IRON METABOLISM DISORDERS - Columbia University
IRON METABOLISM DISORDERS
ANEMIA
Definition
? Decrease in the number of circulating red blood cells
? Most common hematologic disorder by far
1
ANEMIA
Causes ? Blood loss ? Decreased production of red blood cells
(Marrow failure) ? Increased destruction of red blood cells
? Hemolysis
? Distinguished by reticulocyte count
? Decreased in states of decreased production ? Increased in destruction of red blood cells
ANEMIA
Causes - Decreased Production
? Cytoplasmic production of protein
? Usually normocytic (MCV 80-100 fl) or microcytic (MCV < 80 fl)
? Nuclear division/maturation
? Usually macrocytic (MCV > 100 fl)
2
ANEMIA
Causes - Cytoplasmic Protein Production
? Decreased hemoglobin synthesis
? Disorders of globin synthesis ? Disorders of heme synthesis
? Heme synthesis
? Decreased Iron ? Iron not in utilizable form ? Decreased heme synthesis
IRON DEFICIENCY ANEMIA
Prevalence
Country
Men (%) Women (%)
S. India
6
35
N. India
64
Latin America 4
17
Israel
14
29
Poland
Sweden
7
USA
1
13
Pregnant Women (%)
56 80 38 47 22
3
IRON
? Functions as electron transporter; vital for life ? Must be in ferrous (Fe+2) state for activity ? In anaerobic conditions, easy to maintain
ferrous state ? Iron readily donates electrons to oxygen, ?
superoxide radicals, H2O2, OH? radicals ? Ferric (Fe+3) ions cannot transport electrons or
O2 ? Organisms able to limit exposure to iron had
major survival advantage
IRON
Body Compartments - 75 kg man
Stores 1000 mg
Tissue 170 mg
4 mg
Absorption < 1 mg/day Excretion < 1 mg/day
Red Cells 2400 mg
4
Transferrin Receptor
IRON CYCLE
CIRCULATING RBCs
Fe Fe
Fe
Fe
Fe
Ferritin Ferritin
Fe
Fe
Fe
Fe
RBC PRECURSOR
Fe
Fe
Fe
Fe
MONONUCLEAR PHAGOCYTES
FeFe Fe
Ferritin
slow
Hemosiderin
TRANSFERRIN
INTRACELLULAR IRON TRANSPORT
Fe+2
Transferrin
Transferrin receptor
Lysosome
H+ H+
H+
H+
Fe+2
5
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