Anemia (pronounced /əˈniːmiə/, also spelled In the early 18th century, English spelling was not standardized. Differences became noticeable after the publishing of influential dictionaries. Current British English spellings follow, for the most part, those of Samuel Johnson's Dictionary of the English Language , whereas many American English spellings follow Noah Webster's An American anaemia and anæmia; from Ancient Greek Ancient Greek is the historical stage in the development of the Greek language spanning the Archaic , Classical (c. 5th–4th centuries BC), and Hellenistic (c. 3rd century BC – 6th century AD) periods of ancient Greece and the ancient world. It is predated in the 2nd millennium BC by Mycenaean Greek. Its Hellenistic phase is known as Koine (& ἀναιμία anaimia, meaning lack of blood) is a decrease in normal number of red blood cells Red blood cells are the most common type of blood cell and the vertebrate organism's principal means of delivering oxygen (O2) to the body tissues via the blood flow through the circulatory system. They take up oxygen in the lungs or gills and release it while squeezing through the body's capillaries (RBCs) or less than the normal quantity of hemoglobin Hemoglobin is the iron-containing oxygen-transport metalloprotein in the red blood cells of vertebrates and the tissues of some invertebrates. Hemoglobin in the blood is what transports oxygen from the lungs or gills to the rest of the body (i.e. the tissues) where it releases the oxygen for cell use 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.
Because hemoglobin (found inside RBCs) normally carries oxygen Oxygen (pronounced /ˈɒksɨdʒɨn/, OK-si-jin, from the Greek roots ὀξύς (acid, literally "sharp", from the taste of acids) and -γενής (-genēs) (producer, literally begetter), is the element with atomic number 8 and represented by the symbol O. It is a member of the chalcogen group on the periodic table, and is a highly from the lungs to the tissues Tissue is a cellular organizational level intermediate between cells and a complete organism. Hence, a tissue is an ensemble of cells, not necessarily identical, but from the same origin, that together carry out a specific function. Organs are then formed by the functional grouping together of multiple tissues, anemia leads to hypoxia Hypoxia is a pathological condition in which the body as a whole or a region of the body (tissue hypoxia) is deprived of adequate oxygen supply. Variations in arterial oxygen concentrations can be part of the normal physiology, for example, during strenuous physical exercise. A mismatch between oxygen supply and its demand at the cellular level (lack of oxygen) in organs. Because all human cells depend on oxygen Oxygen (pronounced /ˈɒksɨdʒɨn/, OK-si-jin, from the Greek roots ὀξύς (acid, literally "sharp", from the taste of acids) and -γενής (-genēs) (producer, literally begetter), is the element with atomic number 8 and represented by the symbol O. It is a member of the chalcogen group on the periodic table, and is a highly for survival, varying degrees of anemia can have a wide range of clinical consequences.
Anemia is the most common disorder of the blood. There are several kinds of anemia, produced by a variety of underlying causes. Anemia can be classified in a variety of ways, based on the morphology of RBCs, underlying etiologic mechanisms, and discernible clinical spectra, to mention a few. The three main classes of anemia include excessive blood loss (acutely such as a hemorrhage Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system. Bleeding can occur internally, where blood leaks from blood vessels inside the body or externally, either through a natural opening such as the vagina, mouth, nose, ear or anus, or through a break in the skin. The complete or chronically through low-volume loss), excessive blood cell destruction (hemolysis Hemolysis —from the Greek αἷμα (aima, haema, hemo-) meaning "blood" and λύσις (lusis, lysis, -lysis) meaning a "loosing", "setting free" or "releasing"—is the breaking open of erythrocytes (red blood cells) and the release of their contents (hemoglobin) into surrounding fluid (e.g., blood) or deficient red blood cell production (ineffective hematopoiesis Haematopoiesis (or hematopoiesis in the United States; sometimes also haemopoiesis or hemopoiesis) is the formation of blood cellular components. All cellular blood components are derived from haematopoietic stem cells. In a healthy adult person, approximately 1011–1012 new blood cells are produced daily in order to maintain steady state levels).
There are two major approaches: the "kinetic" approach which involves evaluating production, destruction and loss,[3] and the "morphologic" approach which groups anemia by red blood cell size. The morphologic approach uses a quickly available and cheap lab test as its starting point (the MCV The mean corpuscular volume, or "mean cell volume" , is a measure of the average red blood cell volume (i.e. size) that is reported as part of a standard complete blood count). On the other hand, focusing early on the question of production may allow the clinician to more rapidly expose cases where multiple causes of anemia coexist.
