Anemia Classification and external resources
ICD-10	D50.-D64.
ICD-9	280-285
DiseasesDB	663
MedlinePlus	000560
eMedicine	med/132  emerg/808 emerg/734
MeSH	D000740

Anemia (AmE) or anæmia/anaemia (BrE), from the Greek (Ἀναιμία) (an-haîma) meaning "without blood," is defined as a qualitative or quantitative deficiency of hemoglobin, a molecule inside red blood cells (RBCs). A fern is any one of a group of about 20000 Species of Plants classified in the phylum or division Pteridophyta, also known as Filicophyta Species of the genus Anemia are sometimes called flowering ferns but this term is more commonly applied to ferns of the genus Osmunda. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The International Statistical Classification of Diseases and Related Health Problems 10th Revision ( ICD -10) is a coding of diseases and signs symptoms abnormal findings The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify Diseases The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. The Diseases Database is a free Website that provides information about the relationships between medical conditions Symptoms, and Medications. MedlinePlus, with the MedlinePlus Medical Encyclopedia, is a website network containing Health information from the world's largest medical Library eMedicine is an online clinical medical knowledge base that was founded in 1996 by Scott Plantz and Richard Lavely two medical doctors Medical Subject Headings ( MeSH) is a huge Controlled vocabulary (or metadata system for the purpose of indexing journal articles and books Phonology North American English regional phonology In many ways compared to English English, North American English is conservative in its Phonology. British English or UK English ( BrE, BE, en-GB) is the broad term used to distinguish the forms of the English language used in the Greek (el ελληνική γλώσσα or simply el ελληνικά — "Hellenic" is an Indo-European language, spoken today by 15-22 million people mainly Hemoglobin ( also spelled haemoglobin and abbreviated Hb or Hgb) is the Iron -containing Oxygen -transport Metalloprotein Red blood cells are the most common type of Blood cell and the Vertebrate body's principal means of delivering Oxygen to the body tissues via the Blood As hemoglobin carries oxygen from the lungs to the tissues, anemia leads to hypoxia (lack of oxygen) in organs. Oxygen (from the Greek roots ὀξύς (oxys (acid literally "sharp" from the taste of acids and -γενής (-genēs (producer literally begetteris the Tissue is a cellular organizational level intermediate between cells and a complete organism Chronic Hypoxia is a pathological condition in which the body as a whole ( generalized hypoxia) or region of the body ( tissue hypoxia) is deprived of adequate Since all human cells depend on oxygen for survival, varying degrees of anemia can have a wide range of clinical consequences. Oxygen (from the Greek roots ὀξύς (oxys (acid literally "sharp" from the taste of acids and -γενής (-genēs (producer literally begetteris the

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). Bleeding, technically known as hemorrhaging / haemorrhaging (see American and British spelling differences) is the loss of Blood from Hemolysis (or haemolysis)—from the Greek Hemo-, Greek meaning blood - Lysis, meaning to break open—is the breaking Haematopoiesis (from Ancient Greek haima blood poiesis to make (or hematopoiesis in the United States sometimes also haemopoiesis or

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.

There are two major approaches of classifying anemias, the "kinetic" approach which involves evaluating production, destruction and loss^[1], 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 MCV, is a measure of the average Red blood cell volume (i On the other hand, focusing early on the question of production may allow the clinician more rapidly to expose cases where multiple causes of anemia coexist.

Contents 1 Signs and symptoms 2 Diagnosis 3 Classification 3.1 Production vs. destruction or loss 3.2 Red blood cell size 3.2.1 Microcytic anemia 3.2.2 Normocytic anemia 3.2.3 Macrocytic anemia 3.2.4 Dimorphic anemia 3.2.5 Heinz body anemia 4 Specific anemias 5 Possible complications 6 Anemia during pregnancy 7 Treatments for anemia 7.1 Blood transfusions for anemia 7.2 Hyperbaric Oxygenation 8 References 9 Books 10 See also 11 External links

Signs and symptoms

Anemia goes undetected in many people, and symptoms can be small and vague. Most commonly, people with anemia report a feeling of weakness or fatigue in general or during exercise, general malaise and sometimes poor concentration. Malaise is a feeling of general discomfort or uneasiness an "out of sorts" feeling often the first indication of an infection or other disease People with more severe anemia often report dyspnea (shortness of breath) on exertion. Dyspnea or dyspnoea (pronounced disp-nee-ah, IPA /dɪsp'niə/ from Latin dyspnoea, from Greek dyspnoia from Very severe anemia prompts the body to compensate by increasing cardiac output, leading to palpitations and sweatiness, and to heart failure. Cardiac output (Q is the volume of blood being pumped by the Heart, in particular by a ventricle in a minute A palpitation (medical term ectopic heart beat) is an abnormal awareness of the beating of the Heart, whether it is too slow too fast irregular Heart failure is a Cardiac condition that occurs when a problem with the structure or function of the Heart impairs its ability to supply

