ANEMIA AND ITS COMPLICATIONS

DR AMIT TIRTH DEPT OF COMMUNITY DENTISTRY

Introduction
  

Definition Grading Classification

1- Morphological classification 2- Etiological classification

      

Causes & Symptoms Types of anemia Diagnosis Treatment Prevention Conclusion References

DEFINITION


Anaemia is defined as clinical condition characterized by reduction in the number of RBC less than 4 million/cc mm or the or content of hemoglobin less than 12 gm% or gm% both. both. Decrease O2 carrying capacity of blood

GRADING
Mild Anaemia : Haemoglobin 8-12 gm% gm% Moderate Anaemia : Haemoglobin 5-8 gm% gm% Mild Anaemia 8Severe Anaemia :: Haemoglobinless12 gm% % Haemoglobin 8- than 5 gm% gm Moderate Anaemia : Haemoglobin 5-8 gm% 5Severe Anaemia : Haemoglobin less than 5 gm%

Morphological classification
A- Normocytic Normochromic Anemia (Hb % &Size are normal only RBC count is reduced B- Macrocytic Normochromic Anemia (Hb% is normal onlyRBC cells are larger due to which cell count is reduced C- MacrocyticHypochromic Anemia (Hb%is reduced % RBC are larger and immature D- Microcytic Hypochromic Anemia (Hb% is less,RBC are smaller in size

Etiological classification
A- Hemorrhagic Anemia B- Hemolytic Anemia : - hereditary spherocytosis - Sickle cell anemia -Thalassemia C- Nutritional Deficiency Anemia : - iron deficiendy anemia - pernicius anemia - megaloblastic anemia D- Aplastic Anemia

Causes & symptoms

 

Decreased red blood cell production, or bleeding Increased red blood cell destruction. Poor diet can contribute to vitamin deficiency and iron deficiency anemia. However, excessive bleeding is the most common cause of anemia, and the speed with which blood loss occurs has a significant effect on the severity of symptoms.

Chronic blood loss may be caused by:

Heavy menstrual flow  Hemorrhoids  Nosebleeds  Cancer  Gastrointestinal tumors  Stomach ulcers  Long-term alcohol abuse LongAcute blood loss is usually the result of::  Childbirth  Injury  Ruptured blood vessel  Surgery


MICROCYTIC HYPOCHROMIC ANAEMIA or CHRONIC BLOODLOSS



Hemoglobin percententage decreases due to deficiency of Fe Fe deficiency also occurs due to more requirement of Fe in certain phases of life as in growing children's, during pregnancy and lactation Patient suffering from peptic ulcers, piles, blood dysentery ,warm infections, poor absorption of iron as in diarrhea

Folic acid deficiency Anemia



Folic acid deficiency anemia is the most common type of megaloblastic anemia, anemia, in which red blood cells are bigger than normal. It is caused by a normal. deficiency of folic acid, a vitamin that the body needs to produce normal cells. cells. Folic acid anemia is especially common in infants and teenagers. teenagers. Although this condition usually results from a dietary deficiency

Folic acid deficiency anemia



Smoking raises the risk of developing this condition by interfering with the absorption of vitamin C, which the body needs to absorb woman's body needs eight times more folic acid than it does otherwise. otherwise.

Vitamin B12 deficiency



Vitamin B12 deficiency anemia is another type of megaloblastic anemia that develops when the body does not absorb enough of this nutrient. nutrient. Necessary for the creation of red blood cells, B12 is found in meat and vegetables. vegetables. Large amounts of B12 are stored in the body, so this condition may not become apparent until as long as four years after B12 absorption slows down or stops. stops.

Pernicious Anemia
The resulting drop in red blood cell production can cause: cause:
  

loss of sensation in the legs, hands, and feet weight loss yellowyellow-blue color blindness Since most people who eat meat or eggs get enough B12 in their diets, a deficiency of this vitamin usually means that the body is not absorbing it properly. This can occur properly. among people who have had intestinal surgery. surgery. Symptoms of pernicious anemia include problems with movement or balance, tingling in the hands and feet, confusion, depression, and memory loss. loss.

