Anemia

Anemia

Introduction

Anemia is a condition in which the number of red blood cells or the amount of hemoglobin (the protein that carries oxygen in them) is low.

Red blood cells contain hemoglobin, a protein that enables them to carry oxygen from the lungs and deliver it to all parts of the body. When the number of red blood cells is reduced or the amount of hemoglobin in them is low, the blood cannot carry an adequate supply of oxygen. An inadequate supply of oxygen in the tissues produces the symptoms of anemia.

Causes

The causes of anemia are numerous, but most can be grouped within three major mechanisms that produce anemia:

1- Blood loss (excessive bleeding)

2- Inadequate production of red blood cells

3- Excessive destruction of red blood cells

Common Causes of Anemia

1- Chronic excessive bleeding

Bladder tumor       Cancer in the digestive tract      Heavy menstrual bleeding

Hemorrhoids          Kidney tumors

Nosebleeds            Polyps in the digestive tract       Ulcers in the stomach or small intestine

2- Sudden excessive bleeding 

Injuries                  Childbirth                                A ruptured blood vessel Surgery

3- Decreased red blood cell production

Aplastic anemia          Chronic disorders            Folate deficiency

Iron deficiency            Leukemia                       Lymphoma

Metastatic cancer        Myelodysplasia (abnormalities in bone marrow tissue

Myelofibrosis               Multiple myeloma            Vitamin B12 deficiency

Vitamin C deficiency

4- Increased red blood cell destruction

Autoimmune reactions against red blood cells  - An enlarged spleen

Glucose-6-phosphate dehydrogenase (G6PD) deficiency

Hemoglobin C disease         Hemoglobin E disease      Hemoglobin S-C disease

Hereditary elliptocytosis      Hereditary spherocytosis    Mechanical damage to red blood cells

Symptoms and Diagnosis

Symptoms vary depending on the severity of the anemia and how rapidly it develops. Some people with mild anemia, particularly when it develops slowly, have no symptoms at all. Other people may experience symptoms only with physical exertion. More severe anemia may produce symptoms even when people are resting.Symptoms are more severe when mild or severe anemia develops rapidly, such as with bleeding that occurs when a blood vessel ruptures

Mild anemia often causes fatigue, weakness, and paleness. In addition to these symptoms, more severe anemia may produce faintness, dizziness, increased thirst, sweating, a weak and rapid pulse, and rapid breathing. Severe anemia may produce painful lower leg cramps during exercise, shortness of breath, and chest pain, especially if people already have impaired blood circulation in the legs or certain types of lung or heart disease.

Sometimes anemia is detected before people notice symptoms, when routine blood tests are done.

Low levels of hemoglobin and a low hematocrit (the percentage of red blood cells in the total blood volume) found in a blood sample confirm the anemia. Other tests, such as examining a blood sample under a microscope and less often examining a sample taken from the bone marrow, help determine the cause of the anemia.

Treatment

- Increase the amount of iron in your diet. Good dietary sources of iron include red meat, beans, egg yolk, whole-grain products, nuts, and seafood. Many processed foods and milk are also reinforced with iron.Oral Iron supplement is included . If anemia doesn't improve,patient is treated with iron injection.

 - folate also is an important factor that is recommend in anemia treatment . Good dietary sources of folate include fresh fruits, green leafy vegetables, cruciferous vegetables (cauliflower, broccoli and brussel sprouts), liver and kidney, dairy products, and whole grain cereals. Vegetables should be eaten raw or lightly cooked.

 -  vitamin B-12  deficiency anemia, the treatment depends on the cause of   the deficiency. There is a good chance that many of the symptoms of deficiency will improve once the body is provided with the needed B-12. Good dietary sources of vitamin B-12 are meat, liver, and kidney; fish, oyster, and clams; and milk, cheese and eggs.

 most people who have anemia from bleeding need to take iron supplements, in additon to epoetin alfa ,vitamin B12,folic acid and chromium element

- Blood transfusion may be needed in severe blood loss