Pallor (pale skin, mucosal linings and nail beds) is often a useful diagnostic sign in moderate or severe anemia, but it is not always apparent. Pallor (also called pastiness or wanness) is a reduced amount of oxy Hemoglobin in Skin or Mucous membrane, a pale color which can A nail is a horn -like structure at the end of an animal's Finger or Toe. Other useful signs are cheilosis and koilonychia. Angular cheilitis (also called perlèche cheilosis or angular stomatitis) is an inflammatory lesion at the labial commissure or corner of the mouth and often occurs bilaterally Koilonychia is a Nail disease that can be a sign of iron-deficiency Anemia.

Pica, the consumption of non-food such as dirt, paper, wax, grass and hair, may be a symptom of iron deficiency, although it occurs often in those who have normal levels of hemoglobin. Pica is a medical disorder characterized by an Appetite for largely non-nutritive substances (e

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.

Diagnosis

Generally, clinicians request complete blood counts in the first batch of blood tests in the diagnosis of an anemia. A complete blood count ( CBC) also known as full blood count ( FBC) or full blood exam ( FBE) or blood panel, is Apart from reporting the number of red blood cells and the hemoglobin level, the automatic counters also measure the size of the red blood cells by flow cytometry, which is an important tool in distinguishing between the causes of anemia. Red blood cells are the most common type of Blood cell and the Vertebrate body's principal means of delivering Oxygen to the body tissues via the Blood Hemoglobin ( also spelled haemoglobin and abbreviated Hb or Hgb) is the Iron -containing Oxygen -transport Metalloprotein 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 Flow cytometry is a technique for counting examining and sorting microscopic particles suspended in a stream of fluid Examination of a stained blood smear using a microscope can also be helpful, and is sometimes a necessity in regions of the world where automated analysis is less accessible. A Blood Film or Peripheral Blood Smear is a slide made from a drop of Blood, that allows the cells to be examined microscopically A microscope ( Greek: ( micron) = small + ( skopein) = to look or see is an instrument for viewing objects that are

In modern counters, four parameters (RBC count, hemoglobin concentration, MCV and RDW) are measured, allowing others (hematocrit, MCH and MCHC) to be calculated, and compared to values adjusted for age and sex. The mean corpuscular volume, or MCV, is a measure of the average Red blood cell volume (i 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 The hematocrit ( Ht or HCT) or packed cell volume ( PCV) or erythrocyte volume fraction (EVF is the proportion of Blood The mean corpuscular hemoglobin, or "mean cell hemoglobin" ( MCH) is the average mass of Hemoglobin per Red blood cell in a sample of blood The mean corpuscular hemoglobin concentration, or MCHC, is a measure of the concentration of Hemoglobin in a given volume of packed Red blood cell. Some counters estimate hematocrit from direct measurements. For adult men, a hemoglobin level less than 13. 0 g/dl (grams per deciliter) is diagnostic of anemia, and for adult women, the diagnostic threshold is below 12. 0 g/dl.

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 count is a quantitative measure of the bone marrow's production of new red blood cells. Reticulocytes are immature Red blood cells typically composing about 1% of the red cells in the human body 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 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. The Reticulocyte production index (RPI also called a corrected reticulocyte count) is a calculated value used in the diagnosis of Anemia. 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 can help assess whether the bone marrow will be able to compensate for the loss, and at what rate. Erythropoiesis is the process by which Red blood cells (erythrocytes are produced

When the cause is not obvious, clinicians use other tests: ESR, ferritin, serum iron, transferrin, RBC folate level, serum vitamin B12, hemoglobin electrophoresis, renal function tests (e. The erythrocyte sedimentation rate (ESR also called a sedimentation rate, sed rate, or Biernacki Reaction, is the rate at which Red blood cells Ferritin is a Globular protein complex consisting of 24 protein subunits and is the main intracellular iron storage protein in both Prokaryotes Serum iron is a medical laboratory test that measures the amount of circulating Iron that is bound to Transferrin. Transferrin is a Blood plasma Protein for Iron Ion delivery Transferrin is a Glycoprotein, which binds iron very tightly but reversibly Folic acid (also known as Vitamin M and Folacin) and Folate (the Anionic form are forms of the water-soluble Vitamin B9 Haemoglobin electrophoresis is a Blood test that can detect different types of Haemoglobin. Renal function, in Nephrology, is an indication of the state of the Kidney and its role in Renal physiology. g. serum creatinine). Creatinine is a break-down product of Creatine phosphate in Muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass

