Iron Deficiency Anemia: Etiology, Pathophysiology, Diagnosis, and Treatment Approaches
Abstract
Iron deficiency anemia (IDA) is a common health problem that affects about 1.24 billion people around the world, mostly children and women of childbearing age. IDA happens when the body doesn't get enough iron, loses too much iron, or can't absorb it properly. This makes erythropoiesis, cellular metabolism, and immune function worse. The World Health Organization says that 40% of women who are pregnant and 32.5% of women who are not pregnant have anemia. People with IDA often feel tired, weak, pale, and have trouble thinking clearly. Lab tests, such as hemoglobin, blood ferritin, and transferrin saturation, are used to make the diagnosis. You can treat the condition in two ways: by taking iron supplements by mouth, such as ferrous sulfate, ferrous gluconate, and ferrous fumarate; or, for serious cases, by giving iron through an IV. Strategies for prevention depend on increasing the amount of iron you get from food, making it more bioavailable, and keeping infections under control. Food addition and fortification programs have been shown to help lower the number of people with IDA. However, problems still exist, especially in areas with poor economies. Recent advance in acknowledging how iron is used and controlled has implications for creating targeted therapeutic approaches. A key regulator of iron balance, hepcidin, is a key player in the pathophysiology of IDA. This review shows how complicated IDA is and how important it is to have treatment plans that consider underlying causes, dietary factors, and socioeconomic factors.
Keywords: Iron Deficiency Anemia (IDA), Erythropoiesis, Hemoglobin, Nutritional Deficiencies, Neurological Disorders, Iron Supplements.
Keywords:
Iron Deficiency Anemia (IDA),, Erythropoiesis,, Hemoglobin,, Nutritional Deficiencies, , Neurological Disorders, , Iron Supplements.DOI
https://doi.org/10.22270/jddt.v14i11.6899References
1. Kaur T, Upadhyay J, Nandave M, Alsayari A, Alshehri SA, Pukale S, Wahab S, Ahmad W, Rashid S, Ansari MN. Exploring progress in iron supplement formulation approaches for treating iron deficiency anemia through bibliometric and thematic analysis. Heliyon. 2024 Apr 4;10(7):e29058. https://doi.org/10.1016/j.heliyon.2024.e29058 PMid:38623202 PMCid:PMC11016621
2. Khoury A, Pagan KA, Farland MZ. Ferric Maltol: A New Oral Iron Formulation for the Treatment of Iron Deficiency in Adults. Ann Pharmacother. 2021 Feb;55(2):222-229. https://doi.org/10.1177/1060028020941014 PMid:32633548
3. Benson CS, Shah A, Frice MC, Frice CJ, "Iron deficiency anaemia in pregnancy: A contemperory review, Obsteric Medicine", 2021;14(2):67-76. https://doi.org/10.1177/1753495X20932426 PMid:34394714 PMCid:PMC8358243
4. Kurbonova GA, Lapasova ZK, "Current Views on Iron Deficiency Anaemia In Patients With Cardiovascular Disease", 2022; 4(3): 59-64. https://doi.org/10.37547/TAJMSPR/Volume04Issue03-12
5. Hussain U, Zia K, Iqbal R, Saeed M, Ashraf N. Efficacy of a Novel Food Supplement (Ferfer®) Containing Microencapsulated Iron in Liposomal Form in Female Iron Deficiency Anemia. Cureus. 2019 May 7;11(5):e4603. https://doi.org/10.7759/cureus.4603
6. Kumar A, Gupta S, Meena LP, Meher MP, Rai M, Kumar S, Bharti A. Study to evaluate the etiology of iron deficiency anemia at a teaching hospital in northeastern part of India. J Family Med Prim Care. 2020 Jun 30;9(6):3076-3081. https://doi.org/10.4103/jfmpc.jfmpc_3_20 PMid:32984176 PMCid:PMC7491828
7. Gupte S, Mukhopadhyay A, Puri M, Gopinath PM, Wani R, Sharma JB, Swami OC. A meta-analysis of ferric carboxymaltose versus other intravenous iron preparations for the management of iron deficiency anemia during pregnancy. Rev Bras Ginecol Obstet. 2024 Mar 15;46:e-rbgo21. https://doi.org/10.61622/rbgo/2024AO21 PMid:38765534 PMCid:PMC11075392
