Answers to Patient Case: John Doe

1. Common Signs and Symptoms of Iron Deficiency Anemia:

• Fatigue and weakness: This is a hallmark symptom due to reduced oxygen delivery to tissues.
• Pale skin and conjunctiva: Reduced red blood cells (RBCs) carrying hemoglobin lead to less color in the skin and mucous membranes.
• Shortness of breath on exertion: The body struggles to deliver enough oxygen to meet increased demands during activity.
• Other symptoms may include: dizziness, headache, cold hands and feet, restless legs syndrome, and cognitive difficulties.

2. Explanation of Laboratory Findings:

• Hemoglobin (Hb) and Hematocrit (Hct): These values are below the normal range, indicating a decrease in the total number of RBCs and the percentage of blood volume occupied by RBCs.
• Mean Corpuscular Volume (MCV): While slightly low, MCV suggests John’s RBCs are microcytic (smaller than usual), which is a characteristic finding in iron deficiency anemia.
• Serum Iron and Total Iron Binding Capacity (TIBC): Both are lower than normal. Low serum iron indicates depleted iron stores, and a high TIBC suggests the body’s increased demand for iron due to deficiency.
• Ferritin: This is a sensitive marker of iron stores. John’s very low ferritin level confirms iron deficiency.

3. Potential Causes of Iron Deficiency Anemia in Adults and Further Investigations:

• Dietary iron deficiency: Inadequate intake of iron-rich foods like red meat, poultry, fish, beans, and dark leafy greens.
• Reduced iron absorption: Conditions like celiac disease, inflammatory bowel disease, or chronic use of proton pump inhibitors can hinder iron absorption.
• Increased iron losses: Blood loss is a common cause. This could be due to heavy menstrual bleeding in women, chronic gastrointestinal bleeding (ulcers, hemorrhoids, tumors), or recent surgeries.

Further investigations for John Doe might include:

• Stool tests: To check for occult blood loss (invisible bleeding in the stool).
• Upper endoscopy or colonoscopy: To visualize the upper and lower gastrointestinal tract for potential sources of bleeding, if stool tests are positive.
• Urine tests: To rule out urinary tract bleeding.

4. Treatment Options for Iron Deficiency Anemia:

• Iron supplementation: Oral iron tablets are the mainstay of treatment. The dose and type of iron will be determined by the severity of the deficiency and individual factors.
• Dietary modifications: Increasing intake of iron-rich foods and consuming vitamin C alongside iron to enhance absorption.
• Addressing the underlying cause: If an identifiable cause exists, such as blood loss, treating that cause is crucial for long-term management.