Types of anaemia

Am Fam Physician. 2018;98(7):437-442 Author disclosure: No relevant financial affiliations. The opinions and assertions in this article are those of the authors and do not represent official policy of the Army Medical Department, Department of the Army, or the Department of the Defense. Article Sections Anemia is associated with increased morbidity and mortality in older adults. Diagnostic cutoff values for defining anemia vary with age, sex, and possibly race. Anemia is often asymptomatic and discovered incidentally on laboratory testing. Patients may present with symptoms related to associated conditions, such as blood loss, or related to decreased oxygen-carrying capacity, such as weakness, fatigue, and shortness of breath. Causes of anemia in older adults include nutritional deficiency, chronic kidney disease, chronic inflammation, and occult blood loss from gastrointestinal malignancy, although in many patients the etiology is unknown. The evaluation includes a detailed history and physical examination, assessment of risk factors for underlying conditions, and assessment of mean corpuscular volume. A serum ferritin level should be obtained for patients with normocytic or microcytic anemia. A low serum ferritin level in a patient with normocytic or microcytic anemia is associated with iron deficiency anemia. In older patients with suspected iron deficiency anemia, endoscopy is warranted to evaluate for gastrointestinal malignancy. Patients with an elevated serum ferrit...

Introduction Anaemia is a common condition that results in impaired oxygen delivery to body tissues due to reduced haemoglobin. It affects over 1.62 billion people globally. 1,2 Anaemia is defined as a haemoglobin level two standard deviations below the normal for age and sex. 3 In women, a normal haemoglobin level is 115-165 g/L, while it is slightly increased in men at 130-180 g/L, due to larger body size. 4 Anaemia can be classified according to the average size of the red blood cells (RBC), referred to as mean corpuscular volume (MCV): 5,6 • Microcytic anaemia: MCV 100 This article describes the general clinical features of anaemia and the causes of microcytic, normocytic and macrocytic anaemia. You might also be interested in our over 1000 flashcards that cover key medical topics. Clinical features History Typical symptoms of anaemia include: 7 • Pallor • Fatigue • Breathlessness • Dizziness • Palpitations • Cold hands and feet Other important areas to cover in the history include: 8 • Dietary history (to rule out malnutrition) • Causes of potential blood loss (e.g. menorrhagia) • Issues with malabsorption (e.g. gastrectomy, coeliac disease) • Family history of haematological disorders • Any episodes of black tarry stools (suggestive of gastrointestinal bleeding) • Symptoms of chronic disease (e.g. cardiac, renal, hepatic) Clinical examination In the context of suspected anaemia, a comprehensive examination of the major systems must be performed. Possible clinical fin...

Symptoms Vitamin deficiency anemia usually develops slowly over several months to years. Signs and symptoms may be subtle at first but usually increase as the deficiency worsens. These may include: • Fatigue • Shortness of breath • Dizziness • Pale or yellowish skin • Irregular heartbeats • Weight loss • Numbness or tingling in the hands and feet • Muscle weakness • Personality changes • Unsteady movements • Mental confusion or forgetfulness Causes Vitamin deficiency anemia can occur if you don't eat enough foods containing vitamin B-12 and folate, or if your body has trouble absorbing or processing these vitamins. Vitamin B-12 deficiencies Low levels of vitamin B-12 can be caused by: • Diet. Vitamin B-12 is mainly found in meat, eggs and milk, so people who don't eat these types of foods may need to take B-12 supplements. Some foods have been fortified with B-12, including some breakfast cereals and some nutritional yeast products. • Pernicious anemia. This condition occurs when the body's immune system attacks cells in the stomach that produce a substance called intrinsic factor. Without this substance, B-12 can't be absorbed in the intestines. • Gastric surgeries. If portions of your stomach or intestines have been surgically removed, that can reduce the amount of intrinsic factor produced and the amount of space available for vitamin B-12 to be absorbed. • Intestinal problems. Crohn's disease and celiac disease can interfere with absorption of vitamin B-12, as can tape...

• Tingling, prickling feelings (also called "pins and needles" or paresthesia) • Muscle weakness • Ataxia: An inability to voluntarily coordinate and control your muscle movements, which can affect eye movement, speech, and swallowing • Digestive tract issues like bloating, nausea, and loss of appetite • An enlarged • Frequent infections • Easily bleeding • Fevers • Tiny, circular red spots on the skin caused by bleeding from small blood vessels ( petechiae) • Nosebleeds • Blood in stool • • Nausea • • Abnormally formed kidneys, heart, lungs, digestive tract, arms, and hands (specific to Fanconi anemia, a form of aplastic anemia) Anemia, especially if it's severe, can strain your heart, weaken your immune system, and lead to other complications. It can cause pregnancy complications or developmental problems in infancy and childhood. When to See a Healthcare Provider If you’ve been diagnosed with anemia and you experience a worsening of symptoms like chest pain, trouble breathing, fast or irregular heartbeat, head to the hospital immediately. If possible, get someone else to drive you. You may be experiencing heart problems, including heart failure. • You’ve already been diagnosed with an underlying condition that can lead to anemia (e.g., kidney disease, • You have a family history of inherited anemia (consider undergoing genetic testing and counseling for it) • You're experiencing a number of anemia symptoms; this could be a sign of a more serious or chronic condition lik...

Thalassemia is an inherited blood disorder that affects your body’s ability to produce hemoglobin and healthy red blood cells. Types include alpha and beta thalassemia. Thalassemia may cause you to experience anemia-like symptoms that range from mild to severe. Treatment can consist of blood transfusions and iron chelation therapy. Overview What is thalassemia? Thalassemia (thal-uh-SEE-me-uh) is an inherited If you have thalassemia, your body produces fewer healthy hemoglobin proteins, and your How does thalassemia affect my body? Thalassemia can cause mild or severe • • Trouble breathing. • Feeling cold. • • Pale skin. Who is at risk for thalassemia? The Symptoms and Causes What causes thalassemia? Hemoglobin consists of four protein chains, two alpha globin chains and two beta globin chains. Each chain — both alpha and beta — contains genetic information, or genes, passed down from your parents. Think of these • Alpha globin protein chains consist of four genes, two from each parent. • Beta globin protein chains consist of two genes, one from each parent. The thalassemia you have depends on whether your alpha or beta chain contains the genetic defect. The extent of the defect will determine how severe your condition is. What are the types of thalassemia? Thalassemia is classified as trait, minor, intermedia and major to describe how severe the condition is. These labels represent a range where having a thalassemia trait means that you may experience mild anemia symptoms ...