8. Burton JK, Yates LC, Whyte L, Fitzsimons E, Stott DJ. New horizons in iron deficiency anaemia in older adults. Age Ageing. 2020 Apr 27;49(3):309-318. https://doi.org/10.1093/ageing/afz199 PMid:32103233
9. Sundararajan S, Rabe H. Prevention of iron deficiency anemia in infants and toddlers. Pediatr Res. 2021 Jan;89(1):63-73. https://doi.org/10.1038/s41390-020-0907-5 PMid:32330927
10. Benson CS, Shah A, Stanworth SJ, Frise CJ, Spiby H, Lax SJ, Murray J, Klein AA, "The effect of iron deficiency and anaemia on women's health", Association of anaesthetics, 2021; 76(4): 1-2. https://doi.org/10.1111/anae.15405 PMid:33682105
12. Wiafe MA, Ayenu J, Eli-Cophie D. A Review of the Risk Factors for Iron Deficiency Anaemia among Adolescents in Developing Countries. Anemia. 2023 Jan 3;2023:6406286. https://doi.org/10.1155/2023/6406286 PMid:36636253 PMCid:PMC9831712
13. Leung, A. K. C., Lam, J. M., Wong, A. H. C., Hon, K. L., Li, X., Iron deficiency anameia: an updated review, Current pediatric reviews, 202420(3), 1-3. https://doi.org/10.2174/1573396320666230727102042 PMid:37497686
13. Kontoghiorghes GJ, Kolnagou A, Theodora D, Neocleous M, Kontoghiorghe CN, "New Era in the Treatment of Iron Deficiency Anaemia Using Trimaltol Iron and Other Lipophilic Iron Chelator Complexes: Historical Perspectives of Discovery and Future Applications" International journal for molecular science ,2021; 22(5546): 1-34. https://doi.org/10.3390/ijms22115546 PMid:34074010 PMCid:PMC8197347
14. Animasahun BA, Itiola AY, "Iron deficiency and iron deficiency anaemia in children: physiology, epidemiology, aetiology, clinical effects, laboratory diagnosis and treatment: literature review" Journal of Xiangya Medicine, 2021; 69(22): 1-14. https://doi.org/10.21037/jxym-21-6
15. Maladkar S, Shankar S, Yadav A, "A Novel Approach for Iron Deficiency Anaemia with Liposomal Iron: Concept to Clinic", Journal of Biosciences and Medicines,2020; 8: 27-41. https://doi.org/10.4236/jbm.2020.89003
16. Rivella S, "Iron metabolism under conditions of ineffective erythropoiesis in b-thalassemia" The American Society of Hematology, 2019; 133(1): 51-58. https://doi.org/10.1182/blood-2018-07-815928 PMid:30401707 PMCid:PMC6318430
19. Benson AE, Shatzel JJ, Ryan KS, Hedges MA, Martens K, Aslan JE, Lo JO. The incidence, complications, and treatment of iron deficiency in pregnancy. Eur J Haematol. 2022 Dec;109(6):633-642. https://doi.org/10.1111/ejh.13870 PMid:36153674 PMCid:PMC9669178
20. Camaschella C. Iron deficiency. Blood. 2019 Jan 3;133(1):30-39. doi: 10.1182/blood-2018-05-815944. Epub 2018 Nov 6. Erratum in: Blood. 2023 Feb 09;141(6):682. https://doi.org/10.1182/blood.2022018610 PMCid:PMC10023716
21. Animasahun BA, Itiola AY, "Iron deficiency and Iron deficiency anaemia in children: physiology, epidemiology, aetiology, clinical effect, laboratory diagnosis and treatment: Literature review" Journal of xiangya medicine, 2021;6(22). https://doi.org/10.21037/jxym-21-6
20. Sandra E Juula, Richard J Dermanb, Michael Auerbach, "Perinatal Iron Deficiency: Implications for Mothers and Infants", Neonatology,2019;115: 269-274. https://doi.org/10.1159/000495978 PMid:30759449
21. Cappellini MD, Musallam KM, Taher AT, "Iron deficiency anaemia revisited", The Association for the Publication of the Journal of Internal Medicine,2020;287, 153-170. https://doi.org/10.1111/joim.13004 PMid:31665543
22. Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, São Paulo, "Iron deficiency anaemia in children: a challenge for public health and for society", Sao Paulo Medicine Jornal, 2005; 123(2): 88-92.
