9/10/2017 0 Comments Causes Of Acute Anemia In AdultsAnemia - Wikipedia. Anemia is a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood,[3][4] or a lowered ability of the blood to carry oxygen.[5] When anemia comes on slowly, the symptoms are often vague and may include feeling tired, weakness, shortness of breath or a poor ability to exercise.[1] Anemia that comes on quickly often has greater symptoms, which may include confusion, feeling like one is going to pass out, loss of consciousness, or increased thirst.[1] Anemia must be significant before a person becomes noticeably pale.[1] Additional symptoms may occur depending on the underlying cause.[1]The three main types of anemia are due to blood loss, decreased red blood cell production, and increased red blood cell breakdown.[1] Causes of blood loss include trauma and gastrointestinal bleeding, among others.[1] Causes of decreased production include iron deficiency, a lack of vitamin B1. Causes of increased breakdown include a number of genetic conditions such as sickle cell anemia, infections like malaria, and certain autoimmune diseases.[1] It can also be classified based on the size of red blood cells and amount of hemoglobin in each cell.[1] If the cells are small, it is microcytic anemia.[1] If they are large, it is macrocytic anemia while if they are normal sized, it is normocytic anemia.[1] Diagnosis in men is based on a hemoglobin of less than 1. L (1. 3 to 1. 4 g/d. L), while in women, it must be less than 1. L (1. 2 to 1. 3 g/d. Iron-deficiency anemia is anemia caused by a. the systemic effects that anemia causes. of development may have greater consequences than it does for adults. · Iron-deficiency anemia is the most common type of anemia and occurs when the body does not have enough iron. The body needs iron to produce hemoglobin. ![]() L).[1][6] Further testing is then required to determine the cause.[1]Certain groups of individuals, such as pregnant women, benefit from the use of iron pills for prevention.[1][7]Dietary supplementation, without determining the specific cause, is not recommended. The use of blood transfusions is typically based on a person's signs and symptoms.[1] In those without symptoms, they are not recommended unless hemoglobin levels are less than 6. L (6 to 8 g/d. L).[1][8] These recommendations may also apply to some people with acute bleeding.[1]Erythropoiesis- stimulating medications are only recommended in those with severe anemia.[8]Anemia is the most common blood disorder, affecting about a third of the global population.[2][1]Iron- deficiency anemia affects nearly 1 billion people.[9] In 2. It is more common in women than men,[9] during pregnancy, and in children and the elderly.[1] Anemia increases costs of medical care and lowers a person's productivity through a decreased ability to work.[6] The name is derived from Ancient Greek: ἀναιμίαanaimia, meaning "lack of blood", from ἀν- an- , "not" and αἷμα haima, "blood".[1. Signs and symptoms[edit]. Main symptoms that may appear in anemia[1. The hand of a person with severe anemia (on the left) compared to one without (on the right)Anemia goes undetected in many people and symptoms can be minor. The symptoms can be related to an underlying cause or the anemia itself. Most commonly, people with anemia report feelings of weakness or tired, and sometimes poor concentration. They may also report shortness of breath on exertion. In very severe anemia, the body may compensate for the lack of oxygen- carrying capability of the blood by increasing cardiac output. The patient may have symptoms related to this, such as palpitations, angina (if pre- existing heart disease is present), intermittent claudication of the legs, and symptoms of heart failure.
· This leaflet deals with Acute Diarrhoea in Adults and loose Stools Treatment. The rest of this leaflet deals only with infectious causes of acute. Learn about anemia symptoms, treatment, and causes like poor nutrition. whereas in acute anemia symptoms can be abrupt and more distressing. In adults, red. On examination, the signs exhibited may include pallor (paleskin, lining mucosa, conjunctiva and nail beds), but this is not a reliable sign. There may be signs of specific causes of anemia, e. In severe anemia, there may be signs of a hyperdynamic circulation: tachycardia (a fast heart rate), bounding pulse, flow murmurs, and cardiacventricular hypertrophy (enlargement). There may be signs of heart failure. Pica, the consumption of non- food items such as ice, but also paper, wax, or grass, and even hair or dirt, may be a symptom of iron deficiency, although it occurs often in those who have normal levels of hemoglobin. Chronic anemia may result in behavioral disturbances in children as a direct result of impaired neurological development in infants, and reduced academic performance in children of school age. Restless legs syndrome is more common in those with iron- deficiency anemia.