Pernicious Anemia


Pernicious anemia (B12) usually strikes people 5060 (B12) 50 years of age. Eating disorders or an unbalanced diet age. increases the risk of developing pernicious anemia. anemia. So do diabetes mellitus, gastritis, stomach cancer, mellitus, gastritis, disease, stomach surgery, thyroid disease, and family history of pernicious anemia

Vitamin C deficiency Anemia



A rare disorder that causes the bone marrow to manufacture abnormally small red blood cells, vitamin C deficiency anemia results from a severe, longlong-standing dietary deficiency. deficiency.

Hemolytic Anemia


Some people are born with hemolytic anemia. Some acquire anemia. this condition, in which infection or antibodies destroy red blood cells more rapidly than bone marrow can replace them. them. Hemolytic anemia can enlarge the spleen and accelerate the destruction of red blood cells (hemolysis). (hemolysis). Other complications of hemolytic anemia may include pain, shock, gallstones, and other serious health problems. problems.

An inherited form of hemolytic anemia, thalassemia stems from the body's inability to manufacture as much normal hemoglobin as it needs. Characterized by production of red blood cells that are unusually small and fragile, thalassemia only affects people who inherit the gene for it from each parent

Sickle cell Anemia

Chronic, incurable condition that causes the body to produce defective hemoglobin, which forces red blood cells to assume an abnormal crescent shape. shape. Unlike normal oval cells, fragile sickle cells cannot hold enough hemoglobin to nourish body tissues. tissues. The deformed shape makes it hard for sickle cells to pass through narrow blood vessels. When capillaries vessels. become obstructed, a life-threatening lifecondition called sickle cell crisis is likely to occur. occur.

Diagnosis


Personal and family health history may suggest the presence of certain types of anemia. anemia. Laboratory tests that measure the percentage of red blood cells or the amount of hemoglobin in the blood are used to confirm diagnosis and determine which type of anemia is responsible for a patient's symptoms. symptoms. X rays and examinations of bone marrow may be used to identify the source of bleeding

Treatment


Anyone who has anemia caused by poor nutrition should modify his or her diet To include more vitamins, minerals, and iron. Foods such as iron. lean red meats, dried beans and fruits, liver, poultry, and enriched breads and cereals are all good sources of iron. iron. In addition, eating foods rich in vitamin C such as citrus fruits and juices can promote the absorption of iron

Treatment cont..


Patients diagnosed with iron-deficiency anemia should ironundergo a thorough physical examination and medical history to determine the cause of the anemia, particularly If chronic or acute blood loss is suspected. The cause of a suspected. specific anemia will determine the type of treatment recommended. recommended. Anemia due to nutritional deficiencies can usually be treated at home with iron supplements or self administered injections of vitamin B12. People with folic acid anemia should take oral 12. folic acid replacements. Vitamin C deficiency anemia can be replacements. cured by taking daily supplements of vitamin C.

Prevention


Avoiding excessive use of alcohol, eating a balanced diet that contains plenty of iron-rich foods, and taking a daily ironmultivitamin can help prevent anemia Avoiding lengthy exposure to industrial chemicals and drugs known to cause aplastic anemia. anemia. Not taking medication that has triggered hemolytic anemia and not eating foods that have caused hemolysis (breakdown of red blood cells). cells). Receiving regular B12 shots to prevent pernicious anemia resulting from gastritis or stomach surgery

Conclusion
   

Anemia is most often recognized by abnormal screening laboratory tests Patients less commonly present with advanced anemia and its attendant signs and symptoms Acute anemia is nearly always due to blood loss or haemolysis. The evaluation of the patient with anemia requires a careful history and physical examination

References


HARRISONS PRINCIPLES OF INTERNAL MEDICINEMEDICINE14TH EDITION,VOL. 1 EDITION,VOL. ESSENTIALS OF MEDICALPHYSIOLOGY-K MEDICALPHYSIOLOGYSEMBULINGAM 3RD EDITION CONCISE MEDICAL PHYSIOLOGY CHAUDHURI -3RD EDITION HUMAN PHYSIOLOGY SYSTEMIC AND APPLIED SUBHASH SHALYA TEXT BOOK OF CLINICAL MEDICINE FOR DENTAL STUDENTS DR. S.N.CHUG DR. www.pubmed. www.pubmed.com, www.anemia,.org www.anemia,.

 

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GUIDED BY :- DR G.K.TANDON PROFESSOR & HEAD

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