ANEMIA

Presented by
TALHA BIN ZUBAIR
CONTENTS:
1.Definition
2.Causes
3.Types
a. Sickle cell anemia
b. Fe deficiency
c. Vitamin deficiency
d. Bone marrow and other issues
e. By RBC destruction
4.Symptoms
5.Diet
6.Diagnosis and tests
7.Treatment
DEFINITION
 Anemia is a condition that develops when your
blood lacks enough healthy red blood cells or
hemoglobin.
 Hemoglobin (an iron rich protein) is a main part of
red blood cells and binds oxygen.
 Patients with anemia may feel tired, fatigue easily,
appear pale, develop palpitations, and become short
of breath.
 For men, anemia is typically defined as
hemoglobin level of less than 13.5 gram/100 ml
 In women hemoglobin of less than 12.0
gram/100 ml.
 CAUSES

The causes of anemia may be classified as:

1. Blood loss.
2. Impaired red blood cell (RBC)
production.
3. Increased RBC destruction (hemolytic
anemia)
Anemia caused by blood loss:
 The most common type of anemia iron deficiency
anemia often falls into this category.
 It is caused by a shortage of iron, most often through
blood loss. Blood loss can be
1. Rapid blood loss:
It include surgery, childbirth, trauma, or a ruptured
blood vessel.
2. Chronic blood loss:
Is more common in cases of anemia. It can result from a
stomach ulcer, cancer, or tumor.
Causes of anemia due to blood loss include:
 Gastrointestinal conditions, such as ulcers, cancer, or
gastritis.
 Use of non steroidal anti-inflammatory drugs (NSAIDs),
such as aspirin.
 Menstrual bleeding.
Impaired red blood cell (RBC)
production:
Anemia caused by decreased or faulty red blood cells
include:
 Sickle cell anemia:
Red blood cells are misshapen and break down
abnormally quickly.
 Iron-deficiency anemia:
Too few red blood cells are produced because of a poor
diet, menstruation or surgical removal of part of the gut.
 Bone marrow and stem cell problems:
It occurs when few or no stem cells are present.
 Vitamin deficiency anemia:
Vitamin B-12 and folate are both essential for the
production of red blood cells. Examples include
megaloblastic anemia and pernicious anemia.
Increased red blood cell
destruction:
 Red blood cells typically have a life span of 120
days in the bloodstream.
 One type of anemia that falls into this category is
autoimmune hemolytic anemia, where the body's
immune system mistakenly identifies its own red
blood cells as a foreign substance and attacks
them.
 Excessive hemolysis (red blood cell breakdown)
can occur for many reasons, including:
 Infections.
 Certain drugs, for example, some antibiotics.
 Snake or spider venom.
 Toxins produced through advanced kidney or liver
disease.
 IRON DEFICIENCY ANEMIA
 The most common form of anemia is iron deficiency anemia
which is usually due to chronic blood loss.
 Iron deficiency occurs when the rate of loss or use of iron is
more than its rate of absorption and use.
 The reasons for this are:
 Chronic blood loss: Most commonly due to excessive
menstruation or bleeding into or from the gut as a result of a
peptic ulcer, gastritis, hemorrhoids or in children, worm
infestation.
 Increased use of iron: In pregnancy, due to the growth of the
fetus or children undergoing rapid growth spurts in infancy and
adolescence.
 Decreased absorption of iron
 lack of stomach acid
 chronic diarrhea
 malabsorption.
 SICKLE CELL ANEMIA
 Sickle cell anemia is a serious disease in which the body makes
sickle-shaped ("C"-shaped) red blood cells.
 Normal red blood cells are disk-shaped and move easily
through your blood vessels.
 Red blood cells contain the protein hemoglobin (an iron-rich
protein that gives blood its red colour and carries oxygen from
the lungs to the rest of the body).
 Sickle cells contain abnormal hemoglobin that causes the cells
to have a sickle shape, which don’t move easily through the
