Anemia ferropenica
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Iron-Deficiency Anemia (Anemia Ferropénica): Diagnosis, Prevalence, and Treatment
Introduction to Iron-Deficiency Anemia
Iron-deficiency anemia (IDA) is the most common type of anemia worldwide, characterized by a lack of sufficient iron, which is crucial for oxygen transport and erythropoiesis. This condition is particularly prevalent among adolescents, children, and women of reproductive age due to increased iron demands during growth, menstruation, and pregnancy .
Prevalence of Iron-Deficiency Anemia
Adolescents and Children
Iron-deficiency anemia is notably prevalent among adolescents, with increased needs for iron due to growth spurts and menstruation in females. Studies indicate that iron deficiency is common in teenagers, with a significant number of cases being attributed to dietary insufficiencies and increased physiological demands. In rural school populations, the prevalence of iron deficiency without anemia was found to be 3.2%, highlighting the need for early detection and intervention. Similarly, in children living under conditions of poverty, the prevalence of iron deficiency anemia was reported to be 2.5%, with iron deficiency alone at 4.4%.
Pregnant Women
Pregnancy significantly increases the risk of iron-deficiency anemia due to the heightened iron requirements for fetal development. A study conducted in Ecuador on pregnant women showed a notable incidence of anemia, emphasizing the importance of dietary interventions rich in iron to manage and prevent this condition.
Athletes
Athletes, particularly those involved in endurance sports, are also at high risk for iron-deficiency anemia. This is due to increased iron utilization, loss through sweat, and potential dietary insufficiencies. Preventive measures include ensuring adequate carbohydrate and protein intake, along with iron-rich foods, to maintain optimal iron levels and athletic performance.
Diagnosis and Differential Diagnosis
Iron-deficiency anemia is typically diagnosed through blood tests measuring hemoglobin, mean corpuscular volume (MCV), serum ferritin, transferrin saturation, and soluble transferrin receptors. It is crucial to differentiate IDA from other microcytic anemias such as thalassemia and anemia of chronic disease . In cases where oral iron treatment does not yield results, conditions like Helicobacter pylori infection, autoimmune atrophic gastritis, and celiac disease should be ruled out as they can cause malabsorption and refractory iron deficiency.
Treatment Options
Oral Iron Supplementation
The primary treatment for iron-deficiency anemia is oral iron supplementation, typically in the form of ferrous salts. Studies comparing the efficacy and tolerability of different iron formulations, such as ferrous sulfate and iron polymaltose complex, found no significant differences in outcomes, suggesting that both are effective options for treating IDA in children.
Intravenous Iron
In certain cases, particularly where oral iron is ineffective or not tolerated, intravenous iron supplementation may be necessary. This approach is often considered for patients with chronic conditions like heart failure, where iron deficiency can exacerbate symptoms and impact quality of life.
Dietary Interventions
Preventive dietary measures are essential, especially in high-risk groups such as young children, pregnant women, and athletes. Recommendations include consuming iron-rich foods like red meat, leafy greens, and fortified cereals, and avoiding inhibitors of iron absorption such as phytates and tannins .
Conclusion
Iron-deficiency anemia remains a significant public health issue, particularly among adolescents, children, pregnant women, and athletes. Early diagnosis, effective treatment, and preventive dietary measures are crucial in managing this condition and mitigating its impact on health and development. Continued research and public health initiatives are essential to address the underlying causes and improve outcomes for those affected by iron-deficiency anemia.
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