Symptoms of iron deficiency anemia

Men suffer iron deficiency anemia worse than women; the elderly are heavier than the young.

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

There are two groups of symptoms of iron deficiency anemia.

[1], [2], [3], [4], [5], [6]

General anemic symptoms of iron deficiency anemia in children

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

Sideropenic symptoms of iron deficiency anemia in children

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

The clinical picture of iron deficiency anemia depends on the degree of iron deficiency and on the duration of its existence. With the increase in the degree of iron deficiency anemia, the asthenoneurotic syndrome increases: irritability, lethargy, apathy; in infants and young children there is a gradual lag in the psychomotor development, for 2-4 weeks or more, the development of speech lags behind. In older children - complaints of headaches and dizziness, memory impairment. Changes in the cardiovascular system are increasing: shortness of breath, muffling of heart sounds. ECG reveals signs of hypoxic, dystrophic changes in the myocardium. The limbs in the child are always cold. Most patients with moderate and severe anemia have an increase in liver and spleen, especially with concomitant deficiencies of protein, vitamins and infants - with active rickets. The secretion of gastric juice decreases, absorption of amino acids, vitamins, microelements is violated. Decreased immunity and nonspecific protective factors.

A vivid and memorable manifestation of sideropenia is the distortion of taste and smell. At the same time there is an attachment to eating chalk, clay, tooth powder, dry tea, coal, raw products - dough, groats, vermicelli, minced meat. There is an attraction to the smells of acetone, kerosene, gasoline, naphthalene, shoe cream, nail polish, exhaust gases. This group of disorders is denoted by a single term - pica chlorotica (from the Latin pica - forty - a bird that eats the ground). The nature of this pathological attraction to eating unusual products is not entirely clear, but it is assumed that it is based on tissue deficiency of iron in the cells of the central nervous system. It is known that this state is not a compensatory reaction, since the substances eaten are usually poor in iron and even violate its absorption.

Summarizing the information on the iron balance, it is necessary to emphasize the complexity of the regulation of its exchange, the influence of a multitude of factors at each stage of ferrokinetics.

With sideropenia, there is a lesion of the mucosa of the oral cavity and the gastrointestinal tract. In the origin of these trophic changes, tissue deficit of iron is important, leading to metabolic abnormalities in the cells. In iron deficiency anemia, angular stomatitis is noted in 14-20% of cases, glossitis in 23-39%; Less common is the syndrome of sideropenic dysphagia of Plummer-Vinson, manifested by difficulty in swallowing dense and dry food. In the stomach with iron deficiency anemia, acid formation is inhibited. Restructuring of the mucosa occurs in both the thin and the thick sections of the intestine.

There may be signs of vegetative-vascular dysfunction: unstable blood pressure with a tendency to hypotension, sweating, acrocyanosis, marbling. Occasional diffuse neurologic symptoms are detected.

Unmotivated subfebrile condition is possible.

Symptoms of iron deficiency anemia

Symptoms of anemia	Symptoms of sideropenia (deficiency of trace elements and vitamins)
Complaints weakness, lethargy, dizziness, decreased efficiency; decreased tolerance to physical activity; headaches, irritability, dyspnoea, syncope, tinnitus	Complaints weakness, dizziness; perversion of taste, smell, appetite (pica chlorotica); dysphagia, dyspepsia; disruption of the sphincter for coughing and laughing; drowsiness
Objectively pallor of the skin and mucous membranes; tachycardia, hypotension; expansion of the boundaries of the heart; muffling heart sounds; systolic murmur; "top" noise on the jugular veins	Objectively dry skin, angular stomatitis, cheilosis, "seizures" in the corners of the mouth; dryness, brittleness, hair loss; fragility, softness, thinning, longitudinal or transverse striation of the nails; often platonic and coilonichia; glossitis (bright red, shiny, edematous, painful tongue, atrophy of papillae); caries of teeth, their crumbling, abnormal growth, defects in enamel; atrophic esophagitis, atrophic gastritis, dysfunction of the gastrointestinal tract, propensity to constipation; atrophy of the genital mucosa; dysmenorrhea; subfebrile condition

When iron deficiency anemia, there are shifts in the hormonal status and in the immune system: firstly, the level of ACTH and TSH increases, which is apparently due to adaptive-adaptive response. With the increase in the terms of the disease, a functional insufficiency of the glucocorticoid function of the adrenal glands is formed. There is an increase in the level of IgM, changes in IgG and IgA appear to be compensatory. The early manifestation of iron deficiency is the insufficiency of cellular immunity, absolute lymphocytosis, the differentiation of lymphocyte populations is impaired.

Nonspecific resistance of the body with iron deficiency anemia is also undergoing changes. Note incomplete phagocytosis - the process of bacterial capture is normal, and intracellular digestion is disrupted in connection with a decrease in myeloperoxidase activity. The concentration of complement changes insignificantly. With iron deficiency anemia, microbicidal activity decreases with respect to peroxidase-positive microorganisms - staphylococci, Candida fungi. Infectious diseases against the background of iron deficiency anemia aggravate the course of sideropenia, as the growth and multiplication of microorganisms are carried out with iron consumption.

Summarizing the description of the clinical picture of iron deficiency anemia, two pathogenetic lines can be indicated:

1. insufficient supply of tissues with oxygen;
2. violation of the activity of tissue respiration enzymes, that is, the disruption of almost all cells of the body, which determines the variegation of clinical manifestations of iron deficiency anemia.