blood iron presentation

8/13/2019 Blood Iron Presentation

1/27

Dr : MANAL ABDALLAASSOCIATE PROFESSOR

CLINICAL PATHOLOGY

TAIBAH UNIVERSITY

KSA


2/27

Most iron in the o!" is#resent in the he$o%&oin'n! s$'&& #'rt in $"o%&oin (en)"$es s*+h 's +'t'&'se'n! +"to+hro$e P,-./

en)"$e.


3/27

Tot'& o!" iron +ontent is'##ro0i$'t&" - %$

The '1er'%e &oss o2 3 $% o2 iron

#er !'" $*st e re#&'+e! "!iet'r" so*r+es ( #re%n'nt or$enstr*'te! 4o$en 'n!

+hi&!ren h'1e %re'ter ironre5*ire$ents o2ten ot'ine! "!iet s*##&e$ent'tion


4/27

The tot'& Iron +ontent o2 the '!*&t o!" is'##ro0i$'te&" - % 67/ $$o&8( o2 4hi+ht4o thir!s is in h'e$o%&oin9

Iron stores 6 $'in&" s#&een( &i1er 'n! one$'rro48 +ont'in 'o*t one,5*'rter o2 theo!"(s iron9

Most o2 the re$'in!er is in $"o%&oin('n! other h'e$o#roteins9

On&" /93 o2 the tot'& o!" iron is in the#&'s$'( 4here it is '&$ost '&& o*n! to 'tr'ns#ort #rotein( tr'ns2errin


5/27

' si%ni2i+'nt '$o*nt o2iron is store! 's 2erritin

'n! he$osi!erine $'in&"in the one $'rro4 (&i1er'n! s#&een.


6/27

Functions of IronFunctions of Iron

Formulation of hemoglobinFormulation of hemoglobinFormulation of myoglobinFormulation of myoglobin

Binding OBinding O22to RBC and transportto RBC and transport

Muscle activityMuscle activity

Immune system T cell antibodiesImmune system T cell antibodies


7/27

Iron DistributionIron DistributionFunctional

FormsHemoglobin

MyoglobinCytochromes

Storage

FormsApoferritin

FerritinHemosiderin


8/27

The $e'n !'i&" int'e o2 iron is'o*t ;/ $%( &ess th'n 3/< o2 this

is 'sore!9

Re%*&'tion o2 iron 'sor#tion is!eter$ine! " the st'te o2 o!"

iron( ein% in+re'se! 4hen the" 're!e#&ete! 'n! !e+re'se! 4hen the"'re '!e5*'te

It is '&so in+re'se! 4hener"thro#oiesis is in+re'se!

The $'in site o2 iron 'sor#tion is

the #ro0i$'& s$'&& o4e&


9/27

Iron AbsorptionIron AbsorptionMucosal cellsDuodenumAbsorptive SurfaceTimeTypes of Iron


10/27


11/27

Iron is $ore re'!i&" 'sor#e! in the Fe;=

2or$ *t !iet'r" iron is $'in&" in the Fe>=

2or$9 G'stri+ se+retions &ier'te iron 2ro$ 2oo!

'n! #ro$ote +on1ersion o2 Fe>=to Fe=; As+ori+ '+i! 2'+i&it'te iron 'sortion

4hi&e #h"ti+ '+i!( #hos#h'tes 'n!o0'&'tes 2or$ inso&*&e +o$#&e0es 4ith

iron 'n! !e+re'se its 'sor#tion9 On+e 'sore!( Iron is either tr'ns#orte!

!ire+t&" into the &oo! stre'$ or +o$ines4ith '#o2erretin in $*+os'& +e&&s to 2or$

2erritin


12/27

In the &oo!( iron is tr'ns#orte! o*n!to tr'ns2errin9 Tr'ns2errin is nor$'&&"'o*t one thir! s't*r'te! 4ith iron9

In tiss*es( iron is o*n! in 2erretin 'n!h'e$osi!rin9 Free iron is 1er" to0i+'n! #rotein in!in% '&&o4s iron to etr'ns#orte! 'n! store! in ' non,to0i+2or$9

Iron is &ost 2ro$ the o!" in 2'e+es( "!es5*'$'tion o2 sin 'n! in 4o$en "$enstr*'& &oo! &oss


