Which of the following statements about
iron deficiency anemia is correct
a) Decreased TIBC
b) Increased ferritin levels
c) Bone marrow iron is decreased after serum iron is decreased
d) Bone marrow iron is decreased earlier than serum iron
Correct Answer - D
Ans. is ‘D’ i.e., Bone marrow iron is decreased earlier than serum
iron
"In iron deficiency anemia the first change is decrease in iron stores
"
The decrease in iron stores is demonstrated by decreased serum
ferritin level.
Remember,
Serum ferritin reflects the amount of storage iron in the body.
As the total body iron level begins to fall a characteristic,
sequence of events ensue :
First Stage or Prelatent Stage of Iron Depletion
When iron loss exceeds absorption, a negative iron balance exists.
Stored iron begins to be, mobilized from stores. The iron present in
the macrophages of liver, spleen and bone marrow are depleted
Decrease in stored iron is reflected by decrease in serum ferritin.
At this stage all other parameters of iron status are normal.
Second Stage or Stage of Latent Iron Deficiency :
Iron stores are exhausted but the blood hemoglobin level remains
higher than the lower limit of normal. o After the exhaustion of iron
stores :
The plasma iron concentration fallsQ.
Plasma iron binding capacity increases2.
Percentage saturation falls below 15%Q.
The percentage of sideroblast decreases in the bone marrowQ.
Third Stage or Stage of Apparent Iron Deficiency Anemia
Supply of iron to marrow becomes inadequate for normal
hemoglobin production,
So the blood hemoglobin concentration fallsQ below the lower limit of
normal and iron deficiency anemia is apparent.