[medical citation needed]. Figure shows normal red blood cells flowing freely in a blood vessel. The inset image shows a cross- section of a normal red blood cell with normal hemoglobin.[1. The causes of anemia may be classified as impaired red blood cell (RBC) production, increased RBC destruction (hemolytic anemias), blood loss and fluid overload (hypervolemia). Several of these may interplay to cause anemia eventually. Indeed, the most common cause of anemia is blood loss, but this usually does not cause any lasting symptoms unless a relatively impaired RBC production develops, in turn most commonly by iron deficiency.[1. See Iron deficiency anemia)Impaired production[edit]Disturbance of proliferation and maturation of erythroblasts. Other mechanisms of impaired RBC production. Increased destruction[edit]Anemias of increased red blood cell destruction are generally classified as hemolytic anemias. These are generally featuring jaundice and elevated lactate dehydrogenase levels.[medical citation needed]Blood loss[edit]The roots of the words anemia and ischemia both refer to the basic idea of "lack of blood", but anemia and ischemia are not the same thing in modern medical terminology. The word anemia used alone implies widespreadeffects from blood that either is too scarce (e. In contrast, the word ischemia refers solely to the lack of blood (poor perfusion). Thus ischemia in a body part can cause localized anemic effects within those tissues. Fluid overload[edit]Fluid overload (hypervolemia) causes decreased hemoglobin concentration and apparent anemia: General causes of hypervolemia include excessive sodium or fluid intake, sodium or water retention and fluid shift into the intravascular space.[2. Intestinal inflammation[edit]Certain gastrointestinal disorders can cause anemia. The mechanisms involved are multifactorial and not limited to malabsorption but mainly related to chronic intestinal inflammation, which causes dysregulation of hepcidin that leads to decreased access of iron to the circulation.[2. Diagnosis[edit]Definitions[edit]There are a number of definitions of anemia; reviews provide comparison and contrast of them.[3. A strict but broad definition is an absolute decrease in red blood cell mass,[3. An operational definition is a decrease in whole- blood hemoglobin concentration of more than 2 standard deviations below the mean of an age- and sex- matched reference range.[3. It is difficult to directly measure RBC mass,[3. RBCs) or the hemoglobin (Hb) in the blood are often used instead to indirectly estimate the value.[3. Hemotocrit; however, is concentration dependent and is therefore not completely accurate. For example, during pregnancy a woman's RBC mass is normal but because of an increase in blood volume the hemoglobin and hematocrit are diluted and thus decreased. Another example would be bleeding where the RBC mass would decrease but the concentrations of hemoglobin and hematocrit initially remains normal until fluids shift from other areas of the body to the intravascular space. The anemia is also classified by severity into mild (1. L to normal), moderate (8. L to 1. 10 g/L), and severe anemia (less than 8. L) in adult males and adult non pregnant females.[3. Different values are used in pregnancy and children.[3. Testing[edit]Anemia is typically diagnosed on a complete blood count. Apart from reporting the number of red blood cells and the hemoglobin level, the automatic counters also measure the size of the red blood cells by flow cytometry, which is an important tool in distinguishing between the causes of anemia. Examination of a stained blood smear using a microscope can also be helpful, and it is sometimes a necessity in regions of the world where automated analysis is less accessible.[medical citation needed]In modern counters, four parameters (RBC count, hemoglobin concentration, MCV and RDW) are measured, allowing others (hematocrit, MCH and MCHC) to be calculated, and compared to values adjusted for age and sex. Some counters estimate hematocrit from direct measurements.[medical citation needed]WHO's Hemoglobin thresholds used to define anemia[3. L = 0. 6. 20. 6 mmol/L)Age or gender group. Hb threshold (g/dl)Hb threshold (mmol/l)Children (0. Children (5–1. 2 yrs)1. Teens (1. 2–1. 