Case Study: Iron-Deficiency Anemia

Anemia is a particular type of condition in which there are not a significant amount of healthy red blood cells that are able to adequately carry oxygen to the body tissue. Anemia comes in a variety of forms and types and each has a specific cause. The common cause of anemia is typically considered to be loss of blood. Anemia is characterized as being either acute or long term and can range in terms of mild to severe (Khurana, 2005). In examining the case of Ms. A, it appears that she has iron-deficiency anemia.

Iron deficiency anemia is considered to be one of the more frequent dietary deficiencies on a global scale. There is evidence to suggest that iron deficiency anemia causes exhaustion and other cognitive issues within both children and adults. The prevalence of this form of anemia within the United States tends to vary by age, race as well as sex. The metabolic process of iron is atypical in that it is managed through absorption rather than secretion (Killip et al., 2007). 

Women, who are menstruating, such as Ms. A with the problem of menorrhagia and dysmenorrheal, are prone to developing IDA. "Menstruating women lose from 0.6 to 2.5 percent [of their iron] or more per day. Iron deficiency results when iron demand by the body is not met by iron absorption from the diet" (Killip et al., 2007). Therefore, it can be reasoned that Ms. A's nutritional intake needs to be adjusted. She should not have to take aspirin to avoid joint stiffness that occurs when she's playing golf. 

In order to ensure that this is the type of anemia that Ms. A has, a "serum ferritin test [will be performed]. The definitive test for IDA is measur[ing the] serum ferritin. A low serum ferritin level is diagnostic of an iron depleted state. Contrary to current dogma that says the serum ferritin level may be elevated in the presence of [an] acute phase reaction, a diagnosis of IDA is extremely unlikely in the presence of normal or elevated serum ferritin levels" (Tefferi, 2003). While there are other ways of understanding whether Ms. A truly has iron deficiency anemia, that particular methodology is the most definitive.

There are many different types of treatments that Ms. A can consider if she does not want to alter her nutritional intake, even though that is a recommended practice. Killip et al. (2007) note that "blood transfusions should be considered for patients [who have] IDA if they are experiencing fatigue. [Additionally], liquid iron preparation may be a choice [in certain cases]" (pg.676). If Ms. A opts for liquid iron preparation rather than the tablet form (that is often the case with iron supplements), she may have to consider "laxatives, stool softeners and adequate intake of liquids [that] can alleviate the constipating effects of oral iron therapy" (Killip et al., 2007). Essentially, Ms. A will have to be informed of all of the options available to her and the potential side effects associated with treatment of her iron deficiency anemia.

Should Ms. A decide to change her diet, there are many foods that are rich in iron including red meat, egg yolks, artichokes, dried fruit such as prunes and raisins, dark greens such as collards and spinach, beans, and liver (Khurana, 2005; Killip et al., 2007). Most hospitals and medical facilities have a type of protocol that they follow after recommending treatment to patients.  While Ms. A is being treated for her iron deficiency anemia, there will need to be continual monitoring to ensure that whatever treatment is selected is working properly and eliminating the issues that she has been encountering for the last 10-12 years. While taking aspirin is recommended to avoid heart attacks, taking 1,000 mg of the drug every 3 to 4 hours for 6 days during her menstruation is a key problem that not only inclined a belief that she was iron deficient but that there was a definite issue that was in need of immediate addressing. There is hope that once Ms. A begins taking treatment to hopefully alleviate the symptoms of her iron deficiency anemia, that she will stop feeling lightheaded, and experiencing an elevated heart rate and respiratory rate and that her blood pressure will normalize.

References

Khurana, I. (2005). Textbook Of Medical Physiology. Elsevier India.

Killip, S., Bennett, J., & Chambers, M. D. (2007, March 1). Iron Deficiency Anemia.American Family Physician, 75(5), 671-678.

Tefferi, A. (2003). Anemia in Adults: A Contemporary Approach to Diagnosis. Mayo Clinic Proceedings, 78, 1274-1280.