Iron deficiency and hemolytic anemia

[addy]

Hey guys,

Pathoma says, on page 51, that "Iron deficiency anemia occurs with chronic hemolysis" in the setting of microangiopathic hemolytic anemia...can someone explain why? In my mind, if heme breaks down to Fe in the blood, won't duodenal cells pick it up and store it inside or have transferritin pick it up?

He didn't seem to mention it in his video, unless I completely missed it.

Thanks!

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[sanj238]

Hey guys,

In my mind, if heme breaks down to Fe in the blood, won't duodenal cells pick it up and store it inside
Thanks!

I wan't to be snarky and mean. But that would be wrong. Also, I could be missing something. But can you explain how iron in blood is picked up by duodenal cells?

Also, once heme is broken down it is excreted via the urine and feces as bilirubin. The anemia that he is referring to is via the decrease in RBCs since the body cannot keep up with the breakdown of RBC. RBC breakdown > formation = anemia. Remember, RBC is not only about iron. other components sufch as porphorin and whatever make up red blood cells- these will decline.

There is no known mechanism for a major iron excretion. Most of iron regulation is via controlled absorption of iron when needed.

 

[addy]

I wan't to be snarky and mean. But that would be wrong. Also, I could be missing something. But can you explain how iron in blood is picked up by duodenal cells?
/quote]

Sorry, that was stupid on my end. I was thinking transferritin picking it up and taking it to bone marrow/liver/spleen, not duodenum