When the diagnosis remains difficult, a bone marrow examination allows direct examination of the precursors to red cells. Bone marrow examination refers to the pathologic analysis of samples of Bone marrow obtained by bone marrow biopsy (often called a Trephine biopsy

Classification

Production vs. destruction or loss

The "kinetic" approach to anemia yields what many argue is the most clinically relevant classification of anemia. This classification depends on evaluation of several hematological parameters, particularly the blood reticulocyte (precursor of mature RBCs) count. Reticulocytes are immature Red blood cells typically composing about 1% of the red cells in the human body This then yields the classification of defects by decreased RBC production versus increased RBC destruction and/or loss. Clinical signs of loss or destruction include abnormal peripheral blood smear with signs of hemolysis; elevated LDH suggesting cell destruction; or clinical signs of bleeding, such as guiaic-positive stool, radiographic findings, or frank bleeding. A Blood Film or Peripheral Blood Smear is a slide made from a drop of Blood, that allows the cells to be examined microscopically Lactate dehydrogenase ( LDH) is an Enzyme ( present in a wide variety of organisms including plants and animals

Here is a simplified schematic of this approach:

Anemia

Reticulocyte production index shows inadequate production response to anemia. The Reticulocyte production index (RPI also called a corrected reticulocyte count) is a calculated value used in the diagnosis of Anemia.

Reticulocyte production index shows appropriate response to anemia = ongoing hemolysis or blood loss without RBC production problem. The Reticulocyte production index (RPI also called a corrected reticulocyte count) is a calculated value used in the diagnosis of Anemia.

No clinical findings consistent with hemolysis or blood loss: pure disorder of production.

Clinical findings and abnormal MCV: hemolysis or loss and chronic disorder of production*.

Clinical findings and normal MCV= acute hemolysis or loss without adequate time for bone marrow production to compensate**. 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

Macrocytic anemia (MCV>100)

Normocytic anemia (80<MCV<100)

Microcytic anemia (MCV<80)

* For instance, sickle cell anemia with superimposed iron deficiency; chronic gastric bleeding with B12 and folate deficiency; and other instances of anemia with more than one cause. Microcytic Anaemia is a generic term for any type of anemia characterized by small red Blood cells The normal Mean corpuscular volume (abbreviated to MCV ** Confirm by repeating reticulocyte count: ongoing combination of low reticulocyte production index, normal MCV and hemolysis or loss may be seen in bone marrow failure or anemia of chronic disease, with superimposed or related hemolysis or blood loss.

Red blood cell size

In the morphological approach, anemia is classified by the size of red blood cells; this is either done automatically or on microscopic examination of a peripheral blood smear. The size is reflected in the mean corpuscular volume (MCV). The mean corpuscular volume, or MCV, is a measure of the average Red blood cell volume (i If the cells are smaller than normal (under 80 fl), the anemia is said to be microcytic; if they are normal size (80-100 fl), normocytic; and if they are larger than normal (over 100 fl), the anemia is classified as macrocytic. The litre or liter (see spelling differences) is a unit of Volume. This scheme quickly exposes some of the most common causes of anemia; for instance, a microcytic anemia is often the result of iron deficiency. For a more specific and detailed discussion of Anemia caused by iron deficiency see the Wikipedia article Iron deficiency anemia. In clinical workup, the MCV will be one of the first pieces of information available; so even among clinicians who consider the "kinetic" approach more useful philosophically, morphology will remain an important element of classification and diagnosis.