blood vessels – they are stiff and sticky and tend to form
clumps and get stuck in the blood vessels.
 The clumps of sickle cells block blood flow in the blood vessels
that lead to the limbs and organs.
VITAMIN DEFICIENCY ANEMIA
 Your body also needs vitamin B12 and folate in order to
produce enough red blood cells.
 Anemia due to vitamin B12 deficiency is called pernicious
anemia and usually occurs when the body is not able to absorb
vitamin B12 properly or due to intestinal problems.
 This type can also be caused by a lack of vitamin B12 in the
diet.
 Some pernicious anemia occurs because the body's small
intestine can't properly absorb vitamin B12 which may be due
to the wrong bacteria in the small intestines; certain diseases
that interfere with vitamin B12 absorption; certain medicines;
surgical removal of part of the small intestine; and tapeworm
infection.
 Sometimes people develop pernicious anemia because they
don't get enough vitamin B12 in their diets.
Anemia due to Bone marrow
Problems:
 Bone marrow and stem cell problems may prevent the body from
producing enough red blood cells. Some of the stem cells found
in bone marrow develop into red blood cells. If you have too few
stem cells, they're defective, or replaced by other cells such as
metastatic cancer cells, anemia may result. Anemia resulting
from bone marrow or stem cell problems include:
 Aplastic anemia occurs when there's a marked reduction in the
number of stem cells or absence of these cells. It can be
inherited, can occur without apparent cause, or can occur when
the bone marrow(stem cells) is injured by medications, radiation,
chemotherapy, or infection. The most common symptoms are
fatigue, shortness of breath, dizziness, headache, chest pain,
coldness in your hands and feet.
 Treatment for aplastic anemia includes blood transfusions,
blood and marrow stem cell transplants, and medication. These
treatments can prevent or limit complications, relieve symptoms,
and improve quality of life.
 Thalassemia occurs when the red cells can't mature
and grow properly. Thalassemia is an inherited
condition and can range in severity from mild to
life-threatening; the most severe form is called
Cooley's anemia. Symptoms of thalassemia are
caused by a lack of oxygen in the blood stream.
 Three standard treatments are used to treat
moderate and severe forms of thalassemia, these
include blood transfusions, iron chelation therapy,
and folic acid supplements.
 Lead exposure is toxic to the bone marrow, leading
to fewer red blood cells. Lead poisoning occurs in
adults from work-related exposure and in children
who eat paint chips.
 Hemolytic Anemia:
 When destruction of red blood cells outpaces a person’s bone
marrow production of these cells, hemolytic anemia occurs.
 Intrinsic hemolytic anemia develops when the red blood cells
produced by your body don’t function properly. This condition
is often inherited, such as in people with sickle cell anemia or
thalassemia.
 Extrinsic hemolytic anemia develops by several methods, such
as when the spleen traps and destroys healthy red blood cells or
an autoimmune reaction occurs. It can also come from red blood
cell destruction due to infection, tumors, autoimmune disorders,
medication side effects, leukemia, lymphoma.
 Other times, a metabolic abnormality, such as in people with
G6PD(glucose 6-phosphate dehydrogenase) deficiency, or red
blood cell membrane instability can lead to the condition.
 Treatments for hemolytic anemia include blood transfusions,
medicines, plasmapheresis, surgery, blood and marrow stem cell
transplants and lifestyle changes.
Symptoms:

 Symptoms varies according to the types of

disease.
 Mild at first then become severe.
SYMPTOMS:

