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안기완,홍승만,전의섭 조선대학교 1994 The Medical Journal of Chosun University Vol.19 No.2
Iron deficiency is a common one of nutritional deficiency, which denotes a deficit in total body iron. resulting from iron requirements that exceed iron supply. It remains the most common cause of anemia, both in the Korea and world wide. The development of iron deficiency progresses in stage. storage iron depletion occurs first. at this stage, a bone marrow aspirate staine with Prussan blue shows marked reduced or absent deposits of iron in macrophages and accompained by a decreased in the level of serum ferritin. in the next stage, the iron binding capacity of the serum rises, followed by a drop in serum iron. the final stage is the development of microcytic and hypochromic in circulating red cells. Bone marrow examinations is not essential diagnostic modality of iron deficiency anemia (IDA), but is necessary for early definitive diagnosis of IDA. So, We studied 65 cases of IDA patients who were performed bone marrow aspiration and biopsy. and 60 cases of normal healthy control from January 1990 to necember 1993 in Cho-sun University. The results of the analysis were as follows : 1) The total number of 65 patients were 26 males and 39 females. The peak incidence was at ages of 21-30 years and mean ages was 34.8 years. 2) Gastrointestinal bleeding was the most common cause of IDA (gastric ulcer 23.1%, duodenal ulcer 9.2%, gastric cancer 9.2% and hemorrhagic gastritis 4.2 %). 3) Most patients showed medical attention because of general (61.5%), gastrointestinal (58.5%) or cardio-pulmonary (36.9%)symptoms. 4) The mean hemoglobin level was 7.71± 0.83 g/dl, Mean corpuscular volume(MCV) 71.63± 4.56 fL, Red cell volume distribution width(RDW) 17.23±0.72 %, corrected reticulocyte 1.49±0.45%, serum iron 35.07±25.45 ug/dl, TIBC 352.44±43.99 ug/dl and serum ferritin 8.93±8.42 ng/ml. The peripheral red cell morphology was mainly microcyhz and hypochromic ficture(89.2% and 87.7%). Bone marrow iron stians showed that the suitable iron was absent, grade 0 in 92.3% and grade 1 in 7.7% 5) All cases were treated with iron preparation and 26.2% with blood transfusion(from 1 unit to 15 units). 69.2% showed complete recovery with therapeutic maneuvers and 30.1% relapse or no reponse which was probably stemmed from uncorretability(9.2%), uncooperability (9.2%), side effect(3.1%) and replapse of underlying diseases(6.2%). IDA is not definitive diagnosis, but one of the clinical sign of etiologic diseases. So, for the definintive treatment. it is important that the etiologic diseases were corrected.
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