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Signs and symptoms
Main symptoms that may appear in anemia.[4]Anemia goes undetermined in many people, and symptoms can be minor or 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 Malaise is a feeling of general discomfort or uneasiness, an "out of sorts" feeling, often the first indication of an infection or other disease. Malaise is often defined in medicinal research as a "general feeling of being unwell" and sometimes poor concentration. They may also report shortness of breath, dyspnea Dyspnea or dyspnoea , (from Latin dyspnoea, from Greek dyspnoia from dyspnoos, shortness of breath), also called shortness of breath (SOB) or air hunger, is a debilitating symptom that is the experience of unpleasant or uncomfortable respiratory sensations. It is a common symptom of numerous medical disorders, particularly those involving the, on exertion. In very severe anemia, the body may compensate for the lack of oxygen carrying capability of the blood by increasing cardiac output Cardiac output is the volume of blood being pumped by the heart, in particular by a Left or Right ventricle in the Time interval of one minute. CO may be measured in many ways, for example dm3/min (1 dm3 equals 1000 cm3 or 1 litre). Q is furthermore the combined sum of output from the right ventricle and the output from the left ventricle during. The patient may have symptoms related to this, such as palpitations A palpitation is an abnormality of heartbeat that causes a conscious awareness of its beating, whether it is too slow, too fast, irregular, or at its normal frequency. The word may also refer to this sensation itself. It can be caused by ectopic beat, which is a more specific diagnosis, angina (if preexisting heart disease is present), intermittent claudication Claudication, literally 'limping' , is a medical term usually referring to impairment in walking, or a "painful, aching, cramping, uncomfortable, or tired feeling in the legs that occurs during walking and is relieved by rest". The perceived level of pain from claudication can be mild to extremely severe. Claudication is most common in of the legs, and symptoms of heart failure Heart failure is generally defined as inability of the heart to supply sufficient blood flow to meet the body's needs. It has various diagnostic criteria, and the term heart failure is often incorrectly used to describe other cardiac-related illnesses, such as myocardial infarction (heart attack) or cardiac arrest.
On examination, the signs exhibited may include pallor Pallor is a reduced amount of oxyhemoglobin in skin or mucous membrane, a pale color which can be caused by illness, emotional shock or stress, stimulant use, lack of exposure to sunlight, anemia or genetics. It is more evident on the face and palms. It can develop suddenly or gradually, depending on the cause (pale skin, mucosal linings and nail beds) but this is not a reliable sign. There may be signs of specific causes of anemia, e.g., koilonychia Koilonychia is a nail disease that can be a sign of hypochromic anemia, especially iron-deficiency anemia.:656 Koilonychia literally means "spoon nails." It refers to abnormally thin nails (usually of the hand) which have lost their convexity, becoming flat or even concave in shape. In a sense, koilonychia is the opposite of nail (in iron deficiency), jaundice Jaundice, is a yellowish pigmentation of the skin, the conjunctival membranes over the sclerae (whites of the eyes), and other mucous membranes caused by hyperbilirubinemia (increased levels of bilirubin in the blood). This hyperbilirubinemia subsequently causes increased levels of bilirubin in the extracellular fluids. Typically, the (when anemia results from abnormal break down of red blood cells — in hemolytic 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 Pica is a medical disorder characterized by an appetite for substances largely non-nutritive (e.g. metal , clay, coal, soil, feces, chalk, paper, soap, mucus, ash, gum, etc.) or an abnormal appetite for some things that may be considered foods, such as food ingredients (e.g., flour, raw potato, raw rice, starch, ice cubes, salt). In order for, 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 Restless legs syndrome , also known as Wittmaack-Ekbom's syndrome, and colloquially as "the jimmylegs" is a condition that is characterized by an irresistible urge to move one's body to stop uncomfortable or odd sensations. It most commonly affects the legs, but can also affect the arms or torso and even phantom limbs. Moving the is more common in those with iron deficiency anemia Iron deficiency anemia is a common type of anemia, and is known as sideropenic anemia. It is the most common cause of microcytic anemia.
Less common symptoms may include swelling of the legs or arms, chronic heartburn, vague bruises, vomiting, increased sweating, and blood in stool.