23. Brady PG. Iron deficiency anemia: a call for aggressive diagnostic evaluation. South Med J. 2007 Oct;100(10):966-7. https://doi.org/10.1097/SMJ.0b013e3181520699 PMid:17943034
24. Agarwal AM, Rets A, "Laboratory approach to investigation of anaemia in pregnancy" International journal for laboratory hematology, 2021; 41(1): 65-75. https://doi.org/10.1111/ijlh.13551 PMid:34288450
26. Sundararajan S, Rabe H. Prevention of iron deficiency anemia in infants and toddlers. Pediatr Res. 2021 Jan;89(1):63-73. https://doi.org/10.1038/s41390-020-0907-5 PMid:32330927
27. Gian Carlo Di Renzo, Filippo Spano, Irene Giardina, Eleonora Brillo, Graziano Clerici & Luis Cabero Roura, "Iron deficiency anaemia in pregnancy" Womens Health, 2015;11(6): 891-900. https://doi.org/10.2217/whe.15.35 PMid:26472066
28. Babker AM, Di Elnaim EO, Hematological changes during all trimesters in normal pregnancy, Journal of Drug Delivery and Therapeutics. 2020;10(2):1-4 https://doi.org/10.22270/jddt.v10i2.3958
28. Beladen CC, Botezatu SP, "Anaemia and Management of Heart Failure Patients" Heart failure clinics, 2021; 17(4): 195-206. https://doi.org/10.1016/j.hfc.2020.12.002 PMid:33673945
30. Ning S, Zeller MP. Management of iron deficiency. Hematology Am Soc Hematol Educ Program. 2019 Dec 6;2019(1):315-322. https://doi.org/10.1182/hematology.2019000034 PMid:31808874 PMCid:PMC6913441
31. Lopez A, Cacoub P, Macdougall JC, Peyrin-Biroulet L, "Iron deficiency anaemia" The Lancet, 2016; 387(10021): P907-916. https://doi.org/10.1016/S0140-6736(15)60865-0 PMid:26314490
31. Kumar A, Sharma E, Marley A, Samaan MA, Brookes MJ, "Iron deficiency anaemia: pathophysiology, assessment, practical management" BMJ journals, 2022. https://doi.org/10.1136/bmjgast-2021-000759 PMid:34996762 PMCid:PMC8744124
32. Elstrott B, Khan L, Olson S, Raghunathan V, DeLoughery T, Shatzel J J, "The role of iron repletion in adult iron deficiency anaemia and other diseases" European journal of haematology, 2020; 104(3): 153-161. https://doi.org/10.1111/ejh.13345 PMid:31715055 PMCid:PMC7031048
33. Chaparro CM, Suchdev PS, "Anaemia epidemiology, pathophysiology, and etiology in low- and middle-income countries" Annals of the New York Academy of Sciences, 2019; 1450(1): 15-31. https://doi.org/10.1111/nyas.14092 PMid:31008520 PMCid:PMC6697587
34. Nikolaoua M, Chrysohooub C, Georgilasc TA, Giamouzisd G, Giannakoulase G, Karavidasf A, Papadopoulosg C, Patsilinakosh S, Tziakasi D, Parissis J, "Management of iron deficiency in chronic heart failure: Practical considerations for clinical use and future directions" European Journal of Internal Medicine, 2019; 65: 17-25. https://doi.org/10.1016/j.ejim.2019.05.011 PMid:31109847
35. Benson BS, Shah A, Stanworth SJ, Frise CJ, Spiby H, Lax SJ, Murray J, Klein AA, "The effect of iron deficiency and anaemia on women's health" Association of Anaesthetist, 2021;76(4): 84-95. https://doi.org/10.1111/anae.15405 PMid:33682105
36. James AH, "Iron Deficiency Anaemia in Pregnancy", Clinical Expert Series, 2021; 138(4): 664-674. https://doi.org/10.1097/AOG.0000000000004559
37. Kaushal S, Priya T, Thakur S, Marwaha P, Kaur H, "The Etiology of Anaemia Among Pregnant Women in the Hill State of Himachal Pradesh in North India: A Cross-Sectional Study", Cureus, 2022; 14(1): 1-7. https://doi.org/10.7759/cureus.21444
