SPOTTERS MEDICINE
ANEMIA WITH KOILONYCHIA
🔹 Definition:
Anemia is a condition where there is a decrease in hemoglobin concentration, red blood cells, or hematocrit, impairing oxygen delivery.
Koilonychia is a nail abnormality where the nails become thin, brittle, and spoon-shaped (concave), typically associated with iron deficiency.
🔹 Common Causes of Anemia:
- Nutritional deficiencies – Iron, folate, vitamin B12
- Chronic blood loss – GI ulcers, menstruation
- Chronic diseases – TB, CKD, cancer
- Bone marrow suppression – Aplastic anemia, drugs
- Hemolytic anemias – Hereditary or acquired
🔹 Iron Deficiency Anemia and Koilonychia:
- Iron deficiency is the most common cause of anemia worldwide
- Chronic iron depletion → affects keratin formation in nails
- Leads to Koilonychia (especially in long-standing cases)
🔹 Causes of Iron Deficiency:
- Inadequate dietary intake (e.g., vegetarians, poor socioeconomic groups)
- Malabsorption (e.g., celiac disease)
- Chronic blood loss (e.g., menorrhagia, hookworm infestation)
- Increased demand (e.g., pregnancy, adolescence)
🔹 Clinical Features of Anemia:
- Fatigue, pallor
- Weakness, dizziness
- Palpitations
- Breathlessness on exertion
- Koilonychia, glossitis, angular cheilitis (in IDA)
🔹 Appearance of Koilonychia:
- Spoon-shaped nails – thin, soft, and concave
- Common in fingernails
- May be associated with brittle or ridged nails
🔹 Diagnosis:
- CBC – low Hb, low MCV (microcytic), low MCH
- Peripheral smear – microcytic hypochromic RBCs
- Serum ferritin – low
- TIBC – increased
- Stool test – occult blood, ova for hookworm
🔹 Treatment:
- Iron supplementation (oral ferrous sulfate 3–6 mg/kg/day)
- Parenteral iron (if severe or malabsorption)
- Treat underlying cause (e.g., deworming, diet correction)
- Nutritional counseling
🔹 Prognosis:
- Excellent with iron therapy and correction of cause
- Koilonychia may reverse in 3–6 months with treatment
PROFESSOR OF MEDICINE
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