Diagnosis
Peripheral blood smear microscopy of a patient with iron-deficiency anemia Iron deficiency anemia is a common type of anemia, and is known as sideropenic anemia. It is the most common cause of microcytic anemia.Generally, clinicians request complete blood counts A complete blood count , also known as full blood count (FBC) or full blood exam (FBE) or blood panel, is a test requested by a doctor or other medical professional that gives information about the cells in a patient's blood. A scientist or lab technician performs the requested testing and provides the requesting medical professional with the in the first batch of blood tests in the diagnosis of an anemia. Apart from reporting the number of red blood cells Red blood cells are the most common type of blood cell and the vertebrate organism's principal means of delivering oxygen (O2) to the body tissues via the blood flow through the circulatory system. They take up oxygen in the lungs or gills and release it while squeezing through the body's capillaries and the hemoglobin Hemoglobin is the iron-containing oxygen-transport metalloprotein in the red blood cells of vertebrates and the tissues of some invertebrates. Hemoglobin in the blood is what transports oxygen from the lungs or gills to the rest of the body (i.e. the tissues) where it releases the oxygen for cell use level, the automatic counters An automated analyser is a medical laboratory instrument designed to measure different chemicals and other characteristics in a number of biological samples quickly, with minimal human assistance also measure the size of the red blood cells by flow cytometry Flow cytometry is a technique for counting and examining microscopic particles, such as cells and chromosomes, by suspending them in a stream of fluid and passing them by an electronic detection apparatus. It allows simultaneous multiparametric analysis of the physical and/or chemical characteristics of up to thousands of particles per second, which is an important tool in distinguishing between the causes of anemia. Examination of a stained blood smear using a microscope A microscope is an instrument to see objects too small for the naked eye. The science of investigating small objects using such an instrument is called microscopy. Microscopic means invisible to the eye unless aided by a microscope can also be helpful, and is sometimes a necessity in regions of the world where automated analysis is less accessible.
In modern counters, four parameters (RBC count, hemoglobin concentration, MCV The mean corpuscular volume, or "mean cell volume" , is a measure of the average red blood cell volume (i.e. size) that is reported as part of a standard complete blood count and RDW The red blood cell distribution width, or RDW, is a measure of the variation of red blood cell width that is reported as part of a standard complete blood count. Usually red blood cells are a standard size of about 6-8μm. Certain disorders, however, cause a significant variation in cell size. Higher RDW values indicate greater variation in size) are measured, allowing others (hematocrit The hematocrit or packed cell volume (PCV) or erythrocyte volume fraction (EVF) is the proportion of blood volume that is occupied by red blood cells. It is normally about 48% for men and 38% for women. It is considered an integral part of a person's complete blood count results, along with hemoglobin concentration, white blood cell count, and, MCH The mean corpuscular hemoglobin, or "mean cell hemoglobin" , is the average mass of hemoglobin per red blood cell in a sample of blood. It is reported as part of a standard complete blood count. MCH value is diminished in hypochromic anemias and MCHC The mean corpuscular hemoglobin concentration, or MCHC, is a measure of the concentration of hemoglobin in a given volume of packed red blood cell. It is reported as part of a standard complete blood count) to be calculated, and compared to values adjusted for age and sex. Some counters estimate hematocrit from direct measurements.
| Age or gender group | Hb threshold (g/dl) | Hb threshold (mmol/l) |
|---|---|---|
| Children (0.5–5.0 yrs) | 11.0 | 6.8 |
| Children (5–12 yrs) | 11.5 | 7.1 |
| Teens (12–15 yrs) | 12.0 | 7.4 |
| Women, non-pregnant (>15yrs) | 12.0 | 7.4 |
| Women, pregnant | 11.0 | 6.8 |
| Men (>15yrs) | 13.0 | 8.1 |
Reticulocyte counts, and the "kinetic" approach to anemia, have become more common than in the past in the large medical centers of the United States and some other wealthy nations, in part because some automatic counters now have the capacity to include reticulocyte counts. A reticulocyte Reticulocytes are immature red blood cells, typically composing about 1% of the red cells in the human body. Reticulocytes develop and mature in the red bone marrow and then circulate for about a day in the blood stream before developing into mature red blood cells. Like mature red blood cells, reticulocytes do not have a cell nucleus. They are count is a quantitative measure of the bone marrow Bone marrow is the flexible tissue found in the hollow interior of bones. In adults, marrow in large bones produces new blood cells. It constitutes 4% of total body weight, i.e. approximately 2.6 kg in adults's production of new red blood cells. The reticulocyte production index is a calculation of the ratio between the level of anemia and the extent to which the reticulocyte count has risen in response. If the degree of anemia is significant, even a "normal" reticulocyte count actually may reflect an inadequate response.