Here is a schematic representation of how to consider anemia with MCV as the starting point:

Anemia

Macrocytic anemia (MCV>100)

Normocytic anemia (80<MCV<100)

Microcytic anemia (MCV<80)

High reticulocyte count

Low reticulocyte count

Other characteristics visible on the peripheral smear may provide valuable clues about a more specific diagnosis; for example, abnormal white blood cells may point to a cause in the bone marrow. Microcytic Anaemia is a generic term for any type of anemia characterized by small red Blood cells The normal Mean corpuscular volume (abbreviated to MCV Reticulocytes are immature Red blood cells typically composing about 1% of the red cells in the human body Reticulocytes are immature Red blood cells typically composing about 1% of the red cells in the human body 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

Microcytic anemia

Microcytic anemia is primarily a result of hemoglobin synthesis failure/insufficiency, which could be caused by several etiologies:

• Heme synthesis defect
  • Iron deficiency anemia
  • Anemia of chronic disease (more commonly presenting as normocytic anemia)
• Globin synthesis defect
  • alpha-, and beta-thalassemia
  • HbE syndrome
  • HbC syndrome
  • and various other unstable hemoglobin diseases
• Sideroblastic defect
  • Hereditary sideroblastic anemia
  • Acquired sideroblastic anemia, including lead toxicity
  • Reversible sideroblastic anemia

Iron deficiency anemia is the most common type of anemia overall and it has many causes. For a discussion of iron deficiency more broadly see the Wikipedia article iron deficiency. Anemia of chronic disease, increasingly referred to as "anemia of inflammation" is a form of Anemia seen in chronic illness e Thalassemia (from Greek θαλασσα thalassa sea + αίμα haima blood British spelling "thalassaemia" is an inherited Autosomal recessive Lead poisoning (also known as saturnism, plumbism, or painter's colic) is a medical condition caused by increased levels of the metal Lead in RBCs often appear hypochromic (paler than usual) and microcytic (smaller than usual) when viewed with a microscope.

• Iron deficiency anemia is caused by insufficient dietary intake or absorption of iron to replace losses from menstruation or losses due to diseases. Iron (ˈаɪɚn is a Chemical element with the symbol Fe (ferrum and Atomic number 26 ^[2] Iron is an essential part of hemoglobin, and low iron levels result in decreased incorporation of hemoglobin into red blood cells. In the United States, 20% of all women of childbearing age have iron deficiency anemia, compared with only 2% of adult men. The principal cause of iron deficiency anemia in premenopausal women is blood lost during menses. See also "Mensuration" a term sometimes used to describe Measurement, particularly in the context of Forestry. Studies have shown that iron deficiency without anemia causes poor school performance and lower IQ in teenage girls. An Intelligence Quotient or IQ is a score derived from one of several different Standardized tests attempting to measure Intelligence. Iron deficiency is the most prevalent deficiency state on a worldwide basis. Iron deficiency is sometimes the cause of abnormal fissuring of the angular (corner) sections of the lips (angular stomatitis). Angular cheilitis (also called perlèche cheilosis or angular stomatitis) is an inflammatory lesion at the labial commissure or corner of the mouth and often occurs bilaterally
• Iron deficiency anemia can also be due to bleeding lesions of the gastrointestinal tract. Fecal occult blood testing, upper endoscopy and lower endoscopy should be performed to identify bleeding lesions. Faecal occult blood is a term for Blood present in the Faeces that is not visibly apparent Colonoscopy is the endoscopic examination of the large colon and the distal part of the small bowel with a CCD camera or a Fiber optic In men and post-menopausal women the chances are higher that bleeding from the gastrointestinal tract could be due to colon polyp or colorectal cancer. A polyp is an abnormal growth of tissue ( Tumor) projecting from a Mucous membrane. Colorectal cancer, also called colon cancer or large bowel cancer, includes Cancerous growths in the colon, Rectum and
• Worldwide, the most common cause of iron deficiency anemia is parasitic infestation (hookworm, amebiasis, schistosomiasis and whipworm). The hookworm is a parasitic Nematode worm that lives in the Small intestine of its host which may be a Mammal such as a Dog, Amoebiasis, or Amebiasis is caused by the Amoeba Entamoeba histolytica. Schistosomiasis (also known as bilharzia, bilharziosis or snail fever) is a Parasitic disease caused by several species of fluke The human whipworm ( Trichuris trichiura or Trichocephalus trichiuris) is a Roundworm, which causes Trichuriasis when it infects ^[3]

Normocytic anemia

Normocytic anaemia occurs when the overall hemoglobin levels are always decreased, but the red blood cell size (Mean corpuscular volume) remains normal. The mean corpuscular volume, or MCV, is a measure of the average Red blood cell volume (i Causes include:

• Acute blood loss
• Anemia of chronic disease
• Aplastic anemia (bone marrow failure)
• Hemolytic anemia

