfuss ML. ILSI Press, International Life Science Institute, Washington,
USA, 1998.

2. Hanumante NM, Kavinde S, Sanwalka NJ ,et al. Iron deficiency anemia in

urban slum. Indian
J Pediatr 2008; 75(4): 355-357.
3. Ashwell S. Observations on chlorosis and its complications. Guy's Hosp Rep
1836;1:529.
4. Sultan ali N ,Zuberi RW, Late weaning ; The most significant risk factor in
the development of iron deficiency anemia at 1-2 years of age; J . Ayub
Med Coll Abbottabad 2005; 15: 3-7( medline
5. Witts LJ. Simple achlorhydric anaemia. Guy's Hosp Rep 1930; 80:253;
1931;81:205.
6. Hopkins D, Emmett P, Steer Coli. et al. Infant feeding in the second 6
months of age
. related to iron status ; an observational study; Arch Dis Child
, 2007;92:850-854.

7. The World Health Report 1998, Page 48.

8. Baral MR; Sharma PR; Khetan BK; Nutritional iron deficiency
anaemia prevalenc Kanti children's Hospital. Nepal Paediatric
society Journal 1985 July- Dec, 4(2): 101-4.
9. Shrestha IL, Anaemia in children of Nepal, Nepal paediatric society
July; 1(1): 80-6.
10. Cutts F, Quinlisk P, Surkhet district anaemia survey, Journal of
Institute of Medicine 1982 March; 4(1): 13-14.
11. Gurubacharya VL, Anaemia: Sample Survey in Nepalese
Children, Nepal Medical Association International Year of child
seminar: The Child in Nepal 1979 Dec 14-15, Kathmandu.