A 25 year old man who is an alcoholic,presents with easy fatiguability and moderate pallor for the past six months. His Hb is 5. 2G% and serum iron level is 190 microgram per dl. The treatment of choice for him would be –
**Core Concept**
The patient is presenting with symptoms of iron deficiency anemia (IDA) due to chronic alcoholism, characterized by easy fatiguability, moderate pallor, low hemoglobin (Hb) levels, and elevated serum iron levels.
**Why the Correct Answer is Right**
The elevated serum iron level in the setting of IDA is due to the lack of transferrin, a protein that binds and transports iron in the blood. Without sufficient transferrin, iron remains in its free form, leading to elevated serum iron levels. The patient's iron deficiency is likely due to chronic alcoholism, which impairs the absorption of iron from the gastrointestinal tract and increases the urinary excretion of iron. The treatment of choice in this case is parenteral iron therapy, specifically iron dextran or iron sucrose, to bypass the gastrointestinal tract and directly replenish the body's iron stores.
**Why Each Wrong Option is Incorrect**
**Option A:** Oral iron supplements would be ineffective in this patient due to impaired iron absorption in the gastrointestinal tract, which is a result of chronic alcoholism.
**Option B:** Blood transfusions may be necessary in severe cases of IDA, but they do not address the underlying issue of iron deficiency and may lead to complications such as iron overload.
**Option C:** Folic acid supplementation is not the primary treatment for IDA, although it may be necessary in cases where the patient has a deficiency in this vitamin as well.
**Clinical Pearl / High-Yield Fact**
In patients with chronic alcoholism, iron deficiency anemia is often due to impaired iron absorption and increased urinary excretion of iron, rather than blood loss or other causes.
**Correct Answer:** C.