5 yrs)1. Women, non- pregnant (> 1. Women, pregnant. 11. Men (> 1. 5yrs)1. Reticulocyte counts, and the "kinetic" approach to anemia, have become more common than in the past in the large medical centers of the United States and some other wealthy nations, in part because some automatic counters now have the capacity to include reticulocyte counts. A reticulocyte count is a quantitative measure of the bone marrow's production of new red blood cells. The reticulocyte production index is a calculation of the ratio between the level of anemia and the extent to which the reticulocyte count has risen in response. If the degree of anemia is significant, even a "normal" reticulocyte count actually may reflect an inadequate response. If an automated count is not available, a reticulocyte count can be done manually following special staining of the blood film. In manual examination, activity of the bone marrow can also be gauged qualitatively by subtle changes in the numbers and the morphology of young RBCs by examination under a microscope. Newly formed RBCs are usually slightly larger than older RBCs and show polychromasia. Even where the source of blood loss is obvious, evaluation of erythropoiesis can help assess whether the bone marrow will be able to compensate for the loss, and at what rate. When the cause is not obvious, clinicians use other tests, such as: ESR, ferritin, serum iron, transferrin, RBC folate level, serum vitamin B1. Anemia caused by low iron in adults. IRON DEFICIENCY ANEMIA OVERVIEWAnemia can be caused by a number of different conditions, including heavy menstrual periods, cancer, and bleeding in the digestive tract, just to name a few. Iron deficiency anemia is a type of anemia that occurs when there is not enough iron to make the hemoglobin in red blood cells. The main causes of iron deficiency anemia in adults are bleeding and conditions that block iron absorption in the intestines. Iron deficiency anemia can be mild or severe, and can be temporary or chronic. The condition is common in the United States, affecting 1 to 2 percent of adults. It is even more common in developing countries, due to deficiencies of iron in the diet. This topic will review the signs and symptoms, potential causes, diagnostic tests, and treatment of iron deficiency anemia in adults. WHAT IS ANEMIA? Anemia is defined as a decreased number of red blood cells (RBCs), as measured by one of the following blood tests: ●Hemoglobin (Hgb) is the iron- containing molecule in RBCs that carries oxygen. Iron is a critical component of hemoglobin; without iron, hemoglobin cannot be formed and fewer RBCs are produced.●Hematocrit (Hct) is the percent of a sample of blood made up of RBCs. The rest of the blood is mostly made up of a fluid called plasma.●RBC count is the number of RBCs in a certain amount of whole blood (usually one microliter [one millionth of a liter]). Iron deficiency anemia occurs when there is an insufficient amount of iron in the body to make hemoglobin. When the quantity of hemoglobin is reduced, fewer RBCs are formed, and the RBCs that are formed are smaller. When iron deficiency is severe, the person may develop symptoms. ANEMIA SIGNS AND SYMPTOMSMany people with iron deficiency anemia have no symptoms at all. Of those who do, the most common symptoms include: ●Weakness●Headache●Irritability●Fatigue●Difficulty exercising (due to shortness of breath, rapid heartbeat)●Brittle nails●Sore tongue●Restless legs syndrome●Pica (an abnormal craving to eat non- food items, such as clay or dirt, paper products, or starch [eg, cornstarch])●Pagophagia (an abnormal craving to eat ice)ANEMIA CAUSESTwo common causes of iron deficiency anemia are blood loss (most common) and decreased absorption of iron from food. Blood loss — The source of blood loss may be obvious, such as in women who have heavy menstrual bleeding or multiple pregnancies, or a known bleeding ulcer. In other cases, the source of the blood loss is not visible, as in someone who has chronic bleeding in their gastrointestinal (GI) tract (eg, stomach, small intestine, colon). This may appear as diarrhea with black, tarry stools, or, if the blood loss is very slow, the stool may appear normal. Donating blood can also cause anemia, especially if it is done on a regular basis. Decreased iron absorption — Normally, the body absorbs iron from food through the GI tract. If the GI tract is not functioning correctly, as is the case in people with certain conditions such as celiac disease, gastritis (stomach inflammation), gastric bypass surgery (eg, for weight loss), or other forms of weight loss surgery, an