Post – Mathew

Respond on two different days who selected different types of anemia than you, in the following ways:

Share insights on how the anemia you selected is similar to or different from the one your colleague selected.

Discuss how genetic, gender, ethnic, age, and behavioral factors impact the diagnosis and prescription of treatment for anemic patients.

                                                                 Main Post

                                                 Iron Deficiency Anemia

            Iron deficiency anemia (IDA) can come from two etiologies or a combination of the two: inadequate dairy intake or chronic blood loss. In both, there is no intrinsic factor in the metabolism of iron and both possible causes deplete the iron stores and decrease the hemoglobin production. In the form of hemoglobin, iron is in constant demand by the body. Blood loss can interrupt this constant demand and causes a depletion of stores even faster than usual (Huether & McCance, 2017, p. 517). 

            “Iron is an element that is usually recycled from aged erythrocytes by macrophage phagocytosis and lysis. Hepcidin is a 25-amino acid peptide that is produced by the liver that bind to ferroportin, a transmembrane protein, inducing its internalization and lysosomal degradation. When iron stores are low, hepcidin production is reduced and ferroportin molecules are expressed on the basolateral membrane of enterocytes, when they transfer iron from the cytoplasm of enterocytes to plasma transferrin” (Hammer & McPhee, 2019, p. 153). 

Pernicious Anemia

            “Pernicious Anemia (PA) is the most common type of macrocytic anemia and is caused by a vitamin B-12 deficiency” (Huether & McCance, 2017, p. 515). The absence of intrinsic factor (IF) is the underlying alteration in PA and this is a required transporter for gastric absorption of dietary vitamin B12. Most of these cases result from a type of autoimmune gastritis which causes atrophy from the destruction of parietal and zymogenic cells. Often, there are antibodies that are against the gastric H+-K+ ATPase, and this is a major protein constituent of parietal cell membranes. Also, autoantibodies that are against IF prevent the formation of the B12-IF complex and this causes PA to be secondary to autoimmune destruction of parietal cells (p. 515). 

Comparison

            IDA is the most common type of anemia in the world and usually is from inadequate dairy intake or chronic blood loss (Huether & McCance, 2017, p. 517). Usually, there is no intrinsic dysfunction but both causes potentially destroy iron stores and reduce hemoglobin synthesis (p. 517). 

            PA is the most common type of macrocytic anemia and is caused by a vitamin B12 deficiency (Huether & McCance, 2017, p. 515). This type of anemia is because of the absence of intrinsic factor (IF) (p. 515).

Gender and Iron Deficiency Anemia

            Gender plays a fairly large role in Iron Deficiency Anemia with women of childbearing age being the main victims. The risk of IDA in women of childbearing age is the highest during reproductive years and decreases during menopause. For men, which is does affect, the highest period of time for IDA is during childhood and adolescence (Huether & McCance, 2017, p. 517). In a study by Malik, et al, (2016), “it was found that 39.1% of pregnant women were actually anemic”. One more fact in support of women being more prone to anemia. 

Genetics and Pernicious Anemia

            Genetics actually plays a fairly large role in the Pernicious Anemia as “deficiency of intrinsic factor (IF) may be congenital. In cases like this, it is a genetic disorder with an autosomal recessive inheritance pattern. There has been identification of family cluster and 20-30% of individuals related to someone with PA have it themselves. Usually, it is first-degree female relatives (Huether & McCance, 2017, p. 515). 

 

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