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What is Prussian blue reaction is used to demonstrate? and explain in detail?
Ans. a (Hemosiderin) (Ref. Harrison medicine 17th ed., Chapter 98 and Figure ell-37)Iron Stores# Prussian blue staining is done for marrow iron stores.- Iron stores can be graded on a scale of 0 to 4+.# A: a marrow with excess iron stores (>4+);# B: normal stores (2-3+);# C: minimal stores (1+); and# D: absent iron stores (0).# Intracellular ferritin is located in both the cytosol and lysosomes, in which partially degraded protein shells of ferritin aggregate into hemosiderin granules.# With a hematoxylin and eosin stain, hemosiderin appears in cells as golden yellow granules.# The iron in hemosiderin is chemically reactive and turns blue-black when exposed to potassium ferrocyanide, which is the basis for the Prussian blue stain.# In iron-overloaded cells, most iron is stored in hemosiderin.Also KnowIRON ABSORPTION# Iron absorption takes place largely in the proximal small intestine.# The function of ferroportin is negatively regulated by hepcidin, the principal iron regulatory hormone.# In the process of release, iron interacts with another ferroxidase, hephaestin, which oxidizes the iron to the ferric form for transferrin binding. Hephaestin is similar to ceruloplasmin, the copper-carrying protein.Sr. Ferritin# Very small amounts of ferritin normally circulate in the plasma.# Its levels correlate well with body iron stores.# During earliest iron deficiency period, iron stores--reflected by the serum ferritin level or the appearance of stainable iron on bone marrow aspirations--decrease.# As long as iron stores are present and can be mobilized, the serum iron, total iron-binding capacity (TIBC), and red cell protoporphyrin levels remain within normal limits. At this stage, red cell morphology and indices are normal.# Gradually, the TIBC increases, as do red cell protoporphyrin levels.# The serum ferritin level is the most convenient laboratory test to estimate iron stores.# By definition, marrow iron stores are absent when the serum ferritin level is <15 pg/L.DIAGNOSIS OF MICROCYTIC ANEMIATestsIron deficiencyInflammationThalassemiaSideroblasticSmearMicro/hypoNormal micro/ hypoMicro/hypo with targetingVariableSI<30<50Normal to highNormal to highTIBC>360<300NormalNormalPercent saturation<1010-2030-8030-80Ferritin (pg/L)<1530-20050-30050-300Hemoglobin patternNormalNormalAbnormalNormalDIAGNOSIS OF HYPOPROLIFERATIVE ANEMIASTestsIron DeficiencyInflammationRenal DiseaseHypometabolicAnemiaMild to severeMildMild to severeMildMCV (ft)60-9080-909090MorphologyNormo-microcyticNormocyticNormocyticNormocyticSI<30<50NormalNormalTIBC>360<300NormalNormalSaturation (%)<1010-20NormalNormalSerum ferritin (mg/L)<1530-200115-150NormalIron stores02-4+1-4+Normal