Macrocytic anemia

• Megaloblastic anemia, the most common cause of macrocytic anemia, is due to a deficiency of either vitamin B12, folic acid (or both). Bleeding, technically known as hemorrhaging / haemorrhaging (see American and British spelling differences) is the loss of Blood from Anemia of chronic disease, increasingly referred to as "anemia of inflammation" is a form of Anemia seen in chronic illness e Hemolytic anemia is Anemia due to Hemolysis, the abnormal breakdown of Red blood cells (RBCs either in the Blood vessels (intravascular hemolysis Megaloblastic anemia is an Anemia (of macrocytic classification which results from inhibition of DNA synthesis in red blood cell production Folic acid (also known as Vitamin M and Folacin) and Folate (the Anionic form are forms of the water-soluble Vitamin B9 Deficiency in folate and/or vitamin B12 can be due either to inadequate intake or insufficient absorption. Malabsorption is a state arising from abnormality in Digestion or Absorption of food nutrients across the gastrointestinal(GI tract. Folate deficiency normally does not produce neurological symptoms, while B12 deficiency does.
  • Pernicious anemia is an autoimmune condition thought to be due to a directed attack against intrinsic factor produced by the parietal cells of the stomach. Pernicious anemia (also known as Biermer's anemia, Addison's anemia, or Addison-Biermer anemia) is a form of Megaloblastic anemia due to Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which results in an immune response against its own cells and tissues Intrinsic factor is a Glycoprotein produced by the Parietal cells of the Stomach. Parietal cells (also called oxyntic cells) are the Stomach Epithelium cells that secrete Gastric acid and Intrinsic factor Intrinsic factor is required to absorb vitamin B12 from food. Therefore, the destruction of intrinsic factor, leads to poor absorption of vitamin B12.
  • Macrocytic anemia can also be caused by removal of the functional portion of the stomach, such as during gastric bypass surgery, leading to reduced vit B12/folate absorption. Gastric bypass procedures (GBP are any of a group of similar operations used to treat Morbid obesity —the severe accumulation of excess weight as fatty tissue—and the health Therefore one must always be aware of anemia following this procedure.
• Alcoholism causes a macrocytosis, although not specifically anemia
• Methotrexate, zidovudine, and other drugs that inhibit DNA replication. Alcoholism is a term with multiple and sometimes conflicting definitions Zidovudine ( INN) or azidothymidine ( AZT) (also called ZDV is a nucleoside analog reverse transcriptase inhibitor (NRTI a type of Antiretroviral DNA replication is the process of copying a double-stranded DNA molecule to form two double-stranded molecules

Macrocytic anemia can be further divided into "megaloblastic anemia" or "non-megaloblastic macrocytic anemia". The cause of megaloblastic anemia is primarily a failure of DNA synthesis with preserved RNA synthesis, which result in restricted cell division of the progenitor cells. The megaloblastic anemias often present with neutrophil hypersegmentation (6-10 lobes). The non-megaloblastic macrocytic anemias have different etiologies (i. e. there is unimpaired DNA globin synthesis,) which occur, for example in alcoholism.

In addition to the non-specific symptoms of anemia, specific features of vitamin B12 deficiency include peripheral neuropathy and subacute combined degeneration of the cord with resulting balance difficulties from posterior column spinal cord pathology. Peripheral neuropathy is the term for damage to Nerves of the Peripheral nervous system, which may be caused either by diseases of the Nerve or from the ^[4] Other features may include a smooth, red tongue and glossitis. Glossitis is Inflammation or Infection of the Tongue. It causes the tongue to swell and change color

The treatment for vitamin B12-deficient anemia was first devised by William Murphy who bled dogs to make them anemic and then fed them various substances to see what (if anything) would make them healthy again. He discovered that ingesting large amounts of liver seemed to cure the disease. George Minot and George Whipple then set about to chemically isolate the curative substance and ultimately were able to isolate the vitamin B12 from the liver. George Richards Minot ( December 2, 1885 in Boston, Massachusetts &ndash February 25, 1950) won the 1934 Nobel George Hoyt Whipple ( August 28, 1878 &ndash February 1, 1976) was an American physician biomedical researcher and medical school educator All three shared the 1934 Nobel Prize in Medicine. Year 1934 ( MCMXXXIV) was a Common year starting on Monday (link will display full 1934 calendar of the Gregorian calendar. The Nobel Prize in Physiology or Medicine (Nobelpriset i fysiologi eller medicin is awarded once a year by the Swedish Karolinska Institute. ^[5]

