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Anemia ferropénica : abordagens terapêuticas convencionais e inovadoras
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A anemia ferropénica é a forma mais comum de anemia e constitui um dos principais problemas de saúde pública a nível mundial, afetando especialmente crianças, mulheres em idade fértil, grávidas, idosos e pessoas com doenças crónicas. Caracteriza-se pela redução da concentração de hemoglobina e pela presença de eritrócitos microcíticos e hipocrómicos, resultando de uma deficiência de ferro, elemento essencial para a síntese da hemoglobina, comprometendo assim o transporte de oxigénio, com consequências relevantes para o organismo. A sua etiologia é multifatorial, incluindo perdas sanguíneas crónicas, ingestão inadequada de ferro, má absorção intestinal e aumento das necessidades fisiológicas. A anemia ferropénica pode desenvolver-se progressivamente a partir de um estado de ferropénia isolada, o que torna o diagnóstico precoce essencial para prevenir complicações clínicas. O diagnóstico baseia-se na integração de dados clínicos e parâmetros laboratoriais, como a ferritina sérica, a saturação da transferrina e os índices eritrocitários. Em casos mais complexos, sobretudo em contextos inflamatórios, biomarcadores emergentes como a hepcidina, o recetor solúvel da transferrina e o conteúdo de hemoglobina nos reticulócitos oferecem maior precisão diagnóstica. O tratamento da anemia ferropénica inclui abordagens convencionais, como a suplementação oral e intravenosa de ferro, bem como transfusões sanguíneas em situações graves. Contudo, limitações relacionadas com a eficácia, adesão à terapêutica e efeitos adversos têm incentivado o desenvolvimento de abordagens terapêuticas inovadoras. Estas incluem a modulação da hepcidina e das vias que regulam o metabolismo do ferro, inibidores da prolil-hidroxilase, regulação epigenética, uso de probióticos, lactoferrina e suplementos com ferro microencapsulado. A investigação nestas áreas tem mostrado resultados promissores, sobretudo em doentes com patologias crónicas ou intolerância ao ferro convencional. Esta monografia apresenta uma revisão abrangente da anemia ferropénica, abordando os aspetos fisiopatológicos, epidemiológicos, diagnósticos e terapêuticos. O objetivo é contribuir para uma maior compreensão desta condição e destacar a importância de estratégias diagnósticas e terapêuticas individualizadas, baseadas na evidência científica mais atual, com vista à melhoria da qualidade de vida dos doentes. Adicionalmente, são exploradas estratégias de prevenção e intervenção populacional, com destaque para a fortificação alimentar, a suplementação dirigida e o papel dos farmacêuticos na promoção da saúde.
Iron deficiency anemia is the most common type of anemia and represents one of the main public health problems worldwide, especially affecting children, women of reproductive age, pregnant women, the elderly, and individuals with chronic diseases. It is characterized by a reduction in hemoglobin concentration and the presence of microcytic and hypochromic red blood cells. This condition results from a deficiency in iron, an essential element for hemoglobin synthesis, thereby compromising oxygen transport and causing significant physiological consequences. Its etiology is multifactorial, including chronic blood loss, inadequate dietary iron intake, intestinal malabsorption, and increased physiological requirements. Iron deficiency anemia can develop progressively from an isolated state of iron deficiency, making early diagnosis crucial to prevent clinical complications. Diagnosis is based on the integration of clinical data and laboratory parameters, such as serum ferritin, transferrin saturation, and erythrocyte indices. In more complex cases, particularly in inflammatory conditions, emerging biomarkers such as hepcidin, soluble transferrin receptor, and reticulocyte hemoglobin content provide greater diagnostic accuracy. The treatment of iron deficiency anemia includes conventional approaches such as oral and intravenous iron supplementation, as well as blood transfusions in severe situations. However, limitations related to therapeutic efficacy, treatment adherence, and adverse effects have led to the development of innovative therapeutic approaches. These include hepcidin modulation and the targeting of pathways that regulate iron metabolism, prolyl hydroxylase inhibitors, epigenetic regulation, and the use of probiotics, lactoferrin, and microencapsulated iron supplements. Research in these areas has shown promising results, particularly in patients with chronic diseases or intolerance to conventional iron therapies. This monograph presents a comprehensive review of iron deficiency anemia, addressing its pathophysiological, epidemiological, diagnostic, and therapeutic aspects. The objective is to contribute to a better understanding of this condition and to highlight the importance of individualized diagnostic and therapeutic strategies, based on the most current scientific evidence, aimed at improving patients’ quality of life. Additionally, preventive and population-level intervention strategies are explored, with emphasis on food fortification, targeted supplementation, and the role of pharmacists in health promotion.
Iron deficiency anemia is the most common type of anemia and represents one of the main public health problems worldwide, especially affecting children, women of reproductive age, pregnant women, the elderly, and individuals with chronic diseases. It is characterized by a reduction in hemoglobin concentration and the presence of microcytic and hypochromic red blood cells. This condition results from a deficiency in iron, an essential element for hemoglobin synthesis, thereby compromising oxygen transport and causing significant physiological consequences. Its etiology is multifactorial, including chronic blood loss, inadequate dietary iron intake, intestinal malabsorption, and increased physiological requirements. Iron deficiency anemia can develop progressively from an isolated state of iron deficiency, making early diagnosis crucial to prevent clinical complications. Diagnosis is based on the integration of clinical data and laboratory parameters, such as serum ferritin, transferrin saturation, and erythrocyte indices. In more complex cases, particularly in inflammatory conditions, emerging biomarkers such as hepcidin, soluble transferrin receptor, and reticulocyte hemoglobin content provide greater diagnostic accuracy. The treatment of iron deficiency anemia includes conventional approaches such as oral and intravenous iron supplementation, as well as blood transfusions in severe situations. However, limitations related to therapeutic efficacy, treatment adherence, and adverse effects have led to the development of innovative therapeutic approaches. These include hepcidin modulation and the targeting of pathways that regulate iron metabolism, prolyl hydroxylase inhibitors, epigenetic regulation, and the use of probiotics, lactoferrin, and microencapsulated iron supplements. Research in these areas has shown promising results, particularly in patients with chronic diseases or intolerance to conventional iron therapies. This monograph presents a comprehensive review of iron deficiency anemia, addressing its pathophysiological, epidemiological, diagnostic, and therapeutic aspects. The objective is to contribute to a better understanding of this condition and to highlight the importance of individualized diagnostic and therapeutic strategies, based on the most current scientific evidence, aimed at improving patients’ quality of life. Additionally, preventive and population-level intervention strategies are explored, with emphasis on food fortification, targeted supplementation, and the role of pharmacists in health promotion.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2025, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
204205450 Anemia ferropénica Hepcidina Estratégias terapêuticas Mestrado integrado - 2025