Main symptoms and
syndromes of patients with
different variants of anemia
Anemia is the decreasing of hemoglobin and
red blood cells amount in the unit of
blood volume
From data of WHO:
a hematocrit less than 40 in men and 37 in
women, or hemoglobin less than 130 g/l in
men and less than 120 g/l in women.
Actuality of theme:
Anemia is very
often met in 20%
women of the
developed
countries and in
50% women of the
non-developed
countries;
More than 50%
patients with
chronic diseases
and tumors;
Considerably
Clinical classification of anemia is
based on morphological prinsiple determination of mean corpuscular
volume (MCV) of red blood cells
MСV- is determined by automatic
laboratory analyzers or by such
formula: MСV = (hematocrit x10) /
amount of RBC (in mln/l).
Normocytic anemia
(MCV - 80-100)
•A loss or destruction of RBC is increased
- Acute bleeding
- Hemolytic anemia
- Hypersplenism
•Decreasing of RBC synthesis
- Deficiency anemia (iron, vitamin В12, folic acid)
- Renal insufficiency
- Anemia, caused by chronic diseases
- Endocrine dysfunctions
•Pathology of bone marrow (for example, action of
medications, infection, aplastic anemia,
myelodysplastic syndrome, plural mieloma and other
infiltrative diseases).
Microcytic anemia
(MCV less than 80)
- Iron-deficiency
anemia
- Thalassemia
- Anemia, caused by chronic diseases
- Sideroblastosis
- Hereditary anemia
- Lead poisoning
- Deficit of copper, poisoning by zinc
Makrocytic anemia
(MCV more than 100 fl)
- Megaloblastic anemia (vitamin В12 or folic acid
deficiency )
- Toxic effect of chemotherapeutic agents
(methotrexate) or other medications (zidovudine
(AZT), phenytoin)
- Pathology of bone marrow
- Chronic abuse by alcohol (toxic effect)
- Liver disease
Depends on the level of hemoglobin in the
blood anemia is divided on:
- light degree (Hb 110-90 g/l),
- middle degree (Hb 89-70 g/l),
- severe degree (Hb less than 69 g/l).
Depends on the size of RBC and their
saturation by hemoglobin (from data of colour
index - CI) anemia is divided on:
- Normocytic normochromic anemia: colour of RBC
is normal and CI is 0,86-1,1;
- Microcytic anemia (can be hypo- or normochromic):
microcytosis , anizopoykilocytosis, hypochromia, CI <
0,7;
- Makrocytic anemia : makrocytosis, even
megalocytosis, CI > 1,1.
ANEMIA CAUSES
•External bleeding: Loss of blood through heavy menstrual
bleeding, wounds, as well as stomach ulcers can cause anemia.
•Iron deficiency: The bone marrow needs iron to make red
blood cells.
•Anemia of chronic disease: Any long-term medical condition
can lead to anemia.
•Kidney disease: The kidneys help the bone marrow to make
red blood cells.
•Pregnancy: Water weight gain during pregnancy dilutes the
red blood cells.
•Poor nutrition: Vitamins and minerals are required to make
red blood cells.
•Alcoholism.
•Uncommon causes of anemia: bleeding disorders, liver
disease, thalassemia, infection, cancer, arthritis, enzyme
deficiency, sickle cell disease, hypothyroidism, toxins, or
hereditary conditions.
Signs and symptoms
Signs of anemia may include the following:
• Black and tarry stools (sticky and foul
smelling)
• Maroon, or visibly bloody stools
• Rapid heart rate
• Rapid breathing
• Pale or cold skin
• Yellow skin called jaundice
• Low blood pressure
• Heart murmur
• Enlargement of the spleen
Symptoms of anemia may include the following:
• Fatigue
• Trouble breathing
• Chest pain
• Abdominal pain
Diagnosis
The only way to diagnose anemia is with a blood test.
Generally, a full blood count is done. Apart from
reporting the amount of red blood cells and the
hemoglobin level, the automatic counters also
measure the size of the red blood cells, which is an
important tool in distinguishing between the causes.
Occasionally, other tests are required to further
distinguish the cause for anemia. These are discussed
with the differential diagnosis (below). The doctor may
also decide to take some other screening blood tests
that might identify the cause of fatigue; glucose levels,
ESR, ferritin, renal function tests and electrolytes
may be part of such a workup.
Lab tests for anemia may include
the following:
1. Complete blood count - Determines the severity of
the anemia and is almost always the first test ordered
2. Stool guaiac - Tests for blood in stool
3. Peripheral blood smear - Looks at the red blood
cells under a microscope
4. Iron level - Low iron is one of the most common
causes of anemia
5. Transferrin level - Looks at a protein that carries
iron around the body
6. Ferritin - Looks at the total iron available in the body
7. Folate - A vitamin needed to produce red blood
cells, which is low in people with poor eating habits
•
•
•
•
•
•
•
Vitamin B12 - A vitamin needed to produce red
blood cells, low in people with poor eating habits
Bilirubin - Useful to determine if the red blood cells
are being destroyed within the body
Lead level - Lead toxicity used to be one of the
more common causes of anemia
Hemoglobin electrophoresis - Sometimes used
when a person has a family history of anemia
Reticulocyte count - A measure of new red blood
cells produced by the bone marrow
Liver function tests - Uncommon tests to
determine how the liver is working
Bone marrow biopsy - One of the last tests done;
looks at production of red blood cells
Thank you for attention!