Anemia is a medical condition that can interfere with daily activities, and can also be harmful if not addressed properly.

Types of Anemia

Types of anemia: morphological classification
The appreciation of the size and the content of erythrocytes hemoglobínico is one of the most commonly used in laboratory tests for the diagnosis of anemia. Erythrocyte greater clinical value index is the mean corpuscular volume (MCV), since it is a morphological criterion for classifying normocytic anemia (VCM: 82-98 fl), macrocytic (MCV> 98 fl), and microcytic (MCV <82 fl).

VCM is correlated with the mean corpuscular hemoglobin, which reports on the mean value content of hemoglobínico circulating erythrocytes. Consequently, the HCM decreases VCM (hypochromic microcytic anemias) in doing so and increases as it increases VCM (/ macrocytic anemias and hipercromas).

Types of anemia: pathophysiological classification
The pathophysiological classification (by their mechanism of production) of anemia was based on the ability of bone marrow to adapt to the decrease in blood hemoglobin concentration. The counting of reticulocytes (which are the precursor cells of red blood cells), indicates the responsiveness of bone marrow against anemia. The decrease in blood hemoglobin concentration always results in a compensating increase of erythropoiesis by increase of the Epo. Therefore, when the bone has a normal regenerative capacity, it must always be an inverse relationship between hemoglobin decrease and the increase in reticulocytes number (regenerative anemia).

By contrast, when the anemia is not accompanied by a proportional increase of reticulocytes number, the regenerative capacity of bone marrow will decreased (arregenerativa anemia).

types, diagnosis, and treatment of anemia

Some of the most common causes of anemia are outlined below:

Acute blood loss.
Acute anemia after a haemorrhage.

Increase in the destruction of red blood cells.
Corpuscular (due to alterations in the erythrocyte itself):
  • Alterations of the membrane. Example: hereditary spherocytosis.
  • Enzyme deficiency. Example: deficit of glucose-6-phosphate dehydrogenase.
  • Alterations of haemoglobin. Examples: sickle cell anemia or thalassemias.
Extracorpusculares (by causes outside the erythrocyte):
  • Toxic. Example: snake venoms or chlorates.
  • Infectious agents: bacteria or parasites (malaria).
  • Mechanical causes. Example: vascular problems.
  • Immunological. Examples: transfusions, hemolytic disease of the newborn, anemias by autoantibodies or drugs.
  • Hypersplenism (the spleen enlarges and destroys many red blood cells).

Impaired germinal cell or precursor of red blood cells:
  • Medullar Aplasia.
  • Myelodysplastic syndromes.
  • Bone marrow infiltration.
Defects of hematopoietic factors (needed to form hemoglobin):
Some examples:
  • Deficit of iron (iron deficiency anemia).
  • Vitamin B12 deficiency.
  • Folic acid deficiency.
  • Erythropoietin deficiency.

Diagnosis of Anemia

Clinical Manifestations
The realization of medical history and physical examination, are always the first step in the study of anemia. Discarded a hemorrhage or underlying disease that justifies the anemia, the study should begin with consideration of gender, age and ethnicity of the patient, as well as its presentation (acute or chronic, time of evolution and existence background).

Laboratory Tests
To confirm the diagnosis of anemia, first, it is necessary to show the decrease of hemoglobin concentration in blood. This blood test called a complete blood count, which determines the levels of hemoglobin in the blood along with other parameters that indicate the morphology and size of erythrocytes. In addition, CBC informs us of possible alterations in other blood cells such as white blood cells and platelets.

In addition to the blood count, a blood smear (which looks the blood directly to the microscope) usually requested. This test can provide a lot of information about the cause of the anemia. According to the diagnosis, suspected can request many other tests, such as the levels of iron and ferritin (the body iron deposits), vitamin B12 and folic acid levels, reticulocytes levels (erythrocyte precursor cells), various autoantibodies, etc.

In arregenerativas anemias - which the cause of anemia is within the bone marrow, it is often necessary to apply for a study of bone marrow aspirate through a bone marrow biopsy. Aspirate is a sting in which bone marrow cells were taken, and is usually performed in the sternum. Biopsy is a puncture with a thicker needle, which takes a bone cylinder, enabling further study of the bone marrow. It is usually done in the iliac crest, which is the flange of bone we have above the hip.

Treatment of Anemia

Anemia treatment depends on the cause that causes it. Whatever, the objective is to increase the level of oxygen that the blood can transport, either by increasing red blood cells or hemoglobin concentration. Of course, we must treat the cause or disease that may have caused anemia.

In general just the replacement of iron orally in cases of iron deficiency anemia; or vitamin B12 and folic acid in cases of megaloblastic anemia.

When due to significant blood loss, blood transfusion is performed. And in more specific cases (such as hereditary syndromes) bone marrow transplantation may be considered. In any case, it is necessary to consult with the specialist that will indicate the most appropriate anemia treatment for your case.

In iron deficiency anemia case, we propose a set of dietary guidelines to regain your normal iron levels.

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