LECTURE 37- NUTRITIONAL- ANEMIAS
Dr. Shaheen Haroon Rashid
Lecture Objectives
• Classify nutritional anemia
• Discuss their pathogenesis
• Describe the basis of investigations
• Explain the basic approach of treatment (diet
and drugs)
Nutritional Anemia Classification
• Nutritional Anemias are mainly classified into
the following:
• Iron Deficiency Anemia
• Megaloblastic Anemia
Iron Metabolism & Iron Deficiency Anemia
Daily
Iron
Cycle
Regulation
of Iron
absorption
Iron requirement & factors effecting absorption
Causes of Iron Deficiency Anemia
The development of iron
deficiency anemia.
Reticuloendothelial
(macrophage) stores are lost
completely before anemia
develops.
Stomatitis:
Investigation & management
Peripheral Smear of Iron Deficiency
Anemia
The enlarged central area of pallor in
the red blood cell (arrows) indicates
a decrease in hemoglobin synthesis
Normal: The RBCs are
uniform in size, and the
central areas of pallor are
slightly less
Vitamin B12, Folate Metabolism & Megaloblastic
Anemia
Absorption of Vitamin B12 &
Folate
The biochemical basis of
Megaloblastic Anemia caused by
Vitamin B12 or Folate Deficiency
Investigations & Treatment of Megaloblastic Anemia
Peripheral Smear of Megaloblastic
Anemias
The enlarged, egg-shaped red blood
cells (macro-ovalocytes)
Normal: The RBCs are
uniform in size, and the
central areas of pallor are
slightly less
Summary
• There are two most common anemias associated with
nutritional deficiency: Iron Deficiency Anemia (IDA) &
Megaloblastic Anemia
• Iron Deficiency Anemia is most common. In the developing
countries, it is most commonly due to dietary deficiency;
while in the developed countries, it is due to chronic blood
loss
• Investigations include Serum Iron, TIBC & Ferritin
• Treatment of IDA involves oral or parenteral replacement
for at least 6 weeks as well as treating the underlying cause
• Megaloblastic Anemia is usually caused by diet,
malabsorption or excess demand
• Investigations include Serum Vit B12, Folate & RBC Folate
levels
• Treatment involves oral/parenteral replacement for at least
3-4 months
References
• Basic Pathology, 8th Edition
• Essential Hematology, 6th Edition
Thank you