Anemia

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Anemia in adults

Anemia is one of the most common pathological conditions among the world's population. Among the types of anemia, several main conditions are distinguished in their classification according to the causes of the development of anemia:

  • Iron deficiency anemia;
  • Hemolytic anemia;
  • Aplastic anemia;
  • Sideroblastic anemia;
  • B12-deficiency anemia as a result of vitamin B12 deficiency;
  • Posthemorrhagic anemia;
  • Sickle cell anemia and other forms.

According to experts, every fourth person on the planet suffers from iron deficiency anemia. The danger of this condition is that iron deficiency anemia occurs in an imperceptible clinical manifestation. Symptoms are felt when the amount of iron, i.e. the amount of hemoglobin, drops to very low levels.

Among adults, the following categories of people may be at higher risk of developing anemia:

  • Those who follow the principles of vegetarian food;
  • Those who regularly lose blood, for example due to physiological reasons (blood loss in women as a result of menstruation), due to diseases (internal bleeding, late stages of hemorrhoids, etc.) and regular donation of blood and plasma by donors;
  • Pregnant and lactating women;
  • Professional athletes;
  • Patients with chronic or acute forms of certain diseases;
  • Food insecure or restricted categories of the population.

The most common form of iron deficiency anemia in anemia, in turn, is caused by iron deficiency and can be caused by one of the following factors:

  • Inadequate intake of iron micronutrients with food;
  • High need for iron according to conditions and individual characteristics (developmental pathologies, impotence, development of diseases, pregnancy, lactation, labor activity, etc.);
  • Strong loss of iron.

Mild forms of anemia can usually be treated by adjusting the diet, taking vitamin-mineral complexes, iron-containing drugs. Moderate to severe anemia requires expert advice and an appropriate course of treatment.

Causes of anemia in men

The diagnostic criterion for anemia in men is a decrease in the concentration of hemoglobin in the blood below 130 g / l. In men, anemia is less common than in women in terms of physiological characteristics: in men there is no monthly blood loss as a result of menstruation, no gestation (pregnancy), lactation (breastfeeding) and, consequently, no loss of vitamins and trace elements.

However, anemia is also common among men and is usually diagnosed as a result of chronic diseases and diseases of various organ systems.

For example, the development of chronic iron deficiency anemia in men is often caused by intestinal erosion, occult gastrointestinal bleeding, ulcers, hemorrhoids. The etiology of anemia in men can be parasitic diseases, cancers of good and bad quality. Because the occurrence of anemia is caused by a variety of factors, they require identification of the underlying cause and appropriate treatment measures.

Anemia in women

In women, anemia is diagnosed when the hemoglobin in the blood is below 120 g / l (110 g / l during pregnancy). Physiologically, women are more prone to anemia.

It causes the female body to lose erythrocytes during menstrual bleeding. The average volume of blood lost during menstruation is 40-50 ml, but during heavy menstruation this amount can be 5 ml and more for 7-100 days. Several such blood losses are likely to lead to anemia.

Another common (20% in women) form of occult anemia among women occurs when the concentration of the ferritin protein decreases. It is a protein that accumulates iron in the blood and separates iron when hemoglobin levels fall.

Anemia in pregnant women

Anemia in pregnant women occurs under the influence of various factors. The developing fetus receives nutrients from the mother's blood, including iron, vitamin B12, and folic acid, which are needed for hemoglobin synthesis. Lack of vitamins and minerals in food, chronic diseases (hepatitis, pyelonephritis), severe toxicosis in the first trimester of pregnancy and the presence of multiple fetuses can lead to the development of anemia in the expectant mother.

Physiological anemia in pregnant women develops due to hydremia, i.e. blood thinning: in the second half of pregnancy, the fluid portion of the blood increases, which naturally leads to a decrease in erythrocytes and the iron they carry. This condition is considered normal if the hemoglobin level is not less than 110 g / l and there are no signs of vitamin and micronutrient deficiencies; such a condition does not mean pathological anemia and passes in a short time.

