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Anemia

Anemia


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Anemia (or anemia) is a condition of the body that is characterized by a decrease in the decrease in the content of red blood cells in the blood. Erythrocytes (red blood cells) along with leukocytes and platelets are formed elements of blood; in addition, red blood cells are the most numerous of these elements.

Many causes can lead to anemia, and often anemia accompanies other diseases. The development of anemia can be caused by a decrease in the content of red blood cells in the blood, destruction of red blood cells or bleeding, sometimes anemia occurs as a result of a combination of these reasons.

The main symptoms of anemia include two - weakness and pallor, however, in order to find out the nature of the development of anemia in each particular person, it is necessary to check the presence of other symptoms.

There are several types of anemia, including iron deficiency anemia, sickle cell anemia, drug anemia and others. The most common anemia is iron deficiency, which is most common in women of childbearing age. Sickle cell anemia is a hereditary disease and is characterized by a severe course, which is often accompanied by painful attacks.

Treatment of anemia can be prescribed only after all the factors leading to the state of anemia have been identified. Blood transfusion for anemia is rarely used.

Myths about anemia

Anemia is a consequence of many causes. Anemia can accompany a large number of diseases. Quite often, anemia is a symptom of some disease. Its quantitative expression is determined by the degree of decrease in the hemoglobin content. Hemoglobin itself is an iron-containing pigment in erythrocytes.

There are three types of mechanisms for the development of anemia. First, anemia results from changes in the normal production of red blood cells by the bone marrow. Secondly, anemia can occur as a result of the destruction of red blood cells (that is, hemolysis processes), as well as a decrease in their life expectancy in human blood (the normal life span of red blood cells - their circulation in the blood - is about 120 days, after which they are destroyed either in the spleen or in the liver). The third type of mechanism for the development of anemia is the occurrence of acute or chronic bleeding. However, one should not think that anemia develops along any specific path; most often there is a combination of all of the above mechanisms.

The first mechanism for the development of anemia is characteristic of patients with oncological diseases. Indeed, in the case of cancer, there is a decrease in the production of red blood cells. However, such anemias can accompany other human diseases, for example, anemia can develop due to kidney disease, protein depletion, or endocrine insufficiency. In some cases, anemia develops as a result of decreased erythropoietin secretion. Erythropoietin is a hormone produced by the kidneys that stimulates the production of red blood cells. Deficiency in the human body of vitamin B12, iron, folic acid can also lead to a state of anemia. These are the substances that are required for the formation of red blood cells.

Defects in red blood cells lead to anemia, which is caused by hemolysis. These defects help accelerate the destruction of red blood cells. Such defects include, for example, a change in the structure of the hemoglobin molecule or disruption of the normal activity of intracellular enzymes. Hemolysis of erythrocytes can be caused by the incompatibility of the blood of the donor and recipient, that is, erythrocytes can be destroyed during blood transfusion (especially when it comes to newborns), as well as some diseases of the spleen. Hemolytic disease - erythroblastosis - leads to the destruction of red blood cells by antibodies in the blood plasma.

Bleeding is the path to the development of chronic anemia. Not entirely true. The fact is that only prolonged (or massive) bleeding is the cause of chronic anemia. All the constituent parts of red blood cells, except for iron in hemoglobin, are capable of rapid recovery, but it is the depletion of iron reserves in the human body due to prolonged blood loss that leads to the development of anemia. Lack of iron in this case also occurs with increased absorption of iron by the intestinal villi. Most often, bleeding occurs in the gastrointestinal tract (gastrointestinal tract) and in the uterus - for example, as a result of tumors or ulcers (in the first case).

Weakness is the main symptom of anemia. The main symptoms of anemia include pallor. It is these two symptoms that are the objective consequence of a decrease in the concentration of hemoglobin. The function of hemoglobin is to transport oxygen from the lungs to all organs and tissues, insufficient supply of the latter leads to increased heart rate and shortness of breath. In the case of a gradual decrease in the concentration of hemoglobin in the patient's body, a person is able to tolerate severe anemia normally. Thus, the severity of the symptoms of anemia is in direct proportion to the severity of the disease itself.

Weakness and pallor are not the only symptoms of anemia. To find out the nature of anemia, you need to check for other symptoms. For example, jaundice may indicate a hemolytic process. Jaundice appears as a result of a sharply increased breakdown of hemoglobin. Bleeding in the intestines may be indicated by black stool.

There are several types of anemic condition. These are iron deficiency anemia, pernicious anemia, aplastic anemia, sickle cell anemia, congenital spherocytic anemia, drug-induced anemia.

