How is hemosiderin visualized in histology?
Prussian blue
Footnote:
It is called PERL’s rxn which detects Fe3+.
Plummer vinson syndrome?
Triad of IDA, glossitis, esophageal webs.
What is Mentzer index and why is it used?
M.I = MCV/RBC count.
It distinguishs between IDA and thalessemia trait
Footnote:
>13 - IDA - bone marrow is struggling to make cells so RBC count is low.
<13 - thallesemia - bone marrow tries hard to compensate by pumping small cells therefore high rbc count.
Findings of IDA on microscopy?
Anisocytosis, poikilocytosis, Target cells , pencil cells
See p.no 65 for slide
What is the significance of soluble Tf/ log ferritin?
Differentiates between Iron Deficiency Anemia (IDA) and Anemia of Chronic Disease (ACD), especially when inflammation makes ferritin unreliable.
Interpretation:
- High Index (>1.5) : Indicates Iron Deficiency Anemia. The body’s demand for iron (sTfR) is high compared to actual stores and ferritin is low.
- Low Index (<1.5): Indicates Anemia of Chronic Disease. Iron stores are present, but “locked away” due to inflammation and ferritin is high
Why use it?
Unlike TIBC or Ferritin alone, sTfR is not affected by inflammation, providing a “truer” look at iron status.
Clinical features of IDA?
Fatigue
Stunted growth
Dyspnea
Palpitations
Koilonychia
Hairloss
Describe iron metabolism?
Iron metabolism has three steps:
Absorption in the DUODENUM → Transport in blood by TRANSFERRIN → Storage as FERRITIN and HEMOSIDERIN.
How is iron absorbed in the intestine and what affects it?
Iron is absorbed in the duodenum in the ferrous (Fe²⁺) form.
Absorption is increased by acids (HCl, vitamin C) and decreased by phytates, carbonates, and tetracyclines.
Explain the role of transporters and enzymes in iron absorption?
Fe³⁺ is reduced to Fe²⁺ by cytochrome b reductase and STEAP.
Fe²⁺ enters enterocytes via DMT1 (apical membrane) and exits via ferroportin (basolateral membrane).
Fe²⁺ is oxidized to Fe³⁺ by hephaestin and ceruloplasmin.
