Specific Anemia Syndromes and Their Management

Abstract

Iron deficiency is the most common cause of anemia in the world. Therefore, it is appropriate to be familiar with some basic concepts of iron metabolism. The normal total amount of body iron is approximately 3 g in a woman and 4 g in a man. Approximately 2.5 g of the irons is in the form of hemoglobin, and the rest is stored in the form of ferritin and hemosiderin. A small amount is found in myoglobin and tissue heme enzymes (peroxidase, catalase, cytochromes). The iron cycle refers to the exchange of iron between the red cells and the storage iron. Stored iron is mostly in the monocyte-macrophage system of the liver, spleen, and bone marrow. There, it combines with the iron storage protein apoferritin and forms ferritin. The ferritin molecule is well structured and soluble and thus can circulate in the peripheral blood in amounts proportional to tissue iron stores. Hemosiderin is an insoluble forms of storage iron that is made up of breakdown products of ferritin. The iron in both ferritin and hemosiderin in available for use in time of need.