Dimorphic anemia

When two causes of anemia act simultaneously, e. g. , macrocytic hypochromic, due to hookworm infestation leading to deficiency of both iron and vitamin B12 or folic acid ^[6] or following a blood transfusion more than one abnormality of red cell indices may be seen. The mean corpuscular hemoglobin concentration, or MCHC, is a measure of the concentration of Hemoglobin in a given volume of packed Red blood cell. The hookworm is a parasitic Nematode worm that lives in the Small intestine of its host which may be a Mammal such as a Dog, Iron (ˈаɪɚn is a Chemical element with the symbol Fe (ferrum and Atomic number 26 Folic acid (also known as Vitamin M and Folacin) and Folate (the Anionic form are forms of the water-soluble Vitamin B9 Blood transfusion is the process of transferring Blood or blood-based products from one person into the Circulatory system of another Evidence for multiple causes appears with an elevated RBC distribution width (RDW), which suggests a wider-than-normal range of red cell sizes.

Heinz body anemia

Heinz bodies are an abnormality that form on the cells in this condition. Heinz bodies (also referred to as "Heinz-Ehrlich bodies" are inclusions within Red blood cells composed of denatured Hemoglobin. This form of anemia may be brought on by taking certain medications; it is also triggered in cats by eating onions^[7] or acetaminophen (Tylenol). WikipediaManual of Style (spelling, articles should conform to one overall spelling style of English typically the one most linked to the article topic (if it is geographic Organicsalsajpg||thumb|right|Onions used in salsa.]]Cooked onions in frying pan Paracetamol ( INN) (ˌpærəˈsiːtəmɒl -ˈsɛtə- or acetaminophen ( USAN) is a widely-used Analgesic and Antipyretic Medication It can be triggered in dogs by ingesting onions or zinc, and in horses by ingesting dry red maple leaves. The dog ( Canis lupus familiaris) is a domesticated Subspecies of the gray wolf, a Mammal of the Canidae family of the order Zinc (ˈzɪŋk from Zink is a Metallic Chemical element with the symbol Zn and Atomic number 30 Acer rubrum ( Red Maple, also known as Swamp or Soft Maple) is one of the most common and widespread deciduous Trees of eastern

Specific anemias

• Anemia of prematurity occurs in premature infants at 2 to 6 weeks of age and results from diminished erythropoietin response to declining hematocrit levels
• Fanconi anemia is an 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. Pathophysiology Preterm infants are often anemic and typically experience heavy blood losses from frequent laboratory testing in the first few weeks of life Fanconi anemia (FA is a genetic disease that affects children and adults from all ethnic backgrounds Hemolytic anemia is Anemia due to Hemolysis, the abnormal breakdown of Red blood cells (RBCs either in the Blood vessels (intravascular hemolysis Jaundice, also known as icterus (attributive adjective "icteric" is yellowish discoloration of the Skin, sclerae (whites of the eyes Lactate dehydrogenase ( LDH) is an Enzyme ( present in a wide variety of organisms including plants and animals It can be autoimmune, immune, hereditary or mechanical (e. Autoimmunity is the failure of an organism to recognize its own constituent parts as self, which results in an immune response against its own cells and tissues Immunity is a material term that describes a state of having sufficient biological defenses to avoid Infection, Disease, or other unwanted biological invasion A genetic disorder is a condition caused by abnormalities in Genes or Chromosomes While some diseases such as Cancer, are due to genetic abnormalities acquired g. heart surgery). Cardiac surgery is Surgery on the Heart and/or Great vessels performed by a Cardiac surgeon. 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. Hereditary spherocytosis is a genetically-transmitted form of Spherocytosis, an auto- hemolytic Anemia characterized by the production of red blood cells 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. Sickle-cell disease or sickle-cell anaemia (or anemia) is a Blood disorder characterized by Red blood cells that assume an abnormal rigid Zygosity refers to the genetic condition of a Zygote. In genetics zygosity describes the similarity or dissimilarity of DNA between Homologous
• 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 anaemia due to vitamin B12 deficiency dependent on impaired absorption of vitamin B12. Warm Antibody Autoimmune Hemolytic Anemia (AIHA is the most common of the autoimmune hemolytic diseases Pernicious anemia (also known as Biermer's anemia, Addison's anemia, or Addison-Biermer anemia) is a form of Megaloblastic anemia due to Megaloblastic anemia is an Anemia (of macrocytic classification which results from inhibition of DNA synthesis in red blood cell production
• 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.

