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Anaemia


Introduction

The condition of having a lower-than-normal number of red blood cells or quantity of hemoglobin.
Normal results vary, but in general are:

Male: 13.8 to 17.2 gm/dL
Female: 12.1 to 15.1 gm/dL
(Note: gm/dL = grams per deciliter)

Anaemia has three main causes: blood loss, lack of red blood cell production, and high rates of red blood cell destruction.
Conditions that may lead to anaemia include

Heavy periods
Pregnancy
Ulcers
Colon polyps or colon cancer
Inherited disorders
A diet that does not have enough iron, folic acid or vitamin B12
Blood disorders such as sickle cell anaemia and thalassemia, or cancer
Aplastic anaemia, a condition that can be inherited or acquired

Anaemia can make you feel tired, cold, dizzy, and irritable. You may be short of breath or have a headache.

References:
www.nhs.uk
www.nhlbi.nih.gov
www.cdc.gov
www.who.int

Symptoms

The most common symptom of anaemia is fatigue or weakness.
Other signs and symptoms of anaemia include:

Shortness of breath
Dizziness
Headache
Coldness in the hands and feet
Pale skin
Chest pain

Reference:
www.nhlbi.nih.gov

Causes

Three main cause of anaemia are:
1) Blood loss
2) Lack of red cell production
3) High rates of red blood cell destruction

1) Blood loss: Blood loss is the most common cause of anaemia, especially in iron-deficiency anaemia. Blood loss can be short term or long term depending upon the conditions.
Bleeding in the digestive or urinary tract can cause blood loss. Surgery, trauma, or cancer also can cause blood loss. Heavy blood loss due to menstruation.
If a lot of blood is lost, the body may lose enough red blood cells to cause anaemia.

2) Lack of Red Blood cell production:
It can be due to "acquired" or "Inherited".

["Acquired" means that the person is not born with the condition, but may develop it at later stages.
"Inherited" means that the condition has been passed by the parents.]
Acquired conditions and factors that can lead to anaemia include:
Poor diet
Unusual hormonal levels
Chronic diseases
Pregnancy
Aplastic anaemia can also prevent body from making enough red blood cells. This condition can be both acquired or inherited.

3) High rates of RBCs destruction:
Factors that can cause destruction of red blood cells.
One condition can be an enlarged or diseased spleen.This is an acquired condition.
Inherited conditions are the one when body destroy too many red blood cells. It can be in sickle cell anaemia, thalassemias, and lack of certain enzymes. These conditions create defects in the red blood cells that cause them to die faster than healthy red blood cells.

Hemolytic anaemia is another example of a condition in which body destroys its red blood cells. Both inherited or acquired conditions or other factors can cause hemolytic anaemia. Examples include immune disorders, infections, certain medicines, or reactions to blood transfusions.

Reference:
www.nhlbi.nih.gov

Diagnosis

Medical History:

Signs and symptoms like weakness, malaise or body aches

Blood tests:

To check for the levels of hemoglobin (it is a protein that transports oxygen)

Red blood cells (cells that contain hemoglobin)is lower than normal.

Physical examination:

Rapid or irregular heartbeat
Rapid or irregular breathing
Enlarged liver or spleen

Complete blood count (CBC): A CBC is generally done to know the number of blood cells in the blood. To check anaemia, physician will see the levels of the red blood cells contained in the blood (hematocrit) and the hemoglobin in blood. Normal adult hematocrit values vary from one medical practice to another but are generally between 38.8 and 50 percent for men and 34.9 and 44.5 percent for women.

A test to determine the size and shape of your red blood cellsSome of red blood cells may also be examined for unusual size, shape and color. This will help in diagnosis. For example, in iron deficiency anaemia, red blood cells are smaller and paler in color than normal. In vitamin deficiency anaemia's, red blood cells are enlarged and fewer in number.

Reference:
www.nhs.uk

Management

Iron supplements: The most commonly prescribed supplement is ferrous sulphate, taken orally (by mouth) two or three times a day.

Dietary supplements: Iron-rich foods include:

Dark-green leafy vegetables, such as spinach
Iron-fortified cereals
Whole grains, such as brown rice
Beans
Nuts
Meat
Apricots

Reference:
www.nhlbi.nih.gov

Complications

Iron deficiency anaemia rarely causes any serious or long-term complications. However, some of the complications are listed below:

Tiredness
Iron deficiency anaemia can leave a person tired and lethargic (lacking in energy), as a result person may be less productive and active at work.

Immune system
Iron deficiency anaemia can affect immune system (the body’s natural defence system), making a person more susceptible to illness and infection.

Heart and lung complications
Adults with severe anaemia may be at risk of developing complications that affect their heart or lungs. For example,

Tachycardia (an abnormally fast heartbeat)
Heart failure, when your heart is not pumping blood around your body very efficiently


Pregnancy
Pregnant women with severe anaemia have an increased risk of developing complications, particularly during and after the birth. They may also develop postnatal depression (a type of depression some women experience after having a baby).

Reference:
www.nhs.uk