The causes of an increase and decrease in iron in the blood

In some pathological conditions and diseases, the iron content in the blood serum changes.

The most important diseases, syndromes, signs of deficiency and excess of iron in the human body

Diseases, syndromes and signs of iron deficiency

Diseases, syndromes and signs of iron excess

Hypochromic anemia Myoglobin deficiency myocardiopathy Atrophic rhinitis Atrophic glossitis Dysgeusia and anorexia Gingivitis and cheilitis Hereditary and congenital sideropenic atrophy of the nasal mucosa, fetid rhinitis (ozena) Iron deficiency esophagopathy (dysphagia in 5-20%) Plummer-Vinson syndrome (4-16% of cases precancer and cancer of the esophagus) Atrophic gastritis Myoglobin deficiency atony of skeletal muscles Koilonychia and other trophic changes in nails

Hereditary hemochromatosis Myocardiopathy with endocardial hyperelastosis (cardiac siderosis) Hepatosis with pigment cirrhosis Siderosis and fibrosis of the pancreas Bronze diabetes Splenomegaly Hypogenitalism Secondary siderosis in thalassemia and other diseases Occupational siderosis of the lungs and siderosis of the eye Iatrogenic transfusion siderosis Allergic purpura Localized lipomyoedema at the site of intramuscular injections of iron preparations

Iron deficiency states (hyposiderosis, iron deficiency anemia) are one of the most common human diseases. The forms of their clinical manifestations are diverse and range from latent states to severe progressive diseases that can lead to typical organ and tissue damage and even death. It is currently generally accepted that the diagnosis of iron deficiency states should be made before the development of the full picture of the disease, that is, before the onset of hypochromic anemia. With iron deficiency, the entire body suffers, and hypochromic anemia is a late stage of the disease.

Modern methods of early diagnosis of hyposiderosis include determination of serum iron concentration, total iron-binding capacity of serum (TIBC), transferrin and ferritin in serum.

Iron metabolism indicators in various types of anemia

Iron metabolism indices	Reference value	Iron deficiency anemia	Infectious tumor anemia	Heme globin synthesis disorder
Serum iron, mcg/dL
men	65-175	<50	<50	>180
women	50-170	<40	<40	>170
TIBC, mcg/dl	250-425	>400	180	200
Saturation coefficient, %	15-54	<15	<15	>60
Ferritin, mcg/l	20-250	<10-12	>150	160-1000

Excessive iron content in the body is called "siderosis" or "hypersiderosis", "hemosiderosis". It can be local and generalized. A distinction is made between exogenous and endogenous siderosis. Exogenous siderosis is often observed in miners involved in the development of red iron ores, in electric welders. Miners' siderosis can be expressed in massive iron deposits in the lung tissue. Local siderosis develops when iron fragments enter the tissue. In particular, siderosis of the eyeball with the deposition of iron oxide hydrate in the ciliary body, epithelium of the anterior chamber, lens, retina and optic nerve has been identified.

Endogenous siderosis is most often of hemoglobin origin and occurs as a result of increased destruction of this blood pigment in the body.

Hemosiderin is an aggregate of iron hydroxide combined with proteins, glycosaminoglycans and lipids. Hemosiderin is formed inside cells of mesenchymal and epithelial nature. Focal deposition of hemosiderin is usually observed at the site of hemorrhages. Hemosiderosis should be distinguished from tissue "ironization", which occurs when some structures (for example, elastic fibers) and cells (for example, neurons of the brain) are impregnated with colloidal iron (in Pick's disease, some hyperkinesis, brown induration of the lungs). A special form of hereditary hemosiderin deposits, arising from ferritin as a result of a disorder of cellular metabolism, is hemochromatosis. In this disease, especially large iron deposits are observed in the liver, pancreas, kidneys, in the cells of the mononuclear phagocyte system, mucous glands of the trachea, in the thyroid gland, epithelium of the tongue and muscles. The most well-known is primary, or idiopathic, hemochromatosis - a hereditary disease characterized by a disturbance in the metabolism of iron-containing pigments, increased absorption of iron in the intestines and its accumulation in tissues and organs with the development of pronounced changes in them.

If there is an excess of iron in the body, a deficiency of copper and zinc may develop.

Determination of serum iron provides an idea of the amount of iron transported in the blood plasma, associated with transferrin. Large variations in the iron content in the blood serum, the possibility of its increase in necrotic processes in tissues and a decrease in inflammatory processes limit the diagnostic value of this study. Determining only the iron content in the blood serum does not provide information on the causes of impaired iron metabolism. For this, it is necessary to determine the concentration of transferrin and ferritin in the blood.