Possible complications

Anemia diminishes the capability of individuals who are affected to perform physical activities. This is a result of one's muscles being forced to depend on anaerobic metabolism. Fermentation is the process of deriving energy from the oxidation of organic compounds such as carbohydrates using an endogenous electron acceptor which is The lack of iron associated with anemia can cause many complications, including hypoxemia, brittle or rigid fingernails, cold intolerance, and possible behavioral disturbances in children. Chronic Hypoxia is a pathological condition in which the body as a whole ( generalized hypoxia) or region of the body ( tissue hypoxia) is deprived of adequate Brittle nails is a condition where the nails are fragile and break frequently Hypoxemia resulting from anemia can worsen the cardio-pulmonary status of patients with pre-existing chronic pulmonary disease. Cold intolerance occurs in one in five patients with iron deficiency anemia, and becomes visible through numbness and tingling.

Anemia during pregnancy

Anemia affects 20% of all females of childbearing age in the United States. Because of the subtlety of the symptoms, women are often unaware that they have this disorder, as they attribute the symptoms to the stresses of their daily lives. Possible problems for the fetus include increased risk of growth retardation, prematurity, intrauterine death, rupture of the amnion and infection. A stillbirth occurs when a Fetus which has died in the Uterus or during labor or delivery exits a Woman 's body For the alien race in Stephen Donaldson 's The Gap Cycle, see Amnion (Gap Cycle.

During pregnancy, women should be especially aware of the symptoms of anemia, as an adult female loses an average of two milligrams of iron daily. Therefore, she must intake a similar quantity of iron in order to make up for this loss. Additionally, a woman loses approximately 500 milligrams of iron with each pregnancy, compared to a loss of 4-100 milligrams of iron with each period. The menstrual cycle is a recurring cycle of physiologic changes that occurs in reproductive-age Females Overt menstruation (where there is blood flow from the Possible consequences for the mother include cardiovascular symptoms, reduced physical and mental performance, reduced immune function, tiredness, reduced peripartal blood reserves and increased need for blood transfusion in the postpartum period.

Treatments for anemia

There are many different treatments for anemia and the treatment depends on severity and the cause.

Iron deficiency from nutritional causes is rare in non-menstruating adults (men and post-menopausal women). The diagnosis of iron deficiency mandates a search for potential sources of loss such as gastrointestinal bleeding from ulcers or colon cancer. Mild to moderate iron deficiency anemia is treated by iron supplementation with ferrous sulfate or ferrous gluconate. Iron(II sulfate or ferrous sulfate is the Chemical compound with the formula ( Fe[[Sulfur S]] O 4 Vitamin C may aid in the body's ability to absorb iron. Vitamin C or L-ascorbate is an Essential nutrient for a large number of higher primate species a small number of other Mammalian

Vitamin supplements given orally (folic acid) or subcutaneously (vitamin B-12) will replace specific deficiencies. Folic acid (also known as Vitamin M and Folacin) and Folate (the Anionic form are forms of the water-soluble Vitamin B9 Cyanocobalamin is an especially common Vitamer of the B-12 vitamin family.

In anemia of chronic disease, anemia associated with chemotherapy, or anemia associated with renal disease, some clinicians prescribe recombinant erythropoietin, epoetin alfa, to stimulate red cell production. Recombinant DNA is a form of synthetic DNA that is engineered through the combination or insertion of one or more DNA strands thereby combining DNA sequences Erythropoietin (ɨˌɹɪθɹoʊˈpɔɪɨtɨn /ɨˌɹɪθɹoʊˈpɔɪtən/ or /ɨˌɹiːθɹoʊ-/ or EPO is a Glycoprotein Hormone that controls Epoetin alfa ( rINN) (ɛˈpoʊɨtɨn is a synthetic form of Erythropoietin.

In severe cases of anemia, or with ongoing blood loss, a blood transfusion may be necessary.

Blood transfusions for anemia

Doctors attempt to avoid blood transfusion in general, since multiple lines of evidence point to increased adverse patient clinical outcomes with more intensive transfusion strategies. Blood transfusion is the process of transferring Blood or blood-based products from one person into the Circulatory system of another The physiological principle that reduction of oxygen delivery associated with anemia leads to adverse clinical outcomes is balanced by the finding that transfusion does not necessarily mitigate these adverse clinical outcomes.

In severe, acute bleeding, transfusions of donated blood are often lifesaving. Improvements in battlefield casualty survival is attributable, at least in part, to the recent improvements in blood banking and transfusion techniques.

