anemia

• Iron deficiency anemia (IDA) is caused by insufficient iron intake or increased loss of iron from the body.
• Vitamin B12 deficiency can lead to pernicious anemia if there are no intrinsic factor-producing cells left in the stomach.
• Vitamin B12 and folate are essential cofactors required for normal red cell production.
• Iron deficiency anemia (IDA) is caused by insufficient iron intake or increased loss of iron from the body.
• Symptoms of IDA include fatigue, weakness, shortness of breath, pale skin, brittle nails, and hair loss.
• Diagnosis of IDA involves measuring hemoglobin levels, hematocrit, mean corpuscular volume (MCV), red cell count, serum ferritin level, transferrin saturation, and total iron-binding capacity (TIBC).
• Folic acid deficiency can be due to poor dietary intake, malabsorption syndromes, pregnancy, alcoholism, or medications such as anticonvulsants and methotrexate.
• Anemias associated with chronic diseases include hemolytic anemia, which occurs when red blood cells break down faster than they can be replaced, leading to low levels of hemoglobin and hematocrit.
• Hemolysis refers to the destruction of RBCs, while hemorrhage involves bleeding.
• The most common cause of vitamin B12 deficiency is lack of dietary sources due to strict vegetarianism.
• Pernicious anemia occurs when the stomach does not produce enough intrinsic factor, which leads to malabsorption of vitamin B12.
• Folate deficiency anemia occurs when dietary sources of folic acid are not sufficient, leading to decreased RBC synthesis.
• Pernicious anemia is characterized by large, pale RBCs with nuclei that appear swollen and have more than five lobes.
• Treatment options for IDA include dietary changes, supplementation with oral iron preparations, and parenteral administration of iron dextran.
• The most common cause of folic acid deficiency anemia is poor nutrition due to poverty, alcoholism, or malabsorption disorders such as celiac disease.
• Pernicious anemia is characterized by macrocytic RBCs due to vitamin B12 deficiency.
• The most common cause of pernicious anemia is lack of intrinsic factor produced by gastric parietal cells.
• The symptoms of folic acid deficiency anemia (FDAn) include fatigue, weakness, pallor, irritability, headache, sore tongue, glossitis, diarrhea, and weight loss.
• Thalassemia major is characterized by severe microcytic hypochromic anemia, splenomegaly, jaundice, and growth retardation.
• Other causes of hemolytic anemia include autoimmune disorders like AIHA, where antibodies attack healthy RBCs, and mechanical trauma, such as sickle cell disease.
• Pernicious anemia is caused by autoimmune gastritis, where antibodies attack parietal cells that produce intrinsic factor needed for absorption of vitamin B12.
• Anemia is a decrease in Hemoglobin (Hgb) or Red Blood Cells (RBC) resulting in decreased oxygen carrying capacity of blood.
• Anemia can result from a decrease in RBC production, an increase in RBC loss, or an increase in RBC destruction.
• Erythropoiesis is the erythrocyte maturation sequence of RBCs, a process that takes about 1 week.
• Normal MCV is 80-100 fL.
• Drugs to avoid in G6PD deficiency as they increase hemolysis include ascorbic acid, NSAIDs, Nitrofurantoin, and Sulphamethoxazole.
• Hemolysis usually begins 1-3 days after initiating drug.
• Urine becomes dark secondary to urobilinogen.
• Jaundice is a common symptom of hemolysis.
• Erythropoiesis is controlled by Erythropoietin (EPO), which is released by the kidney in response to reduced tissue oxygenation caused by a reduction in hemoglobin.
• EPO increases the rate of mitosis and the release of reticulocytes from the bone marrow.
• Iron absorption in the adult body is about 10 - 30 mg per day.
• Iron is required by many of the chemical reactions (i.e oxidation - reduction reactions).
• To be absorbed, dietary iron can be absorbed as part of a protein such as heme protein or must be in its ferrous Fe 2 + form.
• A ferric reductase enzyme on the enterocytes reduces ferric Fe 3 + to Fe 2 +.
• Normal hematological values for adult females are 36 - 46% Hematocrit (Hct), 12 - 16% Hemoglobin (Hgb), 0.5 - 1.5 Micron Corpuscular Volume (MCV), 250 - 400 Reticulocyte count, 11.5 - 14.5 Total Iron Binding Capacity (TIBC), and 12.0 - 14.0 Red Blood Cell Distribution Width (RDW).
• Hematocrit is a blood test that measures the percentage of red blood cells found in whole blood.
• Mean corpuscular volume (MCV) is a measure of the average red blood cell volume (i.e size) that is reported as part of a standard complete blood count.
• In patients with anemia, it is the MCV measurement that allows classification as either a microcytic anemia (MCV below normal range) or macrocytic anemia (MCV above normal range).
• Total iron binding capacity (TIBC) is a blood test that shows if there is too much or too little iron in the blood.