Anemia feripriva

Cauze :
Diagnostic (clinic)
 Diagnostic
(paraclinic)

• Anemie hipocroma
microcitara = Hb ↓ +
VEM ↓ + CHEM ↓ +
trombocitoza (care se
normalizeaza dupa
tratament)
• Hiposideremie +
Feritina < 16ug/dl
• CTLF (transferina) ↑ +
saturatia transferinei ↓
 Tratament
• 1) Suplimentare de Fe din dieta (3-5mg/zi se absoarbe in
mod obisnuit)
• 2)Suplimente orale cu Fe (CI : IBD in stadiul activ,
intoleranta la preparate orale, administrare concomitenta
de agenti de stimulare de eritropoieza)
Tips : -inceperea cu doze mici,
crescute progresiv
-monitorizare HG lunar (daca Hb
se normalizeaza, continuare
tratament oral inca 3 luni)
-administrare concomitenta de
vit C
• 3) Preparate intravenoase de Fe
-de prima linie daca pacientul va urma o interventie
chirurgicala in maxim 6 sapt de la diagnostic, femeile
gravide cu anemie severa, pacienti cu rezectii intestinale
care fac dificila absorbtia Fe)
• A. Ferric carboxymaltose (Ferinject®).

• B. Iron isomaltoside 1000, 10% (Monofer®).

• C. Low molecular weight iron (111) dextran (CosmoFer®)
-doza obisnuita este de 100-200mg Fe (2-4ml solutie) de
2-3 ori/sapt in functie de nivelul Hb
-se adauga doza in ml de CosmoFer la 500ml sol NaCl
0,9% sau Glucoza 5%.
• D. Iron sucrose (Venofer®)

• E. Iron isomaltoside 1000, 5% (Diafer®)

-folosit doar la pacientii cu BCR aflati pe dializa
 • 4) Transfuzia de ME (450-500ml)

Transfuzia de masa eritrocitara nu este

indicata de rutina in anemii tratabile dpdv
farmacologic (ex : anemia feripriva,
anemia megaloblastica)!!!

De obicei, dupa transfuzia unei singure

unitati de ME, Hb va creste cu aprox 1g/dl
(cu o crestere a hematocritului de aprox
3%)
 Bibliografie

1) https://emedicine.medscape.com/article/202333-treatment

2) http://www.cmaj.ca/content/189/10/E409

3) https://b-s
h.org.uk/media/2891/uk_guidelines_iron_deficiency_in_pregnancy.pdf

4) https
://www.bsg.org.uk/resource/guidelines-for-the-management-of-iron-deficiency-an
aemia.html

5) https
://www.ashclinicalnews.org/news/aabb-releases-clinical-practice-guidelines-red-b