Anaemia: Types and Treatment
June 30, 2009
Anaemia is a term that indicates that the concentration of haemoglobin and circulating red blood cells in the blood is less than normal. It may arise in three ways; chronic blood loss that leads to iron deficiency, impaired red blood cell or hemoglobin production or shortened survival of the red blood cells.
Classification
Anaemias may be further characterized as macrocytic, microcytic or normocytic.
Macrocytic anaemia is recognized by an elevated mean cell volume (MCV). Vitamin B12 and folic acid deficiency are the most common causes of this type of anaemia. Macrocytosis (cell size larger than normal red blood cells) may occur without anaemia in case of hypothyroidism and alcohol abuse.
Microcytic anaemia (size of red blood cells smaller than normal) is recognized by a low mean cell volume (MCV). The main cause of microcytic anaemia is iron deficiency, which is usually as a result of chronic blood loss. With iron deficiency there may also be a hypochromic blood picture, which means reduced level of haemoglobin within every red blood cell (low mean cell haemoglobin concentration; MCHC). Thalassaemia minor is also a microcytic anaemia.
Normocytic anaemia (size of red blood cells are of normal size) has a normal MCV. The most common causes for this type of anaemia include chronic disease, bone marrow disorders and renal failure. About 50% of anaemias in old people are normocytic.
Symptoms in anaemia include weakness, dyspnoea on exertion, lethargy, lassitude, tiredness, poor concentration etc. The patients are pre disposed to angina, syncope and congestive heart failure. Iron deficient patients may have specific cravings such as for clay.
Signs
On examination, the patient has signs of pallor of skin and conjunctiva, tachycardia (increased heart rate), increased pulse pressure and sometimes gastro intestinal bleeding. Jaundice may occur in case of hemolytic anaemia.
Treatment
Treatment aims at identifying and treating the underlying cause. Deficiency of vitamin B12 is treated with monthly intra-venous doses and that of iron and folic acid is replaced with oral iron and folic acid supplements. Transfusions are indicated in patients with severe symptoms.
Dietary Prevention
Anaemia can be very well prevented through proper dietary management. A diet that helps prevent anaemia is to be high in fish, eggs, green leafy vegetables, cereals, lentils and beans. Food rich in vitamin C should also be encouraged including oranges, tomatoes, red capsicum etc.
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