TYPES OF ANEMIA

Anemia is defined as a haemoglobin concentration in blood below the lower limit of the normal range for the age and sex of the individual

In symptomatic cases of Anemia, the presenting features are tiredness, easy fatiguability, generalised muscular weakness, lethargy, and headache. Pallor is the most common and characteristic sign which may be seen in the mucous membranes, conjunctivae, and skin Anorexia, flatulence, nausea, constipation, and weight loss may occur

Following is the brief classification of Anemia:

Inadequate dietary intake (improperly balanced diet, vegan or vegetarianism diet, poor iron diet, eating disorder, etc )

Decreased intestinal absorption (celiac disease, atrophic gastritis, intestinal bypass, IBD, etc.)

The usual symptoms are weakness, fatigue, dyspnea on exertion, palpitations, and pallor of the skin, mucous membranes, and sclerae Older patients may develop angina and congestive cardiac failure Patients may have unusual dietary cravings such as pica Menorrhagia (abnormally heavy bleeding at menstruation.) is a common symptom in iron-deficient women.

Long-standing chronic iron deficiency Anemia causes epithelial tissue changes in some patients The changes occur in the nails (koilonychia or spoonshaped nails), tongue (atrophic glossitis), mouth (angular stomatitis), and oesophagus causing dysphagia

ANEMIA OF CHRONIC DISORDERS:

One of the most commonly encountered Anemia is in patients of a variety of chronic systemic diseases in which Anemia develops secondary to a disease process but there is no actual invasion of the bone marrow The Anemia is corrected only if the primary disease is alleviated

Iron Deficiency Anemia

Iron deficiency Anemia develops when the supply of iron is inadequate for the requirement of haemoglobin synthesis Initially, negative iron balance is covered by mobilization from the tissue stores so as to maintain haemoglobin synthesis

It is only after the tissue stores of iron are exhausted that the supply of iron to the marrow becomes insufficient for haemoglobin formation and thus a state of iron deficiency Anemia develops. The development of iron deficiency depends upon one or more of the following factors:

Increased blood loss (esophagitis, ulcers, malignancies, hemorrhagic conditions, etc )

Increased requirements (pregnancy, infancy, adolescence, increased menstrual loss, blood donation, endurance sports, etc.)

In general, 2 factors appear to play a significant role in the pathogenesis of Anemia in chronic disorders. These are defective red cell production and reduced red cell lifespan.

Eg: Infections e g tuberculosis, pneumonia, osteomyelitis, Non-infectious inflammations e g rheumatoid arthritis, SLE, Crohn’s disease ; Hodgkin’s disease disseminated carcinomas and sarcomas; Anemia of renal disease e g uremia, renal failure; Anemia of hypometabolic state e.g. protein malnutrition, scurvy, and pregnancy, liver disease.

MEGALOBLASTIC ANEMIA:

Megaloblastic Anemias are disorders caused by impaired DNA synthesis and are characterized by a distinctive abnormality in the haematopoietic precursors in the bone marrow in which the maturation of the nucleus is delayed relative to that of the cytoplasm. Since cell division is slow but cytoplasmic