Severe anemia in pregnant women poses risks such as miscarriage, premature birth, toxicosis in the third trimester, complications during childbirth, and anemia of the newborn.

Symptoms of anemia in pregnant women include general clinical manifestations of anemia (fatigue, drowsiness, nervousness, nausea, dizziness, dry skin, brittle hair) and changes in smell and taste cravings (chalk, lumps, raw go 'sht eating, wanting to smell pungent substances).

Mild anemia in pregnant and lactating women recovers after childbirth and lactation. However, in recurrent pregnancies that occur soon after, the body does not have time to regain its strength and the anemia becomes more severe and severe, especially if this time interval is less than 2 years. The optimal recovery period of the female body after childbirth is 3-4 years.

Breast anemia

According to a study by experts, lactational anemia is often diagnosed in the severe stages of the disease. The development of anemia occurs due to blood loss during childbirth and a hypoallergenic diet. Spontaneous breast milk production does not cause anemia, but eliminates some important products from the diet, such as legumes (so that the baby's stomach does not drip), meat and dairy products (to prevent allergic reactions in the baby) ) significantly increases the likelihood of developing anemia.

The reason for the late diagnosis of postpartum anemia is that mothers pay more attention to the child without paying attention to their own health, especially young mothers. The health of the baby makes the mother think more than her own health, that the symptoms of anemia - dizziness, fatigue, drowsiness, loss of attention, pale skin - are often caused by fatigue associated with looking after the baby accepted.

Another common cause of iron deficiency anemia in nursing mothers is the misconception that iron supplements can enter milk and adversely affect the baby’s gastrointestinal system. This condition has not been confirmed by experts and the intake of medications, vitamins and minerals prescribed by a doctor should not be delayed when iron deficiency anemia is diagnosed.

Climax anemia

Anemia during menopause in women is a very common condition. Hormonal changes, menstruation, pregnancy, childbirth, various dysfunctional conditions and the development of chronic anemia due to surgical procedures, and against the background of menopause they can be exacerbated.

Dietary restrictions, unbalanced diets, and the use of various medications to lose weight also lead to menopause and anemia during menopause.

During menopause, a decrease in ferritin protein is also observed, which also plays a role as an influencing factor.

Symptoms such as mood swings, fatigue, nervousness, dizziness are often perceived as symptoms of menopause, and the possibility of anemia is set aside, leading to a delay in diagnosis.

Anemia in children

According to the World Health Organization (WHO), 82 percent of children suffer from varying degrees of anemia. Low levels of hemoglobin and iron deficiency cases of various etiologies lead to mental and physical disabilities in the child. The main causes of anemia in children are:

  • Lack of a complete, balanced diet;
  • Disorders of iron absorption in the gastrointestinal tract;
  • Disorders of vitamin metabolism;
  • Parasitic diseases;
  • Dysbacteriosis, gastritis, gastroduodenitis and other gastrointestinal diseases;
  • Hormonal imbalances;
  • Environmental factors: heavy metal poisoning, air, water and food pollution, etc.

The need for iron varies with the age of children and also depends on sexual factors as they begin to reach puberty. Treatment of deficiency anemia in children with a balanced diet is not always effective, so experts prefer to use additional drugs to normalize micronutrients and vitamins in the child's body.

Anemia in infants

The newborn is provided with iron reserves taken from the mother’s body during development in the mother’s womb. Physiological decrease in hemoglobin in the blood is observed in infants born at 4-5 months of age, in premature infants - at 3 months of age, during the period of imperfection of the system of self-formation of blood and rapid physical growth.

Artificial and mixed feeding is one of the risk factors that increases the likelihood of anemia. In particular, hemoglobin deficiency develops consistently as a result of the replacement of breast milk and / or artificial supplements with cow, goat milk, porridge by 9-12 months.

