Symptoms of iron deficiency anemia

Men tolerate iron deficiency anemia worse than women; older people are more severely affected than younger people.

The most vulnerable tissues in iron deficiency anemia are those with epithelial cover as a constantly renewing system. There is a decrease in the activity of digestive glands, gastric, pancreatic enzymes. This explains the presence of leading subjective manifestations of iron deficiency in the form of decreased and perverted appetite, the appearance of trophic disorders, the appearance of dysphagia (difficulty in swallowing dense food), a feeling of a food lump getting stuck in the throat.

There are two groups of symptoms of iron deficiency anemia.

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General anemic symptoms of iron deficiency anemia in children

• pallor of the skin and mucous membranes;
• weakness;
• lethargy;
• dizziness;
• fainting;
• paresthesia;
• dilation of the heart borders, muffled tones, systolic murmur at the apex;
• dyspnea.

Sideropenic symptoms of iron deficiency anemia in children

• complaints of hair loss;
• dull, dry hair, brittle hair;
• eyebrow loss;
• increased fragility of nails, transverse striations;
• increased tooth decay - asymptomatic caries;
• dry skin with the formation of cracks in the feet area;
• difficulty swallowing dry and solid foods;
• cracks in the corners of the mouth (angular stomatitis);
• atrophy of the tongue papillae - atrophic glossitis.

The clinical picture of iron deficiency anemia depends on the degree of iron deficiency and the duration of its existence. As the degree of iron deficiency anemia increases, the asthenoneurotic syndrome intensifies: irritability, lethargy, apathy; in infants and young children, there is a gradual lag in psychomotor development, speech development lags behind by 2-4 weeks or more. Older children complain of headaches and dizziness, memory impairment. Changes in the cardiovascular system intensify: shortness of breath, muffled heart sounds. The ECG reveals signs of hypoxic, dystrophic changes in the myocardium. The child's extremities are constantly cold. Most patients with moderate to severe anemia have an increase in the size of the liver and spleen, especially with concomitant deficiencies of protein, vitamins and, in infants, with active rickets. Secretion of gastric juice decreases, absorption of amino acids, vitamins, and microelements is disrupted. Decreased immunity and non-specific protective factors.

A vivid and memorable manifestation of sideropenia is a perversion of taste and smell. In this case, there is a passion for eating chalk, clay, tooth powder, dry tea, coal, raw foods - dough, cereals, vermicelli, minced meat. There is an attraction to the smells of acetone, kerosene, gasoline, naphthalene, shoe polish, nail polish, exhaust gases. This group of disorders is designated by a single term - pica chlorotica (from the Latin pica - magpie - a bird that eats earth). The nature of such a pathological attraction to eating unusual products is not entirely clear, but it is assumed that it is based on tissue iron deficiency in the cells of the central nervous system. It is known that this condition is not a compensatory reaction, since the substances eaten are usually poor in iron and even disrupt its absorption.

Summarizing the information about iron balance, it is necessary to emphasize the complexity of the regulation of its metabolism, the influence of many factors at each stage of ferrokinetics.

Sideropenia is characterized by damage to the oral mucosa and gastrointestinal tract. Tissue iron deficiency is important in the origin of these trophic changes, leading to metabolic disorders in cells. With iron deficiency anemia, angular stomatitis is observed in 14-20% of cases, glossitis - in 23-39%; less common is Plummer-Vinson sideropenic dysphagia syndrome, which manifests itself as difficulty in swallowing dense and dry food. In the stomach, acid formation is suppressed with iron deficiency anemia. Restructuring of the mucous membrane occurs in both the small and large intestines.

There may be signs of vegetative-vascular dysfunction: unstable arterial pressure with a tendency to hypotension, sweating, acrocyanosis, mottling. Sometimes, diffuse neurological symptoms are detected.

Unmotivated subfebrile temperature is possible.

Symptoms of Iron Deficiency Anemia

Symptoms of anemia	Symptoms of sideropenia (deficiency of trace elements and vitamins)
Complaints weakness, lethargy, dizziness, decreased performance; decreased tolerance to physical activity; headaches, irritability, shortness of breath, fainting, tinnitus	Complaints weakness, dizziness; perversion of taste, smell, appetite (pica chlorotica); dysphagia, dyspepsia; disruption of the sphincters when coughing, laughing; drowsiness
Objectively paleness of the skin and mucous membranes; tachycardia, hypotension; expansion of the borders of the heart; muffled heart sounds; systolic murmur; jugular vein "top" sound	Objectively dry skin, angular stomatitis, cheilosis, cracks in the corners of the mouth; dryness, fragility, hair loss; fragility, softness, thinning, longitudinal or transverse striations of nails; often platonychia and koilonychia; glossitis (bright red, shiny, swollen, painful tongue, papillary atrophy); dental caries, tooth crumbling, abnormal growth, enamel defects; atrophic esophagitis, atrophic gastritis, gastrointestinal dysfunction, tendency to constipation; atrophy of the genital mucosa; dysmenorrhea; subfebrile temperature

Iron deficiency anemia causes changes in the hormonal status and the immune system: initially, the level of ACTH and TSH increases, which is apparently due to an adaptive response. As the disease progresses, functional insufficiency of the glucocorticoid function of the adrenal glands develops. An increase in the level of IgM is noted, changes in IgG and IgA are apparently compensatory in nature. An early manifestation of iron deficiency is insufficiency of cellular immunity, absolute lymphocytosis, and differentiation of lymphocyte populations is disrupted.

Non-specific resistance of the organism also undergoes changes in iron deficiency anemia. Incomplete phagocytosis is noted - the process of bacterial capture proceeds normally, and intracellular digestion is impaired due to a decrease in myeloperoxidase activity. The concentration of complement changes insignificantly. In iron deficiency anemia, microbicidal activity towards peroxidase-positive microorganisms - staphylococci, Candida fungi - decreases. Infectious diseases against the background of iron deficiency anemia aggravate the course of sideropenia, since the growth and reproduction of microorganisms are carried out with the consumption of iron.

To summarize the description of the clinical picture of iron deficiency anemia, two pathogenetic lines can be identified:

1. insufficient supply of oxygen to tissues;
2. disruption of the activity of tissue respiration enzymes, that is, disruption of the functioning of almost all cells of the body, which causes the diversity of clinical manifestations of iron deficiency anemia.