anaemia is present when the haemoglobin is more than two standard deviations below the mean haemoglobin for that individual. it varies with sex and age
symptoms
Annotations:
symptoms depends on the underlying pathology as well as the severity and speed of onset of anaemia. mild anaemia often no symptoms. insidious-onset anaemia, even if profound, likewise may cause few symptoms
in rapid-onset/severe anaemia*: 1)fatigue 2)peripheral
oedema e.g.swollen feet 3)breathlessness 4)angina
Annotations:
3)breathlessness particularly if heart or lung disease is present. anemia is one cause of decompensation of chronic heart failure
4)angina if there is underlying coronary disease which may have been undetected before the anaemia
signs
usually unremarkable*; 1)pallor(palms of the
hand, conjunctiva) may occur 2) a systolic 'flow'
murmur is common 3)evidence of pathology
4)long-standing iron deficiency anaemia,
koilonychia(spoon- shaped nails) may occur
Annotations:
pallor may also occur in people that are not anaemic vice versa
classifications
Annotations:
anaemia is a physiological abnormality, not a diagnosi. a final, pathological diagnosis must always be made
1)microcytic/hypochromic anaemia: the red cells
are smaller than normal and contain less
haemoglobin than normal. common cause are
iron deficiency anaemia and thalassaemia, MCV<80 fl
2)Normochromic and normocytic anaemia:
AKA anaemia of chronic disease. red cells
are normal or just slightly reduce in size and
have a normal Hb conc. common cause
include: 1) chronic infections, 2)inflammatory
diseases 3)malignant disease 4)renal failure. MCV 80-95 fl
Annotations:
1) C.I such as tuberculosis and osteomyelitis
2)I. D such as rheumatoid arthritis and connective tissue disorder
the anaemia of chronic desease is in part caused by the inhibitory effect of interleukin 1 on erythropoiesis, and by erythropoietin deficiency*(especially in renal failure), iron deficiency often complicates chronic disease and may explain a lower than expected haemoglobin
3) Macrocytic anaemia: red cells are larger than normal.
common cause 1)vitamin B12 or folate deficiency 2)cytotoxic
drug treatment e.g azathioprine or cyclophosphamide
3)Myelodysplasia 4)Haemolytic anaemias 5)hypothyroidism
6)liver disease and alcohol abuse MCV >100 fl
Annotations:
6)liver and alcohol abuse result in a macrocytosis but not anaemia!, unless there is a coincidental bleeding or haematinic deficiency