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  Anemia

Anemia is the most common disorder of the blood that occurs when the there is a deficiency of red blood cells and/or hemoglobin. Hemoglobin is known as the oxygen carrying protein of the red blood cells. This blood condition can lead to a lot of health-related problems mainly due to impaired oxygenation because of the reduction of the blood’s ability to transfer the oxygen to all the body tissues and organs causing hypoxia.

Anemia Blood disorder
Anemia


The three major causes of anemia are: excessive RBC destruction (hemolysis), blood loss (acute or chronic) and inadequate RBC production.

Hemolytic type of anemia occurs when the red blood cells are being destroyed prematurely. In short, they have a much shorter life span in contrast to a normal healthy red cell which is 120 days. The bone marrow in these cases also cannot compensate with the body’s increase demand for new young red blood cells. In some patients, the immune system does not recognize his own red blood cells and begins attacking them resulting to a condition known as autoimmune hemolytic anemia. Common forms of inherited hemolytic anemia include sickle cell anemia, thalassemia and glucose-6-phosphate dehydrogenase deficiency. Sickle cell anemia is a severe form of hemolytic anemia found most commonly in people with African heritage. The red cells of these patients are distorted or abnormal sickle shapes that lead to its premature destruction. The thalassemia affects people of Mediterranean, African and Southeast Asian descent. There are two forms: Thalassemia major, also called Cooley’s anemia which is the severe form compared to the Thalassemia minor. RBCs are also rapidly destroyed here and iron is deposited in the skin and vital organs. Most commonly affecting the men of African heritage is the glucose-6-phosphate dehydrogenase (G6PD) deficiency. With this condition, the RBCs either do not make enough of the enzyme or the enzyme that is produced is abnormal. When the patient born with this deficiency has an infection, takes certain medicines or is exposed to specific substances, his RBCs suffer extra stress and destroyed prematurely.

Anemia caused by blood loss can be categorized as acute blood loss due to injury, surgery or a problem with the clotting factors and a slower or chronic long-term blood loss which include: gastrointestinal bleeding from inflammatory bowel disease (IBD), peptic ulcer disease or bowel cancer. Heavy menstrual losses in teenagers and women may also result to anemia and this increases the body’s need for iron (to make new RBCs).

Anemias caused by inadequate production of RBCs are the following: Aplastic anemia, physiologic anemia of infancy, poor dietary iron and vitamin (B12 and folic acid) intake and anemia during pregnancy. Aplastic anemia is a condition wherein the bone marrow can’t make enough RBCs and other stem cells. This can be due to a viral infection or exposure to certain toxic chemicals, radiation or medications such as antibiotics, anticonvulsant drugs and antineoplastic agents. Physiologic anemia of infancy is a temporary drop in the blood count after a child is born and considered to be normal hence; no treatment is required because the infant’s body soon begins to start making new red blood cells on its own. Iron deficiency anemia on the other hand is the most common cause of anemia in children. Most commonly seen in those younger than 2 years old, but can affect any age. This is mainly due to nutritional deficiency or poor dietary iron intake. However, excessive loss of iron from the body can also lead to iron deficiency anemia.

Common signs and symptoms of anemia are the following: shortness of breath, feeling of weakness or easy fatigability, irritability, dizziness, lightheadedness and a rapid heartbeat. The first few symptoms of a child with anemia might be skin paleness and pale lips, palpebral conjunctiva and nailbeds. Depending on the cause of anemia, symptoms may include jaundice, icteric sclerae, splenomegaly and dark tea-colored urine. Severe anemia may lead to markedly increasing cardiac output and eventually heart failure. However, mild anemia goes undetected in many people because symptoms are non-specific.

Diagnostic tests as part of a routine complete physical examination can diagnose anemia. These are: Complete blood count (CBC) - the most frequently requested blood exam, Blood smear examination, Iron tests (total serum iron and ferritin), Hemoglobin electrophoresis, Bone marrow aspiration and biopsy (in suspected aplastic anemia and leukemia), Reticulocyte count (to determine if RBC production is normal).

The treatment of anemia depends on its underlying cause. Iron-rich foods may be recommended along with iron, folic acid B12 supplements. Teenagers with heavy bleeding may be treated with oral contraceptive pill to regulate the menses. Treat the infection if it is the cause to improve the anemia. Other forms of treatment may include transfusions of packed red blood cells, splenectomy and drugs that stimulate the bone marrow to make more red blood cells. In some cases of inherited hemolytic anemia, a bone marrow transplant may be considered.

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