Anemia is defined as a state in which the hemoglobin level is below the normal range for the age and sex of the individual. Given below are the anemic values:

• Newborn -<15g/dl
• Adult males-<12g/dl
• Adult females-<11g/dl

CAUSES:

What is the function of the red blood cell?

Red blood cells deliver oxygen to various tissues of the body. Hemoglobin is a respiratory pigment present in the red blood cells. It carries oxygen to the tissues and carries CO2 from the tissues to the lungs. It consists of basic protein – globin and an iron -porphyrin complex -haem. A rise in the red cell concentration of 2,3 DPG, an intermediate product of glucose metabolism, occurs in anemia and hypoxia.

CAUSE FOR COMMON TYPES OF ANEMIA:

• IRON DEFICIENCY ANEMIA: is due to low store of iron or deficiency of iron in the body. the main cause is due to increased blood loss, increased demands, inadequate dietary intake and decreased absorption.
• ANEMIA OF THE CHRONIC DISEASE: occurs in patients of chronic infections such as endocarditis, tuberculosis, osteomyelitis, SLE, malignant disease and cause is due to non-mobilization of iron from the bone marrow, with the resulting iron gets stuck up in the marrow and is not available for the haemoglobination of the developing red cells.
• SIDEROBLASTIC ANEMIA: is the type of anemia where sideroblasts are present in large number due to hereditary or acquired condition.
• MEGALOBLASTIC ANEMIA: these are macrocytic anemias with megaloblasts in the bone marrow due to deficiency of either vitB12 or folic acid.
• PERNICIOUS ANEMIA: is due to failure of secretion of the intrinsic factor by the stomach to digest the extrinsic factor and the cause is autoimmune antibodies to intrinsic factor.
• HEMOLYTIC ANEMIA is abnormal excessive destruction of red cells that overwhelms the compensatory capacity of the bone marrow caused due to intra-corpuscular and extra-corpuscular defects.
• THALASSEMIA: are genetically transmitted disorders of the reduced rate of synthesis of one or more of the globin polypeptide chains.
• APLASTIC ANEMIA: is a failure of the stem cells to a varying degree producing hypoplasia of the bone marrow elements which is caused due to idiopathic or secondary causes.

RISK FACTORS:

• Nutrition
• Chronic diarrhea
• Malabsorption
• Pregnancy
• Hypoproteinemia
• Hemolysis
• Leukemia
• Chronic infections
• Chronic bloodless

SYMPTOMS:

• Fatigue
• Pallor of skin, mucous membrane, tongue, conjunctiva
• Dizziness
• Weight loss
• Personality changes
• Mental disorientation
• Numbness
• Tinnitus
• Insomnia
• Vertigo
• Headaches
• Amenorrhea
• Loss of libido
• Nausea
• Constipation
• Palpitation
• Angina in older patients
• Throbbing in head and ears

DIAGNOSIS:

BLOOD TESTS/HEMATOCRIT:

• Hemoglobin count
• Red cell count
• MCV, MCHC count
• Reticulocyte count
• WBC count
• Platelet count
• ESR
• Blood film
• Bone marrow
• Serum iron
• TIBC
• Serum ferritin

TREATMENT:

• IRON DEFICIENCY ANEMIA: includes oral iron therapy like ferrous sulfate tablets and parenteral iron therapy that includes iron sorbitol and iron dextran.
• MEGALOBLASTIC ANEMIA: Hydroxocobalamin parenterally with 5mg of folic acid once a week.
• HEMOLYTIC ANEMIA: splenectomy with blood transfusion.
• THALASSEMIA: transfusion to maintain hemoglobin between 8-10mg/dl by desferrioxamine.
• HYPOPLASTIC ANEMIA: blood transfusion, antibiotics, immunosuppressive therapy, ALG, cyclosporine