NPunto

23

Authors: Delgado Macías, S., Montenegro Martínez, J., Pérez Pujalte, S

Anemia is considered the most common cause of medical consultation and hematological disease of higher prevalence in the world population. It is therefore important to make a first differential diagnosis in the patient with anemia, to facilitate the approach of the pathology. It is defined as the decrease in erythrocyte mass and/or hemoglobin concentration. It has a very varied etiology and for its diagnosis it is necessary the combination of several hematological tests, a good anamnesis and in some cases genetic studies at the family level. A key test to detect the first signs of anemia is the blood count, included in routine tests that are generally performed at medical checkups. Another important point for its early detection is the appearance of symptoms, due to the compensatory mechanisms of the body before tissue hypoxia. Once detected, a more comprehensive and differential study is carried out to determine the cause. Due to the importance of this disease globally, the standardization of critical values differentiated by age, race and sex is essential. Updating and automation of the techniques used to provide a rapid diagnosis and facilitate the establishment of a treatment or procedure with the aim of improving the life of patients suffering from it.

33

Authors: Peláez Herrero, N

Iron deficiency anemia is a very common disorder in the world characterized by a deficiency in iron levels that trigger poor production in the red blood cell count. It is mainly caused by increased iron requirements, malabsorption, blood loss and shortage of iron in the diet. In underdeveloped and developing countries, the main cause that triggers anemia is the deficient diet to which this population is subjected, since these are diets poor in micronutrients essential for the proper functioning of the body. However, in rich countries the causes of anemia are totally different, usually due to bleeding or blood loss such as menstruation. Currently, anemia is a public health problem, affecting 40% of children worldwide and over 50% in the case of pregnant women. This review aims to provide an overview of anaemia, especially iron deficiency, and the role of iron in it, highlighting three specific situations: pregnancy, childhood and inflammatory bowel disease (IBD), which are particularly vulnerable due to the aforementioned causes. Likewise, it will be discussed about the different iron preparations that have been used so far and those developed recently, comparing those administered orally with those administered intravenously. Clearly highlighting its main advantages, but, at the same time, highlighting its adverse effects, which in many cases cause the abandonment of treatment. The treatment of choice or first line of iron deficiency anemia will be performed with ferrous sulfate, since it is cheap, has good absorption and replenishes iron levels in the patient quite well, increasing the values of hemoglobin, ferritin and iron saturation, but it has low tolerability with numerous gastrointestinal side effects. If it is not tolerated by the patient, it will be replaced by another preparation. The use of oral or intravenous preparations will depend on the severity of anemia, as well as the need we have to replace normal physiological levels very quickly. Those intended for the oral route have the advantage of being easy to administer and more economical, but have a low gastrointestinal tolerance and low therapeutic compliance. In addition, they do not require any hospital environment for their administration, but can be administered in the patient´s own home. Intravenous compounds, despite requiring a hospital environment and therefore being less accepted by the population, offer a rapid replenishment of iron stores and greater safety, and, of course, do not present side effects at the gastrointestinal level. Finally, it will be assessed which of these treatments will be more appropriate to use depending on the particularity of each individual and their natural iron reverses that the patient possesses at that time. In those suffering from inflammatory bowel disease (IBD), the administration of intravenous iron will be more beneficial in order not to worsen the signs and symptoms of the pathology. In children, to achieve greater acceptance, oral iron therapy will be more convenient and, in pregnant women, intravenous iron treatment seems to be better, but this should be studied carefully by both the patient and the physician. The oral iron preparations that we are going to analyze mainly are: Lactoferrin, ferric maltol and ferrous ascorbate, as oral iron preparations. As intravenous iron preparations we will have low molecular weight iron dextran, sucrose iron and ferric carboxymaltose. In summary, we can conclude by saying that today there is a great variability of pharmaceutical preparations to combat anemic processes and reduce undesirable gastrointestinal side effects.