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Anemia

ANEMIA:

Anemia (pronounced /əˈniːmiə/also spelled anaemiaor anæmia; from Ancient Greekἀναιμία anaimia, meaning “lack of blood”) is a decrease in normal number of red blood cells(RBCs) or less than the normal quantity of hemoglobin in the blood.[1][2]However, it can include decreased oxygen-binding ability of each hemoglobin molecule due to deformity or lack in numerical development as in some other types of hemoglobin deficiency.

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File:Iron deficiency anemia.jpg

Since hemoglobin (found inside RBCs) normally carries oxygenfrom the lungs to the tissues, anemia leads to hypoxia (lack of oxygen) in organs. Since all human cells depend on oxygen for survival, varying degrees of anemia can have a wide range of clinical consequences.

The three main classes of anemia include excessive blood loss (acutely such as a hemorrhage or chronically through low-volume loss), excessive blood cell destruction (hemolysis) or deficient red blood cell production (ineffective hematopoiesis).

Peripheral blood smear microscopy of a patient with iron-deficiency anemia.

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Signs and symptoms

File:Symptoms of anemia.pngAnemia goes undetected in many people, and symptoms can be small and vague. The signs and symptoms can be related to the anemia itself, or the underlying cause.Most commonly, people with anemia report non-specific symptoms of a feeling of weakness, or fatigue, general malaise and sometimes poor concentration. They may also report shortness of breath, dyspnea, on exertion. In very severe anemia, the body may compensate for the lack of oxygen carrying capability of the blood by increasing cardiac output. The patient may have symptoms related to this, such as palpitations, angina (if preexisting heart disease is present), intermittentclaudication of the legs, and symptoms of heart failure.

On examination, the signs exhibited may include pallor (pale skin, mucosal linings and nail beds) but this is not a reliable sign. There may be signs of specific causes of anemia, eg koilonychia (in iron deficiency), jaundice (when anemia results from abnormal break down of red blood cells — in haemolytic anemia), bone deformities (found in thalassaemia major) or leg ulcers (seen in sickle cell disease).

In severe anemia, there may be signs of a hyperdynamic circulation: a fast heart rate (tachycardia), flow murmurs, and cardiac enlargement. There may be signs of heart failure.

Pica, the consumption of non-food based items such as dirt, paper, wax, grass, ice, and hair, may be a symptom of iron deficiency, although it occurs often in those who have normal levels of hemoglobin.

Chronic anemia may result in behavioral disturbances in children as a direct result of impaired neurological development in infants, and reduced scholastic performance in children of school age.

Restless legs syndrome is more common in those with iron deficiency anemia.

Less common symptoms may include swelling of the legs or arms, chronic heartburn, vague bruises, vomiting, increased sweating, and blood in stool.

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Cause

  • Anemia of prematurity occurs in premature infants at 2 to 6 weeks of age and results from diminished erythropoietin response to declining hematocrit levels.
  • Aplastic anemia is a condition generally unresponsive to anti-anemia therapies where bone marrow fails to produce enough red blood cells.
  • Fanconi anemia is a hereditary disorder or defect featuring aplastic anemia and various other abnormalities.
  • Hemolytic anemia causes a separate constellation of symptoms (also featuring jaundice and elevated LDH levels) with numerous potential causes. It can be autoimmuneimmunehereditary or mechanical (e.g.heart surgery). It can result (because of cell fragmentation) in a microcytic anemia, a normochromic anemia, or (because of premature release of immature red blood cells from the bone marrow), a macrocytic anemia.
  • Hereditary spherocytosis is a hereditary defect that results in defects in the RBC cell membrane, causing the erythrocytes to be sequestered and destroyed by the spleen. This leads to a decrease in the number of circulating RBCs and, hence, anemia.
  • Sickle-cell anemia, a hereditary disorder, is due to homozygous hemoglobin S genes.
  • Warm autoimmune hemolytic anemia is an anemia caused by autoimmune attack against red blood cells, primarily by IgG.
  • Cold agglutinin hemolytic anemia is primarily mediated by IgM.
  • Pernicious anemia is a form of megaloblastic anemia due to vitamin B12 deficiency dependent on impaired absorption of vitamin B12.
  • Myelophthisic anemia or Myelophthisis is a severe type of anemia resulting from the replacement of bone marrow by other materials, such as malignant tumors or granulomas.
  • Anemia of Pregnancy is anemia that is induced by blood volume expansion experienced in pregnancy.

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References

  1. ^ MedicineNet.com –> Definition of Anemia Last Editorial Review: 12/9/2000 8:31:00 AM
  2. ^ merriam-webster dictionary –> anemia Retrieved on May 25, 2009
  3. ^ eMedicine – Anemia, Chronic : Article by Fredrick M Abrahamian, DO, FACEP
  4. ^ eMedicineHealth > anemia article Author: Saimak T. Nabili, MD, MPH. Editor: Melissa Conrad Stöppler, MD. Last Editorial Review: 12/9/2008. Retrieved on 4 April 2009
  5. ^ World Health Organization (2008). Worldwide prevalence of anaemia 1993–2005. Geneva: World Health Organization. ISBN 9789241596657. Retrieved 2009-03-25.
  6. ^ Recommendations to Prevent and Control Iron Deficiency in the United States MMWR 1998;47 (No. RR-3) p. 5
  7. ^ Iron Deficiency Anaemia: Assessment, Prevention, and Control: A guide for programme managers
  8. ^ eMedicine – Vitamin B-12 Associated Neurological Diseases : Article by Niranjan N Singh, MD, DM, DNB July 18, 2006

January 27, 2010 - Posted by | Blood, Cancers, Cells

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