 Fatigue
 Weakness
 Paleskin
 Dysphagia
 Tongue swelling
SYMPTOMS:
 Crawling feelings in legs
 Headache
 Irregular heartbeat
 Brittle nails
 Shortness of breath
 Cold hands & feet
 Do’s
 Eat iron-rich foods with vitamin  LEAFY GREEN
C-rich foods, such as oranges,
tomatoes, or strawberries, to  MEAT & POULTRY
improve absorption.  LIVER
 Eat iron-rich foods with foods  SEAFOOD
that contain beta carotene, such  FORTIFIED FOOD
as apricots, red peppers, and
beets, to improve absorption.  BEANS
 Eat a variety of heme and  NUTS AND SEEDS
nonheme iron foods throughout
the day to up your iron intake.
 Eat heme and nonheme iron
foods together whenever
possible to increase iron
absorption.
 Add foods rich in folate and
vitamin B-12 to support red
blood cell production.
 Dont’s
When following a diet plan for anemia,
remember these guidelines:
 Don’t eat iron-rich foods with foods or
beverages that block iron absorption. These
include coffee or tea, eggs, foods high in
oxalates, and foods high in calcium.
 Don’t consume folic acid capsules with milk
or tea.
DIAGNOSIS AND TESTS
 DIAGNOSIS:

Common symptoms of anemia include:

 Fatigue
 Irritability
 Headaches
 Difficulty concentrating
 Detection of a heart murmur
 A significant decrease in your blood pressure
when you stand.
 DIAGNOSIS CONTD.
1. A blood sample will provide an overall count of
your white blood cells, red blood cells
and platelets. If results show anemia, additional
tests may be required to determine the type of
anemia and whether it is related to a more serious
condition.
2. There are basically three different causes
of ANAEMIA:
 Blood loss
 Decreased or faulty red blood cell production
 Destruction of red blood cells.
 TESTS:
 Complete blood count (CBC)
 Blood iron level and your serum ferritin level.
 Levels of VITAMIN B12 and folate,.
 Hemoglobin electrophoresis.
 A reticulocyte count
 A peripheral blood smear
 An osmotic fragility test
TREATMENT:
 Iron deficiency anemia.
 Vitamin deficiency anemia.
 Anemia of chronic disease.
 Aplastic anemia.
 Anemias associated with bone marrow
disease.
 Hemolytic anemias.
 Sickle cell anemia.
 Thalassemia.
 Iron deficiency anemia. Treatment for this form of anemia usually
involves taking iron supplements and making changes to your diet.
 Vitamin deficiency anemias. Treatment for folic acid and B-12
deficiency involves dietary supplements and increasing these nutrients
in your diet. If your digestive system has trouble absorbing vitamin B-
12 from the food you eat, you may need vitamin B-12 shots. At first,
you may receive the shots every other day. Eventually, you'll need shots
just once a month, which may continue for life, depending on your
situation.
 Anemia of chronic disease. There's no specific treatment for this type
of anemia. Doctors focus on treating the underlying disease. If
symptoms become severe, a blood transfusion or injections of synthetic
erythropoietin, a hormone normally produced by your kidneys, may
help stimulate red blood cell production and ease fatigue.
 Aplastic anemia. Treatment for this anemia may include blood
transfusions to boost levels of red blood cells. You may need a bone
marrow transplant if your bone marrow is diseased and can't make
healthy blood cells.
 Anemias associated with bone marrow disease. Treatment of
these various diseases can include medication, chemotherapy or
bone marrow transplantation.
 Hemolytic anemias. Managing hemolytic anemias includes
avoiding suspect medications, treating related infections and taking
drugs that suppress your immune system, which may be attacking
your red blood cells.
 Sickle cell anemia. Treatment for this anemia may include the
administration of oxygen, pain-relieving drugs, and oral and
intravenous fluids to reduce pain and prevent complications.
Doctors also may recommend blood transfusions, folic acid
supplements and antibiotics. A bone marrow transplant may be an
effective treatment in some circumstances. A cancer drug called
hydroxyurea (Droxia, Hydrea) also is used to treat sickle cell
anemia.
 Thalassemia. This anemia may be treated with blood transfusions,
folic acid supplements, medication, removal of the spleen
(splenectomy), or a blood and bone marrow stem cell transplant.
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