Question

• Review Chapter 21 in the Huether and McCance text. Reflect on the pathophysiological mechanisms of iron deficiency anemia.
• Select one of the following types of anemia: pernicious anemia, folate deficiency anemia, sideroblastic anemia, chronic inflammation anemia, or post-hemorrhagic anemia. Identify the pathophysiological mechanisms of the anemia you selected.
• Consider the similarities and differences between iron deficiency anemia and the type of anemia you selected.
• Reflect on how patient factors such as genetics, gender, ethnicity, age, and behavior might impact these anemic disorders.

Answer 1

Pernicious anemia:

Pernicious anemia is due to a deficiency of vitamin B12. The bone marrow produces immature red blood cells which result in poor absorption of Vitamin B12.

Pathophysiological mechanism:

• The parietal cells in the stomach produce intrinsic factor which is responsible for the absorption of Vitamin B12 in the intestine. Intrinsic factor forms a dietary vitamin and transports to the ileum where the absorption of vitamin B12 takes place. When there is a lack of intrinsic factor, the binding of Vitamin B12 is inhibited results in poor absorption of vitamin B12 and results in pernicious anemia.
• It also occurs due to autoimmune disorder whereby the immune system produces antibodies against the intrinsic factor and parietal cells.
• Inadequate amount of vitamin B12 affects the DNA results in immature red cell production. In addition deficiency of cobalamin interfere with the absorption of vitamin B12 results in macrocytic anemia.

Similarities and Differences between the iron deficiency anemia and the pernicious anemia:

Iron deficiency anemia	Pernicious anemia
It is due to lack of oxygen in the red blood cells	It is due to lack of absorption of the vitamin in the intestine.
inadequate dietary intake, blood loss, diminished hemoglobin are the causative factors	Lack of intrinsic factor, intestinal problems are the causative factors.
Treated with iron supplements	Treated with folic acid supplements and vitamin B12.

Patient factors:

Genetic factor:

Anemia that developed due to genetic disorders is less compared to deficiency factors.

Gender:

Comparing to men, women are most probable for anemia. Iron deficiency anemia is more commonly seen in women.

Ethnicity:

Hispanic women and African-American are more probably getting anemia. sickle cell anemia, thalassemia are getting through family genetics.

Age:

Children below 3 years, older adults, premenopausal women, pregnant women are more risk for anemic disorders.