Symptoms of anemia in children under one year of age include:

  • The colorlessness of the skin is the ‘transparency’, ‘blueness’ of the skin because the layers of skin are still very thin;
  • Being upset, crying for no reason;
  • Sleep disorders;
  • Low appetite;
  • Hair loss outside the physiological and normative range;
  • Frequent recurrence;
  • Slow weight gain;
  • Lack of physical, then psychological development, lack of interest, lack of expression of the recovery complex, and so on.

A distinctive feature of children of this age is the ability to absorb iron very well (up to 70%), so many pediatricians do not prescribe medication for anemia in infants, but simply adjust the child's diet, to ' determine the transfer to breast milk. If the condition is severe, iron supplements may be prescribed according to age.

When severe levels of anemia are diagnosed, the reasons for its development may be not in the diet, but in diseases, pathologies and dysfunctions of the child's body. Anemia can also be caused by inherited diseases. If hemoglobin in children is consistently low, the underlying cause of the condition should be identified and treated.

Anemia in preschool children

A large-scale study in 2010 found that anemia in preschool children is caused and prevalent due to iron deficiency: every second child suffers from hemoglobin deficiency due to low iron levels. The etiology of this condition can vary - but most often it is caused by persistent anemia in the early stages of life.

The second factor that triggers anemia in preschool children is often similar to the first factor. Malnutrition, lack of protein (meat products) and vitamins (vegetables), as a result of frequent consumption of semi-finished products and sweets, the child becomes reluctant to eat meat and vegetables. Such cases depend only on parental upbringing.

If the child's diet is normal and he still shows signs of anemia (skin whiteness, rapid fatigue, dry skin, brittle nails), it is recommended to undergo a specialist examination. Although 10 out of 9 anemic children develop anemia due to iron deficiency, in 10% of cases this condition develops due to various diseases and pathologies (celiac disease, leukemia).

Anemia in children of primary school age

The hemoglobin level in children aged 7-11 years is 130 g / l. During this period, the symptoms of anemia gradually increase. Emerging anemia leads to frequent acute respiratory viral and bacterial diseases, fatigue, inattention, which can affect the results of educational activities of school students.

Another important factor in the development of anemia in children attending educational institutions is the inability to control the diet. Children of this age still have a high ability to absorb iron (10%, and in adults this figure is 3%), so foods rich in vitamins and minerals should be included in the diet to treat iron deficiency anemia in children of this age. Filling with is important.

Inactivity, not going out into the fresh air and sitting alone at home, especially playing a tablet, smartphone, computer, encourages you to stay in one position for a long time, which in turn can lead to anemia.

Adolescent anemia

During adolescence, the risk of anemia increases, especially in girls, with the onset of the menstrual cycle, and regular blood loss does not go unnoticed. The second factor that promotes the development of anemia in adolescent girls is related to their concern about their appearance and the introduction of different restrictions on different diets and diets to correct their stature.

During this period, rapid growth, intense exercise, and malnutrition affect adolescents of both sexes. Symptoms of anemia in adolescence include bruising of the sclera of the eye, changes in the shape of the nail, disorders of the digestive system, changes in taste and smell.

Certain forms of the disease during adolescence require drug treatment. When following the instructions of a specialist in treatment, changes in the blood occur after 10-12 days, and after 6-8 weeks there is an improvement in the general condition.

Causes of anemia

Anemia is characterized by a decrease in the concentration of hemoglobin and red blood cells (erythrocytes) in the blood unit. The main function of erythrocytes is gas exchange in tissues, transport of oxygen and carbon dioxide, as well as nutrients and metabolic products.

 

The erythrocyte contains a protein called hemoglobin, which gives the erythrocyte and the blood in general a red color. Hemoglobin contains the trace element iron, so iron deficiency can lead to anemia.

There are three main factors in the development of anemia:

  • Acute or chronic bleeding;
  • Hemolysis, breakdown of erythrocytes;
  • Decreased erythrocyte production by the bone marrow.