inadequate amount of iron may be absorbed, leading to iron deficiency anemia. Other causes — A common cause of iron deficiency anemia in developing countries is a lack of foods that contain iron. However, this is rarely seen in adults in developed countries such as the United States because many foods have added iron (eg, breakfast cereal, bread, pasta). Iron is also available in some plant- based foods. See 'Iron and diet' below.)Pregnant and postpartum women may develop iron deficiency anemia because of the increased iron requirements of the growing fetus and placenta and blood lost at the time of delivery. ANEMIA DIAGNOSISA person may be diagnosed with iron deficiency anemia after blood testing done to evaluate symptoms or after testing done for another, unrelated reason. The initial workup generally involves a medical history, physical examination, and blood tests. Complete blood count — A complete blood count (CBC) is a group of tests that includes a red blood cell (RBC) count, hemoglobin (Hgb), and hematocrit (Hct). It also includes the mean corpuscular volume (MCV, referring to RBC size), mean corpuscular hemoglobin (MCH, referring to the amount of hemoglobin per RBC), and others. In people with iron deficiency anemia, the RBC count, Hgb, and Hct are lower than normal. The MCV and MCH are also usually lower than normal, indicating that the RBCs are smaller (called microcytic) and carry less Hgb than normal RBCs. In the early stages of iron deficiency, the MCV can be low even if anemia is not seen. As part of the CBC, the shape, color, and size of the RBCs are also evaluated (either by a machine or by a person using a microscope). This information can help to determine the type of anemia. Other blood tests — In many cases, iron deficiency anemia is suspected based upon the results of the medical history and the CBC. Further testing is used to confirm the diagnosis.●Serum iron — Measures how much iron is circulating in the blood●Total iron binding capacity (TIBC or transferrin) — Measures the amount of a protein (transferrin) in the blood that is capable of transporting iron to RBCs or body stores●Transferrin saturation — Measures the percentage of iron- binding sites on transferrin that are occupied by iron●Ferritin — Measures ferritin, a protein that stores iron in the liver and spleen. In a person with iron deficiency anemia, the serum iron, transferrin saturation, and ferritin are lower than normal and the TIBC may be higher than normal. Search for source of blood and iron loss — Once the diagnosis of iron deficiency anemia is made in an adult, it is important to identify the cause of blood loss. The healthcare provider may ask questions about the following situations, which can increase the risk of developing iron deficiency anemia: ●For women, history of menstrual bleeding, pregnancy, delivery●GI problems such as ulcer, Helicobacter pylori (H. Surgery on the GI tract (eg, gastric bypass for weight loss)●Family or personal history of bleeding disorders●Family or personal history of colon cancer●Multiple blood donations. If the cause of blood loss is not obvious, there are additional tests that can be done. These include colonoscopy or upper endoscopy to look for areas of bleeding in the GI tract, and blood tests for certain conditions that interfere with iron absorption, such as celiac disease and H. Looking for bleeding in the colon is especially important in people over the age of 5. See "Patient education: Colonoscopy (Beyond the Basics)" and "Patient education: Upper endoscopy (Beyond the Basics)" and "Patient education: Helicobacter pylori infection and treatment (Beyond the Basics)".)ANEMIA TREATMENTThe first step in treating iron deficiency anemia is to determine the cause of the deficiency and correct it, so that iron does not continue to be lost, and any serious condition (for example, colon cancer) is treated as early as possible. After that, the treatment for iron deficiency anemia is to give iron. Iron supplements may be taken by mouth or given as one or more intravenous injections (also sometimes called "parenteral iron" or "IV iron"). Iron is needed to increase production of hemoglobin (Hgb) and also to rebuild the body's iron reserves. Oral iron tablets are used in most people with iron deficiency anemia. Intravenous iron can be used for people whose GI tract is unable to adequately absorb iron or in those who are unable to tolerate oral iron. A blood transfusion may be given if a person is actively bleeding and/or the person's Hgb or hematocrit (Hct) levels are very low. Oral iron — Oral iron tablets are usually a safe, inexpensive, and effective treatment for people with iron deficiency. The following tips are recommended: ●Enteric coated (EC) iron tablets are not recommended because iron is best absorbed from the duodenum and jejunum (the first and middle parts of the small intestine). EC iron releases iron further down in the intestinal tract, where it is not as easily absorbed. In some cases, the EC iron tablet passes through the entire intestinal tract with the coating intact, meaning that none of the iron was absorbed.