Transfusion of the stable but anemic hospitalized patient has been the subject of numerous clinical trials, and transfusion is emerging as a deleterious intervention. In health care clinical trials are conducted to allow safety and Efficacy data to be collected for new drugs or devices

Four randomized controlled clinical trials have been conducted to evaluate aggressive versus conservative transfusion strategies in critically ill patients. All four of these studies failed to find a benefit with more aggressive transfusion strategies. ^{[8] [9] [10] [11]}

In addition, at least two retrospective studies have shown increases in adverse clinical outcomes with more aggressive transfusion strategies. ^{[12] [13]}

Hyperbaric Oxygenation

Treatment of exceptional blood loss (anemia) is recognized as an indication for hyperbaric oxygen (HBO) by the Undersea and Hyperbaric Medical Society. Hyperbaric medicine, also known as hyperbaric oxygen therapy (HBOT is the medical use of Oxygen at a higher than Atmospheric pressure. The Undersea and Hyperbaric Medical Society ( UHMS) is the primary source of information for diving and hyperbaric medicine physiology worldwide ^[14][15] The use of HBO is indicated when oxygen delivery to tissue is not sufficient in patients who cannot be transfused for medical or religious reasons. Oxygen (from the Greek roots ὀξύς (oxys (acid literally "sharp" from the taste of acids and -γενής (-genēs (producer literally begetteris the Blood transfusion is the process of transferring Blood or blood-based products from one person into the Circulatory system of another Medicine is the art and science of healing It encompasses a range of Health care practices evolved to maintain and restore Human Health by the A religion is a set of Tenets and practices often centered upon specific Supernatural and moral claims about Reality, the Cosmos HBO may be used for medical reasons when threat of blood product incompatibility or concern for transmissible disease. A blood product is any component of the Blood which is collected from a donor for use in a Blood transfusion. In Medicine, transmission is the passing of a Disease from an infected individual or group to a previously uninfected individual or group ^[14] The beliefs of some religions (ex: Jehovah's Witnesses) may prohibit the receipt transfused blood products. Jehovah’s Witnesses believe that the Bible prohibits eating blood and that this includes the storage and transfusion of Blood, including in cases of emergency ^[14]

In 2002, Van Meter reviewed the publications surrounding the use of HBO in severe anemia and found that all publications report a positive result. A medical journal is a Scientific journal devoted to the field of Medicine. ^[16]

References

Books

• Breymann, Christian. "Iron Deficiency and Anemia in Pregnancy: Modern Aspects of Diagnosis and Therapy. " Blood Cells, Molecules, and Diseases. Nov/Dec: 2002.
• Conrad, Marcel E. "Iron Deficiency Anemia. " EMedicine. 8 December 2004. Events 1609 - Biblioteca Ambrosiana opens its reading room the second public library of Europe. "MMIV" redirects here For the Modest Mouse album see " Baron von Bullshit Rides Again "
• Raymond, Tina. "Anemia: Diagnosis, Treatment and Prevention. " Midwifery Today. 31 May 1999. Events 1279 BC - Rameses II (The Great (19th dynasty becomes pharaoh of Ancient Egypt. Year 1999 ( MCMXCIX) was a Common year starting on Friday (link will display full 1999 Gregorian calendar)
• Scrimshaw, Nevin. Iron deficiency. Scientific American Oct 1991 pp 46-52
• Schier, Stanley L. Approach to the adult patient with anemia. Up-to-Date (subscription required), accessed in Jan 2006, last changed June 2005.
• WHO Scientific Group on Nutritional Anaemias. "Nutritional anaemias : report of a WHO scientific group (meeting held in Geneva from 13 to 17 March 1967)". World Health Organization. Geneva, 1968.
• Ambulatory Management of Common Forms of Anemia - American Academy of Family Physicians

See also

• Hematology
• Human iron metabolism
• Heme
• Hemoglobin

External links

• National Anemia Action Council (USA)

The American Academy of Family Physicians ( AAFP) was founded in 1947 to promote the science and art of family medicine. Hematology ( American English) or haematology ( British English) is the branch of biology (physiology Pathology, Clinical laboratory Human iron metabolism is the set of chemical reactions maintaining Human homeostasis of Iron. A heme ( American English) or haem ( British English) is a Prosthetic group that consists of an Iron atom contained in the center of Hemoglobin ( also spelled haemoglobin and abbreviated Hb or Hgb) is the Iron -containing Oxygen -transport Metalloprotein

© 2009 citizendia.org; parts available under the terms of GNU Free Documentation License, from http://en.wikipedia.org
Dapyx Software network: MP3 Explorer | Ebook Manager | Zenithic