Anemia. Myths about anemia

Anemia (or anemia) is a condition of the body that is characterized by a decrease in the red blood cell content. Erythrocytes (red blood cells) along with leukocytes and platelets are shaped elements of blood; in addition, the erythrocytes are the most numerous of these elements.

Many causes can lead to anemia, and often anemia accompanies other diseases. The development of anemia can be caused by a decrease in the red blood cells in the blood, destruction of erythrocytes or bleeding, sometimes anemia occurs as a result of the combination of these causes.

The main symptoms of anemia can be attributed to two – weakness and pallor, however, in order to ascertain the nature of the development of anemia in each individual, it is necessary to check the presence of other symptoms.

Several types of anemia are distinguished, for example, iron deficiency anemia, sickle-cell anemia, drug anemia and other types. The most common iron deficiency anemia, which is most often found in women of childbearing period. Sickle-cell anemia is a hereditary disease and is characterized by a severe course, which is often accompanied by painful attacks.

Treatment of anemia can be prescribed only after all the factors that led to the condition of anemia have been determined. Transfusion of blood with anemia is rarely used.

Anemia is the result of many reasons.

Anemia can accompany a large number of diseases. Quite often anemia is a symptom of some disease. Its quantitative expression is determined by the degree of decrease in the hemoglobin content. Hemoglobin is actually an iron-containing pigment of erythrocytes.

There are three types of mechanisms of anemia development.

First, anemia develops as a result of changes in the normal production of red blood cells by the bone marrow. Secondly, anemia can occur as a result of the destruction of red blood cells (ie hemolysis processes), as well as the decrease in the duration of their life in the blood of a person (the normal lifespan of red blood cells – their circulation in the blood – is approximately 120 days, after which they are destroyed or in the spleen, or in the liver). The third type of mechanism of development of anemia is the occurrence of acute or chronic bleeding. However, do not think that anemia develops along a particular path, most often there is a combination of all of the above mechanisms.

The first mechanism of anemia development is characteristic for patients with oncological diseases.

Indeed, in the case of cancer, a decrease in the production of red blood cells is observed. However, such anemia can accompany other human diseases, for example, anemia can develop due to kidney disease, protein depletion or endocrine insufficiency. In some cases, anemia develops as a result of decreased secretion of erythropoietin. Erythropoietin is a hormone produced by the kidneys and stimulating the production of erythrocytes. Deficiency in the human body of vitamin B12, iron, folic acid can also lead to a state of anemia. It is about the substances that are required for the formation of red blood cells.

Defects in erythrocytes lead to anemia, which is caused by hemolysis.

These defects contribute to the acceleration of the destruction of red blood cells. Such defects include, for example, a change in the structure of the hemoglobin molecule or a disruption of the normal activity of intracellular enzymes. Hemolysis of erythrocytes can be caused by the incompatibility of the blood of the donor and recipient, that is, red blood cells can be destroyed by blood transfusion (especially when it comes to newborns), as well as certain diseases of the spleen. Hemolytic disease – erythroblastosis – leads to the destruction of red blood cells by antibodies that are in the blood plasma.

Bleeding is the path to the development of chronic anemia.

Not quite right. The fact is that only prolonged (or massive) bleeding is the cause of the development of chronic anemia. All components of red blood cells, except iron in hemoglobin, are capable of rapid recovery, but it is the depletion of iron stores in the human body due to prolonged hemorrhage leads to the development of anemia. Lack of iron in this case also occurs with increased absorption of iron by intestinal villi. The most common bleeding occurs in the gastrointestinal tract (gastrointestinal tract) and in the uterus – for example, as a result of tumors or ulcers (in the first case).

Weakness is the main symptom of anemia.

The main symptoms of anemia are also pallor. These two symptoms are an objective consequence of a decrease in the concentration of hemoglobin. The function of hemoglobin is to transport oxygen from the lungs to all organs and tissues, insufficient supply of the latter leads to increased heart rate and the appearance of dyspnoea. In the case of a gradual decrease in the concentration of hemoglobin in the patient’s body, a person is able to tolerate normal and severe anemia. Thus, the severity of the symptoms of anemia is directly related to the severity of the disease itself.

Weakness and pallor are the only symptoms of anemia.

To find out the nature of anemia, you need to check for other symptoms. For example, jaundice may indicate a hemolytic process. Jaundice occurs as a result of a dramatically increased decomposition of hemoglobin. Bleeding in the intestine can be indicated by the black color of the stool.

There are several varieties of the state of anemia.

