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What is the different between Iron Deficiency Anemia and B12 deficiency and how can you tell the differences in a patient when they both show similar signs?
Iron deficiency anaemia - as the name suggests - is caused by the lack of sufficient iron. Iron, inside the heme group of the protein Haemoglobin, is necessary to carry Oxygen (and carbon dioxide) inside the red blood cells. If the body tissues are not getting enough oxygen - hypoxia -, anaemia results. The reasons can be: - low dietary intake of heme iron (heme iron is easier to absorb) - malabsorption (prevention of iron absorption) - blood loss (iron lost along with the red blood cells) - increased demand (rapid growth, pregnancy, lactation) Vitamin B12 deficiency can also result in anaemia. The reasons can be: - Vitamin B12 deficiency - folate deficiency - liver disease/cirrhosis - alcoholism - pregnancy - myelodysplastic syndromes. Since anaemias (hypoxia) symptoms generally are the same, diagnosis is based on blood film (blood smear), and blood tests' results of - Hct = percentage of Red blood cells on whole blood, - RCC = red blood cell count, - MCV = Mean cell or corpuscule volume, - MCH = Mean Corpuscular Haemoglobin, - MCHC Mean corpuscular haemoglobin concentration, and also - Serum iron (SI) - Serum ferritin, - Transferrin saturation, - Total Iron binding Capacity (TIBC) . Iron deficiency anaemia: - Red blood cells are hypochromic (paler) and microcytic (smaller), due to less then normal contents of haemoglobin. - Target cells, - elliptocytes (pencil cells) Vitamin B12 deficiency: - Macrocytes (bigger red blood cells, due to delayed release from bone marrow) (Macrocytes are often associated with Macrocyic Anaemia, too) - Target cells, - stomatocytes - hypersegmented neutrophils. Haemoglobin level in both cases are decreased, but MCV (Mean cell volume) is - down in iron deficiency anaemia and - up in Vitamin B12 deficiency (Macrocytic anaemia). - ferritin level is always low in iron deficiency anaemia.
Blood smear?
A blood smear is a laboratory test where a drop of blood is spread thinly on a glass slide and stained to allow for the visualization of blood cells under a microscope. It is used to assess the morphology of different types of blood cells, such as red blood cells, white blood cells, and platelets. Abnormalities in the appearance or distribution of these cells can provide valuable diagnostic information for various medical conditions.
