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Q.2) Whom does it affect the most?
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Ans: Anemia
can occur at any age, but people at the extremes of age are more
susceptible. Females (especially in the age group of 15-45) are more prone to
anemia.
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Q.3) How does Anemia progress? |
Ans: Reduction below normal of
- The number of erythrocytes (Red Blood Corpuscles),
- Quantity of haemoglobin (Hb), or
- The volume of packed red blood cells (Red Blood
Corpuscles) in the blood.
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Q.4) What are the causes of Anemia? |
Ans: Anemia
results from one or more combinations of three basic factors:--
Blood loss.
-
Decreased Red Blood Corpuscles(RBC) production, or
-
Increased RBC destruction (hemolysis).
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Classification
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Anemia can be broadly categorized into three major classifications according to the size or mean corpuscular volume (MCV) of the erythrocytes
(RBCs).
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| A) Microcytosis (decreased MCV)
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- Iron deficiency anemia
- Alpha or beta thalassemia
- Anemia of chronic diseases, chronic inflammation or infection
- Sideroblastic anemia
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| B) Normocytosis (normal MCV)
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- Normal variant.
- Anemia of chronic disease.
- Acute haemorrhage (bleeding).
- Endocrinopathies
- myxedema (decrease in thyroid function),
- Addison's disease (deficient secretion of adrenocortical
hormones)
- HIV-related anemia.
- Dilutional anemia
- Mixed anemia: the presence of two or more causes.
- Myelophthisic anemia: replacement of the normal marrow cells by leukemic, myeloma, or metastatic cancer cells or by myelofibrosis.
- Liver disease like:
- Uremia: history of renal dysfunction;
- Hemoglobinopathies
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C) Macrocytosis (increased MCV)
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- Pure red cell
aplasia
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Drug-induced
-
Underlying malignancies (thymoma, lymphoma),
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Viruses (parvovirus B19).
- Alcoholism
- Aplastic anemia
-
bone marrow failure resulting from
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Drugs
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Radiation
-
Viral infections
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Hereditary (Fanconi's anemia).
- Paroxysmal nocturnal hemoglobinuria (PNH).
- Myelodysplastic syndromes
- Megaloblastic anemias: B12 or folate deficiency.
- Hemolytic anemias: Characterized by an excessive destruction of Red
Blood Corpuscles.
They are:-
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| a.
Extrinsic
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- Antibody-mediated: immunohemolytic
anemia
- Microangiopathic hemolytic anemias:
-
Thrombotic thrombocytopenic purpura
(TTP)
-
Disseminated intravascular coagulation
(DIC)
-
Hemolytic-uremia syndrome (HUS)
- Toxins, malaria
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| b. Intrinsic
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- RBC membrance
defects
-
Hereditary spherocytosis.
-
Hereditary elliptocytosis.
- PNH
- Hemoglobinopathies
-
sickle cell disease
-
thalassemia
- Enzymopthies: G6PD deficiency, pyruvate kinase deficiency
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Q.5)What are the symptoms of Anemia? |
Ans:
The symptoms of anemia are
- Weakness
- Headaches
- Dizziness
- Fatigue.
If the anemia develops slowly, the patient maybe asymptomatic.
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Q.6)What are the signs of Anemia? |
Ans: The Signs are
- On physical examination:
Orthostatic hypotension,
- Tachycardia
- Tachypnea
- Jaundice and hepatosplenomegaly
- Neurologic manifestations, such as loss of vibratory or positional sensation
- Evidence of underlying disease as cause for the anemia.
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Q.7)What investigations are conducted? |
Ans:
Laboratory tests conducted are
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Serum iron
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Total iron-binding capacity (TIBC), and
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Serum ferritin
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Transferring saturation
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Haemoglobin electrophoresis
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Free erythrocyte protoporphyrin (FEP).
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Check feces for occult blood.
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Serum B12.
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Folate levels.
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Thyroid function tests.
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Complete blood count (CBC) with differential and platelet count.
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Reticulocyte count.
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Peripheral smear.
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Bone marrow biopsy and/or aspirate, if required.
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Investigations specific for underlying disease, if any.
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