Definition - anemia: Reduction in the number of red blood cells (erythrocytes), the red blood pigment (hemoglobin) and / or the blood cell count (hematocrit) at normal blood volume.
For example, anemia may be due to malnutrition, hereditary changes, or as a result of another disease. Various anemias are caused by red blood cell disorder. Examples are myelodysplastic syndrome (leukemia precursor), folic acid or vitamin B12 deficiency anemia, iron deficiency anemia, and renal disease-related anemia. The disorder, as in myelodysplastic syndrome, may be due to an erythrocyte growth or maturation disorder, a DNA deficiency disorder such as folate / vitamin B12 deficiency, a red blood staining disorder in iron deficiency, or a decreased or absent renal impairment Hormone release (erythropoietin deficiency) are based.
The hormone erythropoietin is required for the maturation of red blood cells. By congenital red blood cell form defects such as in cases of hemocytosis, sickle cell disease, thalassemia, or by antibody production against erythrocytes (eg in transfusion reactions, Rhesus intolerance or ABO-blood group intolerance in mother and child, autoimmune reactions), drugs, infectious diseases, physical / chemical toxins or Metabolic disorders may lead to an increased reduction of red blood cells. Major bleeding can lead to loss-related anemia.
Finally, a distribution disorder in the sense of an accumulation of large quantities of erythrocytes in an enlarged spleen may result in a lack of erythrocytes in the blood. Apart from the more common dietary forms of anemia such as iron, folic acid or vitamin B12 deficiency, pyridoxine deficiency, lead poisoning, severe protein deficiency and vitamin deficiency (vitamin C, vitamin E, riboflavin) can (rarely) lead to anemia. Deficiency of certain trace elements (copper, zinc, nickel) promotes the development of anemia.
Overall, nutritional anemias are usually deficient in all or several nutrients, rarely just a single nutrient. Mixed forms of anemia occur. Infants, children, women of childbearing age (increased need for menstruation) as well as pregnant and breastfeeding women are particularly affected. 80 percent of all anemias affect women. In Europe, about 10 percent, in developing countries more than half of women of childbearing age suffer from anemia.
Features, diagnostics, history
The first symptoms are mostly fatigue, dizziness and fatigue, sometimes depressive mood. In severe physical activity, these symptoms express earlier than with exclusively sedentary activity. Because the red blood cells carry oxygen from the lungs into the organs, more anemia is associated with poor oxygenation of the organs. This can lead to lack of concentration, fainting, headache, insomnia, sensitivity to cold, shortness of breath, angina pectoris and, above all, heart palpitations or tears.
In the area of the gastrointestinal tract complaints in terms of loss of appetite, diarrhea, constipation, abdominal pain, burning tongue, difficulty swallowing and flatulence (flatulence) are possible. Menorrhagia, libido and potency loss are also observed. Often hair and nails become brittle, cross grooves of the nails can be noticed. Less often there are emotional disturbances in cold and pale hands and / or feet. Depending on the degree of severity, skin and mucous membrane blemishes. Occasionally, even a hitherto unknown heart noise can be noticed, which is due to turbulent currents through the decrease in blood capacity due to the reduced cell count and is harmless.
Prolonged blood deficiency conditions can lead to adaptation reactions of the body, so that only tiredness complaints persist. The diagnosis is made in addition to clinical information and appearance on the reduced erythrocyte count, reduction of the blood pigment (hemoglobin) and / or the blood cell count (hematocrit) in the blood picture. On the type of anemia include clinical information (blood loss, infections, underlying diseases), form of erythrocytes (congenital defects, small or large erythrocytes in certain deficiencies), ferritin, serum iron, iron binding capacity and transferrin, vitamin B12, folic acid, antibody detection and the kidney function notes.
The treatment of anemia is due to its cause
Bleeding anemia: In acute severe blood loss depending on the severity of the symptoms, a blood transfusion is required. For all bleeding, whether acute or chronic, the stopping of the bleeding is in the foreground. Optionally, an iron substitution may be required during the course.