The most common anemia is iron deficiency. Iron deficiency in the body leads to the fact that the bone marrow begins to produce red blood cells, small and pale. These erythrocytes are depleted in hemoglobin. This type of anemia is most often observed in women of childbearing age. In this case, menstrual blood loss and an increased need for iron lead to anemia.

Pernicious anemia is caused by an insufficient amount of vitamin B12 in the human body. The bone marrow is very sensitive to vitamin B12 deficiency. If, with an insufficient content of this vitamin, there is no treatment, then the patient is guaranteed the development of anemia. Pernicious anemia is characterized by the formation of abnormally large cells in the bone marrow. These are megaloblasts that differ markedly from normal red blood cell progenitor cells. The size of megaloblasts is associated with an increase in cytoplasm content. However, the nucleus of megaloblasts is very underdeveloped, they cannot turn into red blood cells. Megaloblasts die in the same place where they were formed - in the bone marrow. In the twentieth century (studies began in 1926) it was discovered that the disease of pernicious anemia is based on the inability of the stomach, which is congenital, to produce a special substance, which, nevertheless, is very necessary for the absorption of the aforementioned vitamin by the intestinal villi. This substance is called the intrinsic factor.

Aplastic anemia is associated with the inability of the bone marrow to produce red blood cells. In this case, there is almost no tissue in the bone marrow that forms red blood cells, the reason for this may be, for example, exposure to ionizing radiation or toxic substances. Sometimes the cause of aplastic anemia remains unclear.

Sickle cell anemia is an inherited disorder. This disease is characterized by a severe course. In sickle cell anemia, the shape of red blood cells becomes abnormal sickle-shaped, such a deformation of red blood cells leads to the development of chronic hemolytic anemia. The latter is almost always accompanied by a slowdown in blood flow (which contributes to the occurrence of painful attacks (these are crises) that occur quite often) and the development of jaundice. In 1949, it was found that this form of red blood cells is due to a violation of the structure of the hemoglobin molecule, which is congenital. The research was carried out by the scientist L. Pauling. It was this fact that became the first evidence of a genetically controlled protein structure.

Congenital spherocytic anemia is caused by a hereditary defect in erythrocytes. This defect causes a state of chronic hemolysis. The normal form of erythrocytes is discoid biconcave. With this type of anemia, erythrocytes acquire a rounded shape. The duration of circulation of such erythrocytes in the blood is much shorter than that of unchanged erythrocytes. Rounded erythrocytes quickly die in the spleen, which can lead to the development of jaundice, the appearance of stones in the gallbladder, and an increase in the size of the spleen.

Many drugs can lead to hemolysis (destruction) of red blood cells. In this case, we are talking about drug anemia. These medicines may even include aspirin and some sulfonamides (if the person taking these medicines is sensitive to them). In this case, such vulnerability of red blood cells is hereditary and is transmitted from parents to children in the form of a deficiency of an enzyme that protects cells from exposure to chemicals. The first such case was described in the twentieth century - in 1952. A. Alving noticed that some patients developed acute anemia due to their use of primaquine, an antimalarial drug.

Treatment for anemia depends on the nature of the anemia. That is, it is necessary to reliably determine the causes and factors that led to the disease. The most effective introduction into the patient's body of missing substances. The latter include vitamin B12, when it comes to pernicious anemia, and iron, when it comes to iron deficiency anemia. In addition, if anemia occurs as a concomitant state of the body with other diseases, then getting rid of the underlying disease (it can be arthritis, hypothyroidism, kidney disease and other diseases) is effective in eliminating it. Sometimes it is necessary to stop taking certain drugs that have a suppressive effect on hematopoiesis.

Anemia requires a blood transfusion. Only in rare and urgent cases, when it is urgently necessary to restore the volume of blood circulating in the human body and, accordingly, the normal amount of hemoglobin. Exchange blood transfusion can be performed in newborns who have a severe course of hemolytic disease. Exchange blood transfusion is the replacement of an infant's blood with blood, which does not include a factor that promotes hemolysis of erythrocytes. The goal is to prevent the newborn from developing jaundice, which can contribute to brain damage. However, you should be aware that such blood transfusions are not always safe and can lead to hepatitis, kidney failure.

Removing the spleen is a treatment option for anemia. This mainly applies to those cases when it comes to congenital spherocytic anemia. Removal of the spleen eliminates all clinical symptoms of this disease.


Watch the video: What is anemia? Hematologic System Diseases. NCLEX-RN. Khan Academy (May 2022).