What is anemia?
Anemia is the reduction of red blood cells or hemoglobin in the blood. This leads to a decrease in the distribution of oxygen to various organs and tissues. In a healthy physiological process, Red blood cell lives for about 120days, and after that, they are destroyed, and new ones are simultaneously formed to make up for the damaged red blood cell.
What is the normal range for red blood cells count? The normal amount of red blood cells in women are: 4.2 – 5.4million cell/mcL and 4.7- 6. 1million cell/mcL in men while hemoglobin is :
- 13.5g/dL – 17.5g/dL in men
- 12.0 – 15.5g/dL in women
- 10.0 – 14.0g/dL in children
- 15.0 – 25.0g/dL in newborns
The Normal mean corpuscular(cells) volume (MCV: which is the measure of the average volume of red blood cell) is 80-100. Deviation from this norm is called Microcytic anemia(MCV<80) and Macrocytic anemia(>100).
There are some disorders that cause normocytic anemia, which is when the MCV is normal, but there is reduced hemoglobin.
What causes anemia?
Anemia occurs due to 3 different pathways:
- Increase the destruction of red blood cell
- Blood loss.
- Decrease production of red blood cell
Increase the destruction of red blood cell (hemolytic anemia):
Hemolytic anemia is the fast destruction of red blood cells that do not meet up with the production of red blood cells. Causes of hemolytic anemia are:
- Sickle cell anemia (SCA): is inherited anemia caused by the inheritance of 2 abnormal hemoglobin genes from both parents. Chromosome 11 is the chromosome affected. The healthy red blood cell is donut-shaped, but in SCA, the RBC shape becomes sickle-shaped( looking like a crescent moon). This affects the proper movement of RBC in the vessels leading to the accumulation of RBC, which leads to so many health crises such as vaso-occlusive crisis, hemolytic crisis, aplastic crisis, sequestration crisis, and acute chest crisis.
- Thalassemia: is a hemoglobin mutation that is inherited. It is mainly an autosomal recessive inheritance: there 2 alpha-globin genes and 2 beta-globin genes. Depending on the gene affected, thalassemia can be classified into alpha and beta-thalassemia.
- Hereditary spherocytosis(is an inherited abnormality of RBC)
- Glucose -6-phosphate dehydrogenase deficiency
- Pyruvate kinase deficiency
- Spur cell hemolytic anemia
- Portal hypertension causing hypersplenism
- Lead poisoning
- Systemic lupus erythematosus Leading to the autoimmune destruction of the RBC
- Rheumatoid arthritis leading to the autoimmune destruction of RBC
- Chronic Lymphocytic Leukemia
- Transfusion reaction after/during a blood transfusion
Anemia caused by excessive bleeding due to the following:
- Gastrointestinal bleeding (from esophageal varices, peptic ulcer, ulcerative colitis)
- Anemia of prematurity is seen in preterm infants
- Cancer of the Urinary bladder
- Lungs Cancer
- Postpartum hemorrhage
- Antepartum hemorrhage
Decreased production of red blood cell
- Pernicious anemia: likewise known as Vitamin B12 Deficiency. It’s usually diagnosed in people of a particular age. The usual onset is 55years and above, but it can affect all ages. Treated with Vit B12 pills or injection
- Iron deficiency anemia: manage with an iron supplement, blood transfusion, and Vitamin C
- Aplastic anemia: is an autoimmune disorder where all types of blood cells are not produced in their appropriate amount.
- Kidney failure: erythropoietin is a hormone produce by the kidneys. Erythropoietin helps in the stimulation of red blood cell production. When the kidneys fail, the creation of erythropoietin is hindered, causing reduce the production of RBC.
- Myelodysplastic syndrome
- Anemia of chronic inflammation
What are the symptoms of anemia?
Here are signs and symptoms of anemia:
- Feeling faint/fainting
- Chest pain
- The pallor of the skin and mucous membrane
- Jaundice of eyes and skin
- Pica (the craving of inedible substance)
- Koilonychia (spoon-shaped nails)
- Leg sores
- Restless legs syndrome
- Pounding pulse
How is anemia diagnosed?
- Full blood count
- Peripheral blood smear
- Cytogenetic testing
- Hemoglobin electrophoresis
- Bone marrow biopsy
- BUN(Blood urea nitrogen)
- CT scan and ultrasound of the abdominal cavity
- Chest X-ray
Treating anemia depends on the cause, so do not diagnose or treat anemia by yourself, consult with your doctor if you suspected you have any symptoms of anemia. Trust your doctor, not advertising of food supplements or multivitamins that will not help eliminate anemia.
Prevention of anemia
Several types of anemia can not be prevented. Although, according to the Mayo Clinic, you can avoid iron deficiency anemia by eating healthy: Iron-rich foods should be part of your daily diet (eg, meat, iron-fortified cereals, beans, vegetables).