Anemia - Symptoms and causes

 ANEMIA

Anemia - Symptoms and causes

Anemia may be defined as a state in which the blood hemoglobin level is below 13.5 g/dl in an adult male and below 11.5 g/dl in an adult female.

Symptoms

a. Fatigue

b. Headache

c. Faintness

d. Breathlessness

e. Angina of effort

f. Palpitation

g. Intermittent claudication

Signs

Non-specific Paler skin, conjunctiva & mucous membrane

- Tachycardia

- High volume pulse

- Ankle edema

- Cardiac failure

- Systolic flow murmur

Specific

Koilonychia (spoon-shaped nails) in iron deficiency. Jaundice-in hemolytic anemia, Bone deformities- in thalassemia major, and Leg ulcers in sickle cell anemia

CLASSIFICATION

There are two classifications According to the cause. related to red blood cell morphology.

Classification according to the cause:

- Inadequate production of RBC

- Blood loss anemia

- Acute-due to acute hemorrhage

- Chronic due to GlT bleeding,

- menorrhagia.

- Excessive destruction of RBC (hemolysis)

CLASSIFICATION ACCORDING TO THE

MORPHOLOGY

This is the most useful classification and mostly classified this is according to anemias classification.

MICROCYTIC (MCV > 100f)

- Iron deficiency anemia

- Thalassemia minor

- Sideroblastic anemia

- Lead poisoning

MACROCYTIC (MCV> 100 f)

Megaloblastic: due to vitamin B12 and folic acid deficiency. Severely macrocytic anemia is almost always due to megaloblastic anemia.

Macrocytic without megaloblastic: due to alcohol excess cirrhosis of the liver, hypothyroidism and reticulocytosis, marrow infiltration, and myelodysplastic syndrome.

NORMOCYTIC (80-100 n)

- Aplastic anemia (bone 1arrow Failure)

- Myelodysplastic syndrome

.- Anemia or chronic diseases such as connective tissue disease, tuberculosis, or chronic renal failure.

Endocrine disorders e.g. hypothyroidism, hypopituitarism & Addison's disease.

Hemolytic anemias

- Malignancy

- Malnutrition

MICROCYTIC ANEMIA

Causes of microcytic anemia 

- Iron deficiency anemia

- Thalassemia minor

- Sideroblastic anemia

- Lead poisoning

- Anemia of chronic disease

IRON DEFICIENCY ANEMIA

Iron deficiency anemia develops when there is an inadequate amount of iron for hemoglobin

synthesis.

CAUSES OF IRON DEFICIENCY

- Poor intake

- Decreased absorption (Celiac disease, gastrectomy)

- Demand in growing pregnancy.

- Blood loss from GIT due to:

- Hookworm infestation 

- From erosions associated with anti

- inflammatory drugs, peptic ulcers, or neoplastic disease.

- Hemorrhoids

- irregular menses periods.

CLINICAL FEATURES

Features of anemia described earlier *Features due to iron deficiency in the tissues producing epithelial changes are the following Brittle nails & nail cracking are common but flattening or concavity of nails (koilonychia) may be present Atrophy of the papillae of the tongue Angular stomatitis Brittle hair. Plummer-Vinson Syndrome: consists of iron deficiency anemia and dysphagia, due to esophageal webs usually in middle-aged Women.