It is iron deficiency anemia, pernicious anemia, aplastic anemia, sickle cell anemia, congenital spherocytic anemia, drug anemia.

железо Iron deficiency anemia is most widespread.

Deficiency of iron in the body leads to the fact that the bone marrow begins to produce erythrocytes small and pale. These erythrocytes are depleted of hemoglobin. This type of anemia is most often observed in women of childbearing age. Anemia in this case leads to menstrual blood loss and an increasing need for iron.

Pernicious anemia is caused by inadequate vitamin B12 in the human body.

Bone marrow is very sensitive to vitamin B12 deficiency. If there is insufficient treatment for this vitamin deficient, the patient is guaranteed the development of anemia. Pernicious anemia is characterized by the formation of abnormally large cells in the bone marrow. These are megaloblasts, which differ markedly from the normal precursor cells of the red blood cells. The size of megaloblasts is associated with an increase in the cytoplasmic content. However, the core of megaloblasts is very underdeveloped, they can not turn into red blood cells. Megaloblasts die in the same place where they formed – in the bone marrow. In the twentieth century (studies started in 1926), it was discovered that the underlying cause of a disease of pernicious anemia is the inability of the stomach, which is innate, to produce a particular substance that is nevertheless very necessary for absorption by the villi of the intestine of the above-mentioned vitamin. This substance was called the internal factor.

Aplastic anemia is associated with the inability of the bone marrow to form red blood cells.

In this case, almost no tissue in the bone marrow, which forms red blood cells, can be caused, for example, by exposure to ionizing radiation or toxic substances. Sometimes the cause of aplastic anemia remains unclear.

Sickle-cell anemia is a hereditary disease.

This disease is characterized by severe course.With sickle cell anemia, the form of erythrocytes becomes anomalous sickle-shaped, such deformation of red blood cells leads to the development of chronic hemolytic anemia. The latter is almost always accompanied by a slowing of the blood flow (which contributes to the occurrence of pain attacks (these are crises) that occur quite often) and the development of jaundice. In 1949, it was found that a similar form of red blood cells is due to a breakdown in the structure of the hemoglobin molecule, which is congenital. The research was conducted by the scientist L. Pauling. This fact was the first evidence of the genetically controlled structure of the protein.

Congenital spherocytic anemia results in a hereditary erythrocyte defect.

This defect causes a state of chronic hemolysis. The normal form of red blood cells is biconvex. With this type of anemia, the erythrocytes become rounded. Duration of circulation of such erythrocytes in the blood is much less than that of red blood cells that have not undergone a change. Rounded red blood cells quickly die in the spleen, which can result in the development of jaundice, the appearance of gallstones, and the enlargement of the spleen in size.

Many drugs can lead to hemolysis (destruction) of erythrocytes.

In this case it is a question of medicinal anemia. Such medicines may include even aspirin and certain sulfonamides (if the person taking these medicines is sensitive to them). In this case, such a vulnerability of red blood cells is hereditary and transmitted from parents to children in the form of an enzyme deficiency that protects cells from the effects of chemicals on them. The first such case was described in the twentieth century – in 1952. A. Alving noted that in some patients acute anemia developed as a result of their use of a primaquine, an antimalarial drug.

Treatment of anemia depends on the nature of anemia.

That is, it is necessary to reliably determine the causes and factors that led to the disease. The most effective introduction into the patient’s body of the missing substances. The latter include vitamin B12, when it comes to pernicious anemia, and iron, when it comes to iron deficiency anemia. In addition, if anemia arises as a condition of the body that accompanies other diseases, then elimination of the underlying disease (it can be arthritis, hypothyroidism, kidney disease and other diseases) is effective in its elimination. Sometimes it is required to cancel the intake of certain drugs that have an overwhelming effect on blood formation.

Anemia requires blood transfusion.

Only in rare and urgent cases, when it is urgently necessary to restore the volume of blood circulating in the human body and, accordingly, the normal amount of hemoglobin. Exchange blood transfusion can be performed in newborns who have a severe course of hemolytic disease. Exchange blood transfusion is a substitute for the blood of an infant for blood, which does not include a factor that promotes hemolysis of red blood cells. The goal is to prevent the development of jaundice in the newborn, which can contribute to brain damage. However, one should be aware that such blood transfusions are not always safe and can lead to hepatitis, renal insufficiency.

Spleen removal is a treatment option for anemia.

This is mainly true when it comes to congenital spherocytic anemia. Removal of the spleen eliminates all the clinical symptoms of this disease.

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