Depending on the type of factors and causes, anemia is divided into the following forms:

  • Due to food - due to incomplete ration or general lack of food;
  • Physical (injury, surgery, complications, frostbite, burns, etc.);
  • Genetic (hereditary) etiology;
  • Infectious diseases or secondary anemia - viral hepatitis A, hepatitis C, liver cirrhosis, liver tuberculosis, glomerulonephritis, diseases of the gastrointestinal tract (ulcerative colitis, colitis, gastritis, Crohn's disease), rheumatoid arthritis, shingles, various oncological diseases develops as a result of sms;
  • Infectious (due to viral, bacterial, parasitic and protozoal diseases);
  • Poisoning by drugs and various substances, especially when taking uncontrolled drugs for a long time (antibiotics, cytostatics, nonsteroidal anti-inflammatory drugs, antithyroid and antiepileptic drugs);
  • Exposure to radioactive waves.

Classification of anemia

Classification of anemia is classified based on its etiology, disease progression, stage of anemia, and diagnostic parameters.

Classification by severity of condition

The severity of anemia is based on blood tests and depends on age, gender, and physiological period.

Normally, hemoglobin is 130-160 g / l in healthy men, 120 to 140 g / l in women, and 110 g / l during pregnancy.

Mild cases of anemia are diagnosed in both sexes when the hemoglobin level is below 90 g / l, cases between 70 and 90 g / l with moderate anemia, and hemoglobin levels below 70 g / l characterized by severe anemia.

Classification by mechanism of development of anemia

There are three factors that can act separately or together in the pathogenesis of anemia:

  • Acute or chronic blood loss;
  • Hematopoiesis (blood production) system pathologies;
  • Early death of erythrocytes (usually their average lifespan is 120 days) due to hereditary and autoimmune diseases.

Classification by color index

The color index is an indicator of the density of hemoglobin and is calculated by a special formula in the process of blood analysis.

  • Hypochromic form in cases where the color index is less than 0,80;
  • Normochrome form when the color index is in the range of 0.80-1.05.
  • Hyperchrome shape when the color index is higher than 1,05.

Classification by morphological features

Erythrocyte count is an important indicator in determining the cause of anemia. Different sizes of erythrocytes may reflect the etiology and pathogenesis of the condition. Typically, erythrocytes are 7-8,2 micrometers (μm) in diameter. Depending on the size of erythrocytes, the following forms are distinguished:

  • Microcytosis - erythrocytes less than 7 μm in diameter, indicating the possibility of iron deficiency;
  • Normocytic - erythrocyte size 7 to 8,2 μm;
  • Macrocytic - erythrocyte size in the range of 8,2 - 11 μm, usually indicates a deficiency of vitamin B 12 or folic acid;
  • Megalocytosis is a megalocytic (megaloblastic) form, in which the diameter of erythrocytes is greater than 11 μm, a violation of erythrocyte production, indicating the presence of some serious diseases.

Classification based on the assessment of bone marrow regenerative capacity

The red part of the bone marrow is the ability to produce erythrocytes - the level of erythropoiesis is assessed by determining the number of reticulocytes, mature cells and immature cells in the blood, and this serves as the main criterion in assessing the regenerative capacity of bone tissue. As a result of this analysis, the patient's condition is assessed and treatment options are determined. The normal concentration of reticulocytes is 0.5-1.2% of the total number of erythrocytes per unit of blood.

Depending on the level of reticulocytes, the following forms are distinguished:

  • Regenerative - shows the normal ability of bone marrow to recover. The level of reticulocytes is 0,5-1,2%;
  • Hyporegenerative - indicates slow regeneration, reticulocytes less than 0,5%;
  • Hyperregenerative - reticulocyte count more than 2%;
  • Aplastic anemia is when the mass of immature red blood cells is less than 0,2% of the total number of erythrocytes. This is a sign of a sharp decline in regenerative capacity.

Methods of prevention of anemia

The most common form of the disease is iron deficiency anemia, which can be prevented by increasing the amount of iron-containing products during periods of risk. The presence of vitamin C, cobalamin (vitamin B 9), folic acid in the diet is also an important factor.

If a person is in the group of those most likely to develop anemia (listed above), regular medical checkups are recommended.

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