●Certain foods and medicines can reduce the effectiveness of iron tablets. Iron tablets usually should not be taken with food, certain antibiotics, tea, coffee, calcium supplements, or milk. Iron should be taken one hour before or two hours after these items. If you take antacids, your iron tablets should be taken two hours before or four hours after the antacids.●Iron tablets are best absorbed in an acidic environment; taking iron with one 2. C tablet or orange juice can enhance iron absorption. Types of oral iron — There are several types of oral iron, and with the exception of the EC iron tablets mentioned above, they are all equally effective. The primary difference between the types is the amount of iron each product contains. For many products, the number of milligrams for the pill is different from the number of milligrams of actual iron molecules (called elemental iron): ●Ferrous fumarate — 1. Ferrous sulfate — 6. Ferrous sulfate liquid — 4. L)●Ferrous gluconate — 2. Polysaccharide iron complex – various doses available. The best way to take oral iron is not clear. Up until recently, iron was typically prescribed to be taken three times a day, every day, for a total dose of 1. A healthcare provider can help to determine what dose and type of iron is most appropriate. Side effects — Some people experience a metallic taste, nausea, constipation, stomach upset, dark- colored stools, and/or vomiting after taking oral iron. What Is Hemolytic Anemia? NHLBI, NIHHemolytic anemia (HEE- moh- lit- ick uh- NEE- me- uh) is a condition in which red blood cells are destroyed and removed from the bloodstream before their normal lifespan is over. Red blood cells are disc- shaped and look like doughnuts without holes in the center. These cells carry oxygen to your body. They also remove carbon dioxide (a waste product) from your body. Red blood cells are made in the bone marrow—a sponge- like tissue inside the bones. They live for about 1. White blood cells and platelets (PLATE- lets) also are made in the bone marrow. White blood cells help fight infections. Platelets stick together to seal small cuts or breaks on blood vessel walls and stop bleeding. When blood cells die, the body's bone marrow makes more blood cells to replace them. However, in hemolytic anemia, the bone marrow can't make red blood cells fast enough to meet the body's needs. Hemolytic anemia can lead to many health problems, such as fatigue (tiredness), pain, irregular heartbeats called arrhythmias (ah- RITH- me- ahs), an enlarged heart, and heart failure. Overview. Hemolytic anemia is a type of anemia. The term "anemia" usually refers to a condition in which the blood has a lower than normal number of red blood cells. Anemia also can occur if your red blood cells don't contain enough hemoglobin (HEE- muh- glow- bin). Hemoglobin is an iron- rich protein that carries oxygen from the lungs to the rest of the body. Anemia has three main causes: blood loss, lack of red blood cell production, or high rates of red blood cell destruction. Hemolytic anemia is caused by high rates of red blood cell destruction. Many diseases, conditions, and factors can cause the body to destroy its red blood cells. These causes can be inherited or acquired. Inherited" means your parents passed the gene(s) for the condition on to you. Acquired" means you aren't born with the condition, but you develop it. Sometimes the cause of hemolytic anemia isn't known. Outlook. There are many types of hemolytic anemia. Treatment and outlook depend on what type you have and how severe it is. The condition can develop suddenly or slowly. Symptoms can range from mild to severe. Hemolytic anemia often can be successfully treated or controlled. Mild hemolytic anemia may need no treatment at all. Severe hemolytic anemia requires prompt and proper treatment, or it may be fatal. Inherited forms of hemolytic anemia are lifelong conditions that may require ongoing treatment. Acquired forms of hemolytic anemia may go away if the cause of the condition is found and corrected.
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