38. Lanser L, Fuchs D, Kurz K, Weiss G, "Physiology and Inflammation Driven Pathophysiology of Iron Homeostasis-Mechanistic Insights into Anaemia of Inflammation and Its Treatment" Nutrients, 2021; 13(11): 1-29. https://doi.org/10.3390/nu13113732 PMid:34835988 PMCid:PMC8619077
39. Franceschi LD, Iolascon A, Taher A, Cappellini MD, "Clinical management of iron deficiency anaemia in adults: Systemic review on advances in diagnosis and treatment" European Journal of Internal Medicine, 2017;42:16-23. https://doi.org/10.1016/j.ejim.2017.04.018 PMid:28528999
40. Svenson N, Bailey J, Durairaj S, Dempsey-Hibbert N, "A simplified diagnostic pathway for the differential diagnosis of iron deficiency anaemia and anaemia of chronic disease" International Journal of Laboratory Hematology, 2021;43:1644-1652. https://doi.org/10.1111/ijlh.13666 PMid:34288431
41. Cotter J, Baldaia C, Ferreira M, Macedo G, Pedroto I, "Diagnosis and treatment of iron-deficiency anaemia in gastrointestinal bleeding: A systematic review" World Journal Gastroenterology, 2020; 26(45): 7242-7257. https://doi.org/10.3748/wjg.v26.i45.7242 PMid:33362380 PMCid:PMC7723662
42. Garzon S, Cacciato PM, Certelli C, Salvaggio C, Magliarditi M, Rizzo G, "Iron Deficiency Anaemia in Pregnancy: Novel Approaches for an Old Problem" Oman Medical Journal, 2020; 35(5): https://doi.org/10.5001/omj.2020.108 PMid:32953141 PMCid:PMC7477519
43. Gómez-Ramírez S,Brilli E, Tarantino G, Girelli D, Muñoz M, "Sucrosomial® Iron: An Updated Review of Its Clinical Efficacy for the Treatment of Iron Deficiency", Pharmaceuticals, 2023, 16(6), 847; https://doi.org/10.3390/ph16060847 PMid:37375794 PMCid:PMC10305423
44. Auerbach M, "Optimizing diagnosis and treatment of iron deficiency and iron deficiency anaemia in women and girls of reproductive age: Clinical opinion" International Journal of Gynecology and Obstetrics, 2023;162(2):68-77. https://doi.org/10.1002/ijgo.14949 PMid:37538014
45. Rakanita Y, Sinuraya RK, Suradji EW, Suwantika AA, Syamsunarno MRAA, Rizky Abdulah R, "The Challenges in Eradication of Iron Deficiency Anaemia in Developing Countries" Systematic Review Pharmacy, 2020; 11(5): 383-401. http://dx.doi.org/10.5530/srp.2019.2.04
46. Lo JO, Benson AE, Martens KL, Hedges MA, McMurry HS, DeLoughery T, Aslan JE, Shatzel JJ, "The role of oral iron in the treatment of adults with iron deficiency" European journal of haematology, 2023;110:123-130. https://doi.org/10.1111/ejh.13892 PMid:36336470 PMCid:PMC9949769
47. Liberal A, Pinela J, Vívar-Quintana AM, Ferreira ICFR, Lillian Barros L, "Fighting Iron-Deficiency Anaemia: Innovations in Food Fortificants and Biofortification Strategies" Foods, 2020; 9(12):1871. https://doi.org/10.3390/foods9121871 PMid:33333874 PMCid:PMC7765292
48. Camaschella C, "Iron deficiency" Blood, 2019;133(1): 30-39. https://doi.org/10.1182/blood.2022018610 PMCid:PMC10023716
49. Benson AA, Shatzel JJ, Ryan KS, Hedge MA, Martens K, Aslan JE, Lo JO, "The incidence, complications, and treatment of iron deficiency in pregnancy" European journal of haematology, 2022;109 ( ):633-642. https://doi.org/10.1111/ejh.13870 PMid:36153674 PMCid:PMC9669178
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