13/27

PLASMA IRON: ormal plasma iron concentration in men

is !" #$" microgram % dl lo&er in &omen It's measurement is of little value in

investigation of iron defeciency( becausemany conditions as infection( trauma(chronic inflammatory disorders andneoplasia are associated &ith lo& plasmairon concentrations

It is of value in diagnosis ofhaemochromatosis and in iron poisining


14/27

Iron is !e+re'se! in:Iron !e2i+ien+" 'ne$i'

Chroni+ in2&'$'tor"!isor!ers

Chroni+ &oo! &oss

Chroni+ !ise'ses 's SLE ( RAThir! tri$ester o2 #re%n'n+"

In'!e5*'te iron 'sortion


15/27

This may be due to inade)uate inta*e(impaired absorption( e+cessive loss or acombination of these, The anaemia thatdevelops is hypochromic and microcytic and

if there is an obvious cause of irondefeciency( further investigation of theanaemia is not re)uired, -o& plasmaferretin concentration and%or an increase in

transferrin receptor concentration &illindicate iron defeciency,


16/27

Ser*$ iron &e1e& isin+re'se! in:

Th'&'sse$i' 'n!he$o&"ti+ 'ne$i'he$o+hro$'tosis

A+*te iron #oisnin%A+ti1e +irrhosis 'n! '+*te

he#'titis


17/27

PLASMA TOTAL IRON BINDING CAPACITY: Measurement of plasma iron binding capacity is

a functional measurement of transferrinconcentration,

.no&ing the plasma iron concentration( thetransferrin saturation can be calculated(normally about //0

1lasma total iron binding capacity is increasedin iron defeciency

Transferrin saturation is increased in ironoverload


18/27

Iron saturation ser*$ iron +on+entr'tion 03//

TIBC


19/27

De+re'se! iron in!in% +'#'+it":He$o+hro$'tosis

A+*te iron #oisnin%A+*te he#'titis 'n! '+ti1e

+irrhosisH"#o#rotene$i'

Th'&'sse$i'Ne#hrosis 'n! ne#hritis


20/27

In+re'se! iron in!in%+'#'+it":

Iron deficiency anemia1regnancy 3 third trimester(4cute and chronic blood loss


21/27

PLASMA FERRETIN It is superior to plasma iron and iron binding

capacity for the assessment of body ironstores

In healthy indivuduals ( plasma ferretinconcentrations are usually &ithin the range2"5/"" ug%-

The only *no&n cause of a lo&concentration is a decrease in body ironstores


22/27

TRANSFERRIN RECEPTORS6 It is a recent addition to the tests available

for the investigation of iron status It is increased in iron defeciency,The plasma concentration increase 2 to /

times normal &hen anaemia is present( butthe rise occur only after iron stores are

depleted It rises also in conditions in &hich there is

chronically increased erythroid proliferation


23/27

E1'&*'tion o2 o!" ironE1'&*'tion o2 o!" iron

st't*sst't*s Iron o1er&o'!

Ser*$ iron +on+entr'tion(#er+ent'%e tr'ns2errin s't*r'tion

Ser*$ 2erritin +on+entr'tionBone $'rro4 ironCo$#*te! to$o%r'#h" 6CT s+'n(M'%neti+ reson'n+e i$'%in% 6MRI(

Li1er io#s"


24/27

Iron !e2i+ien+" Most o2 the &'or'tor" tests 're

re&'te! to re! &oo! +e&& #ro!*+tion: CBC

B&oo! in!i+es Ser*$ iron Ser*$ TIBC Ser*$ 2erritine Iron s't*r'tion Tr'ns2errine re+e#tors


25/27

Iron !e2i+ien+" in!i+'torsIron !e2i+ien+" in!i+'tors

Stor'%e iron !e#&etionSt'in'&e one $'rro4 iron

Ser*$ 2erritin +on+entr'tionIn+re'se! tot'& iron in!in%+'#'+it" 6TIBC(


26/27

This can occur &ith increased intestinalabsorbtion of iron either acutely as in ironpoisining or chronically,

Increased parenteral iron administrationoccur in patients given repeated bloodtransfusions and lead to overloading of ironstores, 7+cess iron is deposite mainly as

hemosidrin in R7 cells,


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7+cess of Fe/8 is added to the sample tosaturate serum transferrin, 9ncomple+edFe/8 is precipitated &ith magnesiumhydro+ide carbonate and the iron bonded to

protein in the supernatent is thenspectrophoto5metricallymeasured,

blood iron presentation

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