If an automated count is not available, a reticulocyte count can be done manually following special staining of the blood film. In manual examination, activity of the bone marrow can also be gauged qualitatively by subtle changes in the numbers and the morphology of young RBCs by examination under a microscope. Newly formed RBCs are usually slightly larger than older RBCs and show polychromasia. Even where the source of blood loss is obvious, evaluation of erythropoiesis Erythropoiesis is the process by which red blood cells are produced. It is stimulated by decreased O2 delivery to the kidneys, which then secrete the hormone erythropoietin . This activates increased erythropoiesis in the hemopoietic tissues. In postnatal birds and mammals (including humans), this usually occurs within the red bone marrow. In the can help assess whether the bone marrow will be able to compensate for the loss, and at what rate.
When the cause is not obvious, clinicians use other tests: ESR The erythrocyte sedimentation rate , also called a sedimentation rate or Biernacki Reaction, is the rate at which red blood cells precipitate in a period of 1 hour. It is a common hematology test which is a non-specific measure of inflammation. To perform the test, anticoagulated blood is placed in an upright tube, known as a Westergren tube, and, ferritin Ferritin is a ubiquitous intracellular protein that stores iron and releases it in a controlled fashion. The protein is produced by almost all living organisms, including bacteria, algae and higher plants, and animals. In humans, it acts as a buffer against iron deficiency and iron overload, serum iron Serum iron is a medical laboratory test that measures the amount of circulating iron that is bound to transferrin. Clinicians order this laboratory test when they are concerned about iron deficiency, which can cause anemia and other problems, transferrin Transferrin is a blood plasma protein for iron ion delivery that, in humans, is encoded by the TF gene. Transferrin is a glycoprotein that binds iron very tightly but reversibly. Although iron bound to transferrin is less than 0.1% of the total body iron, it is the most important iron pool, with the highest rate of turnover (25 mg/24 h), RBC folate level Folic acid and folate (the naturally occurring form), as well as pteroyl-L-glutamic acid and pteroyl-L-glutamate, are forms of the water-soluble vitamin B9. Folic acid is itself not biologically active, but its biological importance is due to tetrahydrofolate and other derivatives after its conversion to dihydrofolic acid in the liver, serum vitamin B12 Vitamin B12, vitamin B12 or vitamin B-12, also called cobalamin, is a water soluble vitamin with a key role in the normal functioning of the brain and nervous system, and for the formation of blood. It is one of the eight B vitamins. It is normally involved in the metabolism of every cell of the human body, especially affecting DNA synthesis and, hemoglobin electrophoresis Hemoglobin electrophoresis is a blood test that can detect different types of hemoglobin. It uses the principles of gel electrophoresis to separate out the various types of hemoglobin. The test can detect abnormal levels of HbS, the form associated with sickle-cell disease, as well as other abnormal hemoglobin-related blood disorders, such as, renal function Renal function, in nephrology, is an indication of the state of the kidney and its role in renal physiology. Glomerular filtration rate describes the flow rate of filtered fluid through the kidney. Creatinine clearance rate (CCr) is the volume of blood plasma that is cleared of creatinine per unit time and is a useful measure for approximating the tests (e.g. serum creatinine).
When the diagnosis remains difficult, a bone marrow examination Bone marrow examination refers to the pathologic analysis of samples of bone marrow obtained by bone marrow biopsy and bone marrow aspiration. Bone marrow examination is used in the diagnosis of a number of conditions, including leukemia, multiple myeloma, anemia, and pancytopenia. The bone marrow produces the cellular elements of the blood, allows direct examination of the precursors to red cells.
Classification
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Cambridge Network, UK
These sickle cells are also destroyed more quickly in the blood compared to normal blood cells, resulting in anaemia . The research team have discovered that deoxygenated sickle cells, unlike normal red blood cells, allow sugars into the cell when ...
bowersc
ue, 06 Jul 2010 13:55:31 GM
The CONDOR study found a lower risk of . anaemia. , mainly of presumed occult GI origin, with celecoxib compared to diclofenac plus PPI. However, rates of GI haemorrhage, obstruction or perforation were identical. ...
Q. i can sometimes sleep for a solid 16 hours even if i'm not that tired the previous night. if i sleep in, i don't wake up until 12 hours after i initially went to sleep. can having an iron deficiency cause me to do this? if not, what does?
Asked by kimberly. - Thu Dec 17 08:45:09 2009 - - 1 Answers - 0 Comments
A. Yes my gf has slight anemia, it has gotten better but she gets tired a lot and goes to sleep early and even when she sleeps 8 or 9 hours she is still wakes up tired. Its frustrating but you have to practice better dieting and exercise, drink more water, eat some bananas, no smoking, and try taking some iron supplements.
Answered by Gary K - Thu Dec 17 09:03:56 2009
