Blood Disorders Forum - Anemia and iron deficiency

Anemia is defined (according to the WHO) as a condition where hemoglobin level is under 12 g/dL (for women) or under 13 g/dL (for men).
Anemia is one of the most common pathologic conditions in people. It is very common in kids under 5, pregnant women, women during the reproductive period, women in climax, older people etc.
Symptoms of anemia are various but not specific. Symptoms depend a lot from the speed of anemia’s development. Acute anemia has more visible symptoms than chronic. Anemia that develops slowly has no symptoms because of the organism’s adaptation until hemoglobin drops under 9 g/dL when symptoms usually occur. Symptoms that are common for all types of anemia are:
1. Livid color of the skin and visible mucosa;
2. Cardio vascular: Hard breathing during physical efforts, palpitations, chest pain, pain in the lower extremities;
3. Neuro-muscular: sleepiness, dizziness, muscle weakness and cramps, headache, noise in the ears, darkness in front of the eyes, coldness;
4. Gastrointestinal: anorexia, nausea, constipation, diarrhea;
5. Genito-urinary: irregular cycles, often peeing, libido loss.
Cardiovascular and neurological symptoms are more severe if there are additional heart or brain disorders present. Every type of anemia has its own specific symptoms.
Anemias are classified according to the etiology in several categories and subcategories:

I. POST-HEMORRHAGIC ANEMIA – acute and chronic

II. ANEMIA DUE TO THE LACK OF BUILDING ELEMENTS:
1. Anemia due to iron deficit;
2. Anemia due to deficit of Vitamin B12;
3. Anemia due to deficit of folic acid;
4. Anemia due to deficit of Vitamin B6;
5. Anemia due to deficit of Vitamin C;
6. Anemia due to deficit of aminoacids.

III. HEMOLITIC ANEMIA:
A. Due to genetic anomalies (inborn):
1. Membrane anomalies (sferocitosis, eliptocitosis, stomatocitosis...);
2. Hemoglobin anomalies (talasemia, hemoglobinopatia S,C,D.E...), and
3. Enzyme deficit (G6PD, piruvat kinaze)
B. Acquired hemolytic anemia:
1. Immune (Rh-incompatibility, autoimmune, drug induced);
2. Not-immune (microangiopatia, traumatic, infections, chemical and physical damages…).
IV. HYPO-REGENERATIVE ANEMIA:
1. Aplastic anemia (congenital, acquired, idiopatic);
2. Infiltration of the bone marrow with malignant cells;
3. Disturbed erythrocytes production due to infections, rheumatic disorders, endocrine disorders etc.;
4. Sideroblastic anemia (congenital and acquired).

Diagnosis of the anemia includes several procedures:
1. Anamnesis – collecting data from the patient about having any bleeding, prolonged menstruation, spotting, peptic ulcer, hemorrhoids, family related anemia etc.
2. Clinical examination;
3. Laboratory blood analyses: hemoglobin, hematocrit, blood count, MCV, MCH, MCHC, reticulocyte percentage, erythrocyte morphology, sedimentation, occult blood test of the feces, bilirubin, urea, creatinin etc.
These are basic laboratory tests that can help us to assume the type of anemia. Specific tests are requested to diagnose any specific type of anemia.
Therapy depends from the type of anemia.

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