Hemorrhagic anemia

There are three main mechanisms for anemia: • Hemorrhage: This is due to loss of RBCs outside vessels. These anemias are usually regenerative (given sufficient time for a bone marrow response). Hemorrhage can be: • Internal:Into a tissue or body cavity, such as the peritoneum. • External: In this case, blood (RBC, plasma) is lost from the body, e.g. hemorrhage from the skin or into gastrointestinal, urinary, respiratory tracts. • Hemolysis: This is due to destruction of RBCs within the body before they have finished their normal lifespan. These anemias are usually regenerative (given sufficient time for a bone marrow response) but may be non-regenerative or inadequately regenerative if the disease concurrently suppresses bone marrow erythropoiesis. The RBCs are usually removed by macrophages in a process called extravascular hemolysis, typically in the spleen, liver and bone marrow. The macrophages phagocytize the RBC prematurely because the RBCs are abnormal (e.g. have antibody attached to them, are more rigid, etc) or macrophages are doing something they are not supposed to because they are excessively activated (e.g. by inflammatory cytokines, such as interferon-γ) or abnormal (e.g. erythrophagocytic histiocytic sarcoma, which is a tumor of macrophages, where macrophages phagocytize excess numbers of normal RBCs). In some patients with hemolytic anemia (depending on the cause and the patient), there can be a concurrent intravascular hemolysis. This is when RBCs lyse (“p...

Related Conditions Aplastic anemia; myelodysplasia; paroxysmal nocturnal hemoglobinuria; myeloproliferative disorders (essential thrombocythemia, myelofibrosis, chronic myelogenous anemia); pure red cell aplasia; chronic renal failure; endocrine-related anemias; drug-induced marrow failure (chemotherapy, other); megaloblastic anemias; nutritional anemias (including iron deficiency); thalassemia; hemoglobinopathies, traumatic blood loss; non-immune congenital hemolytic processes (hereditary spherocytosis, hereditary elliptocytosis, hereditary pyropoikilocytosis); congenital enzymopathies [glucose-6-phosphate dehydrogenase (G6PD) deficiency, fructose-6-phosphate (F6P) deficiency]; non-immune acquired hemolytic disorders [heart-valve hemolysis, march hemoglobinuria, thrombotic thrombocytopenic purpura (TTP), hemolytic-uremic syndrome (HUS), vasculitis, other microangiopathic conditions]; immune-mediated hemolysis (autoimmune hemolytic anemia (AIHA), cryopathic immune hemolytic anemia, drug-induced, delayed hemolytic transfusion reactions, ABO-Rh mismatch); sideroblastic anemia; anemia of chronic disease; myelophthisic anemias; hypersplenism; hemophagocytic lymphohistiocytosis (HLH); infectious marrow failure syndromes (parvovirus, microbacterium avium intracellulare [MAI]) 1. Description of the problem What every clinician needs to know The physiological effect of anemia is a function of: (1) the interval over which the anemia develops, and (2) the overall hemoglobin level. I...

Acute Posthemorrhagic Anemia • • • • Inpatient • Acute posthemorrhagic anemia is a condition that develops when you lose a large amount of blood quickly. Anemia is a low number of red blood cells or a low amount of hemoglobin in your red blood cells. Hemoglobin is a protein that helps red blood cells carry oxygen throughout your body. WHILE YOU ARE HERE: Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered. Activity: You may need to rest. Your healthcare provider will tell you when it is okay to increase your activities. Call your healthcare provider before getting up for the first time. If you ever feel weak or dizzy, sit or lie down right away. Then call your healthcare provider. A heart monitor is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity. You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask...

AMA Citation Longo DL. Longo D.L. Longo, Dan L.Anemia Due to Acute Blood Loss. In: Jameson J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Jameson J, & Fauci A.S., & Kasper D.L., & Hauser S.L., & Longo D.L., & Loscalzo J(Eds.), Eds. J. Larry Jameson, et al.eds. Harrison's Principles of Internal Medicine, 20e. McGraw Hill; 2018. Accessed June 16, 2023. https://accessmedicine.mhmedical.com/content.aspx?bookid=2129§ionid=192017550 APA Citation Longo DL. Longo D.L. Longo, Dan L. (2018). Anemia due to acute blood loss. Jameson J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Jameson J, & Fauci A.S., & Kasper D.L., & Hauser S.L., & Longo D.L., & Loscalzo J(Eds.), Eds. J. Larry Jameson, et al. Harrison's Principles of Internal Medicine, 20e. McGraw Hill. https://accessmedicine.mhmedical.com/content.aspx?bookid=2129§ionid=192017550 MLA Citation Longo DL. Longo D.L. Longo, Dan L. "Anemia Due to Acute Blood Loss." Harrison's Principles of Internal Medicine, 20e Jameson J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Jameson J, & Fauci A.S., & Kasper D.L., & Hauser S.L., & Longo D.L., & Loscalzo J(Eds.), Eds. J. Larry Jameson, et al. McGraw Hill, 2018, https://accessmedicine.mhmedical.com/content.aspx?bookid=2129§ionid=192017550. Blood loss causes anemia by two main mechanisms: (1) by the direct loss of red cells; and (2) if the loss of blood is protracted, it will gradually deplete iron stores, eventually resulting in iron deficiency. The latter...