1. As states by Smith (2012), microcytic anemias are due to impaired hemoglobin production, either from ineffective heme or globin synthesis. The most common causes of decreased heme synthesis are iron deficiency (i.e., when iron loss exceeds intake) and chronic disorders (i.e., infectious, inflammatory or cancerous disorders that impair the utilization of iron). Regardless of the cause, the inhibition of heme synthesis results in erythrocytes that are smaller and contain a lower concentration of hemoglobin than the normal ones. Meanwhile, the impaired synthesis of globin leads to sideroblastic anemia (a condition in which the body has iron available but cannot incorporate it into hemoglobin) and a group of hereditary blood disorders named …show more content…
Microcytic anemias
Iron deficiency is the most common cause of microcytic anemia. The management of iron-deficiency consists in iron supplementation (oral or parenteral) based on age and serum iron values. The most common oral iron given is ferrous sulfate in doses from 200-325 mg, twice or three times a day. Usually a follow-up visit is necessary every 2 to 4 months. The patient should continue therapy for four to six months after hemoglobin has normalized.
Anemia of chronic disease is the second most common form of microcytic anemia and its treatment is directed at correcting its underlying cause. In mild forms treatment may not be necessary. However, in severe forms erythropoiesis-stimulating agents (i.e. Epogen, Procrit) or blood transfusion may be given. As a result, monthly follow-ups are required for the first 6 months after initiating therapy. Patients with anemia of chronic disease should be referred to specialists that treat the suspected underlying disease.
Treatments for thalassemias depend on the type and severity of the disease. In severe forms, the treatment of thalassemia includes iron chelation therapy, blood transfusions, and folic acid supplementation. In mild or asymptomatic forms, thalassemia needs no treatment. Mild cases can be managed by primary care providers and usually require a CBC every 3 to 4