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Anemia : Things to know

           Things to know about Anemia: Anemia is a laboratory finding reflecting a decrease in red blood cell (RBC) mass below an age-appropriate normative value , this can be either:

  • 1-Reduction in RBCs number.

  • 2-Reduction in RBC mass (hematocrit).

  • 3-Reduction hemoglobin concentration.

  The function of RBCs is to deliver oxygen from the lungs to the other parts of the body, and they are made in the bone marrow with many other factors involved in their production such as iron (very important for hemoglobin molecule ) and erythropoietin (secreted by the kidneys, promotes the formation of RBCs in bone marrow).

 

Anemia can be classified into 3 major groups:

  • Microcytic anemia : RBCs smaller than normal (ex, iron deficiency , inherited disorders of hemoglobin) .
  • Normocytic anemia : RBCs normal in size but low in number ( ex, anemia accompanies chronic disease ).
  • Macrocytic anemia : RBCs larger than normal (ex, pernicious anemia, alcoholism ).Toddlers (12 – 24 months ) and adolescent girls account for most cases of iron deficiency anemia, whereas black persons at greater risk for sickle cell anemia, thalassemia occur primarily in patients of Mediterranean and south east Asian descent.

What are the causes of anemia?

There are too many causes:
  • Iron deficiency anemia
  • Pernicious anemia
  • Sickle cell anemia
  • Thalassemia
  • Anemia of chronic disease (ex, cancer , chronic infection)
  • Anemia related to kidney disease
  • Anemia from active bleeding
  • Anemia related to poor nutrition
  • Alcoholism
  • Blood cancer : lymphomas, leukemia
  • Hemolytic anemia (ex, G6PD deficiency ,hereditary spherocytosis ..)
  • Aplastic anemia
  • Liver disease
  • Lead poisoning
  • AIDS
  • Thyroid problems
  • Malaria
  • Cancers
  • Mononucleosis
  • Parasitic infection
  • Bleeding disorders
  • Autoimmune disease (SLE)
  • Paroxysmal nocturnal hemoglobinuria (PNH)In addition to many other reasons, we have just mentioned the most important.

What does an anemic person feel?

Symptoms of anemia appear because of the reduction in oxygen delivery to the body tissue, so that , if the anemia is mild to moderate then it will often be asymptomatic. In infants and toddlers , the dominant symptoms are:
  1. Fatigue
  2. Irritability
  3. Pallor
  4. Increase sleep
  5. Poorfeeding
Failure to thrive In older children, adolescents and adults :
  1. Fatigue
  2. Pallor
  3. Weakness
  4. Exercise intolerance
  5. Headache
  6. Shortness of breath
  7. Palpitation
When the anemia becomes very severe, the symptoms may include:
  1. Chest pain, angina or heart attack
  2. Dizziness
  3. Fainting or passing out
  4. Rapid heart rateSo that , it is a really serious condition.

Diagnosis of anemia

You should know that anemia can be chronic (occurs over a long period of time ) or acute ( occurs quickly) and this may help your doctor to determine the underlying cause of anemia. A complete blood count (CBC) with an evaluation of the patient are enough for your doctor to detect anemia, but a lot of laboratory tests and a good patient history are needed to determine what condition is causing anemia .  

When do I seek a medical advice?

When any of the above mentioned symptoms appears, you should contact your physician to determine the cause of anemia because ,as we mentioned earlier, it indicates the presence of an underlying disease in the body, which need many additional investigations requested by your physician. Add to that the elderly and those with chronic heart and lung disease and kidney disease as well, where their symptoms become worse in the presence of anemia. Active bleeding: whether in the form of bloody vomiting or heavy menstrual bleeding or wounds. Sickle cell disease during crisis. Hemolytic attack in hemolytic diseases.  

Things to know about treatment anemia

Anemia is treated according to the underlying cause. For example, in the case of iron deficiency anemia, the patient must be compensated with iron until the cause of iron deficiency is determined . there is no need to admit the patient to the hospital. But if the cause is severe bleeding, then the patient must admit to hospital and the lost blood must be replaced by blood transfusion and take the necessary medical measures to stop bleeding. We may need blood transfusion during hemolytic attack in blood hemolytic diseases. And ,of course, treat the underlying disease with the appropriate medication to stop the progression of anemia.  

Self-care at home?

You do not have much to do. It is enough to stick to the doses of medicines prescribed by the therapist , and if the disease causing anemia is known, periodic examinations should be conducted to ensure that the disease is well controlled.