Anemia is a condition where there is a too low content of hemoglobin Hb in the blood. This may be the result of defective synthesis, increase in the degradation or loss of red blood cells. Hemoglobin is the red, carbon dioxide and oxygen-transporting protein in blood, which is located in the red blood cells. Anemia is not having "too little" blood, as is sometimes thought.
Hemoglobin contains iron. Iron deficiency may be the direct result of too little iron in the diet, but also the result of inability to incorporate iron or an increased loss of iron already present. However, iron deficiency is not the only cause of anemia, there are dozens of other possible causes, mostly rare or very rare. In the Netherlands, there is talk of anemia when the molar concentration of Hb is less than 7.5 mmol / l in women, 6.8 in pregnant women, and lower than 8.5 mmol / l in men.
Diagnosis of anemia
If there is anemia is determined by means of an Hb determination, a patient is additional diagnostics performed to determine the cause of this anemia to determine. First, a distinction is made between the different types of anemia. This distinction is made by measuring the mean corpuscular volume (MCV) from the red blood cells:
Microcytic anemia MCV <80 fl="" nbsp="" p="">Normocytic anemia MCV 80-100 fl
Macrocytic anemia MCV> 100 fl
The image of a microcytic anemia is found in iron deficiency, with hereditary abnormal forms of hemoglobin, such as thalassemia or sickle cell anemia, or chronic illness. In order to show an iron deficiency anemia, the amount of ferritin determined in the blood of the patient, often in combination with serum iron and transferrin. Is ferritin concentration less than 15 g / l, and there is no question of an inflammatory process, it is an iron deficiency is almost certainly the cause of microcytic anemia.
Normocytic anemia can be caused by bone marrow disease, kidney problems, or by hemolysis, destruction of red blood cells.
Macrocytic anemia can be caused by a deficiency of vitamin B12 and folic acid, alcoholism, drugs, hypothyroidism, liver function or myelodysplastic syndrome (MDS).
Systematic list of causes
Anemia can be caused by:
decreased production of blood cells;
iron deficiency
megaloblastic anemia, vitamin B12 deficiency
megaloblastic anemia, folic acid deficiency
pernicious anemia
by inherited abnormal forms of hemoglobin: eg, thalassemia and sickle cell anemia,
chronic diseases: rheumatoid arthritis, chronic infectious diseases and malignant neoplasms
aplastic anemia: bone marrow diseases where production has been reduced
myelophthisis: diseases in which the bone marrow will disappear, for example, by displacement by tumor cells
hemolysis: increased degradation of blood cells
by abnormalities in the cells themselves: ovalocytose, spherocytosis
by affecting the red blood cells by protozoan parasites: malaria
by auto-immune processes
by splenomegaly
by enzyme deficiencies, such as G6P dehydrogenase and pyruvaatkinasedeficiëntie
by membrane abnormalities, such as paroxysmal nocturnal hemoglobinuria or hereditary spherocytosis
by immunohemolytische anemia
by microangiopathieën such as thrombotic thrombocytopenic purpura, hemolytic uremic syndrome
by blood loss.
in injury or in childbirth, blood loss is so great that more blood is lost than can be made quickly by the body
with heavy periods
prolonged, often unnoticed blood loss from the gut: polyps, tumors, parasites, particularly worms, causing the iron stores of the body is slowly depleted
Iron deficiency
This is, in humans, the most common cause of anemia. Blood loss during menstruation is a lot of iron loss, and / or eating too little iron-containing foods, the synthesis of hemoglobin inhibited. This form of anemia is also common in women of childbearing age. This can be treated by consuming rich in iron, such as beef and lamb, whole grain bread, dark green leafy vegetables, broccoli and green beans food. With prolonged periods strong iron will in tablet form: steel pills must be given additionally. By adding vitamin C to eat iron absorption is enhanced in blood. Vitamin C is found mainly in vegetables such as peppers, especially the red, and broccoli. When fruit is mainly the kiwi which contains lots of vitamin C.
If the cause of iron deficiency anemia, an iron deficiency anemia is not clear beforehand, for example with heavy menstrual periods, should be used to, for example, an intestinal tumor in which the patient daily unnoticed a few ml of blood lost to be excluded. Done further research For people coming from Africa and the area around the Mediterranean are hemoglobinopathies much more than in people from northern areas. This is probably a result of selection pressure by malaria which occurs in warmer climate areas: that runs tend to be less severe in a hemoglobinopathy.
Infections
Serious infections and other chronic diseases that much of the energy of the body can require lead to anemia. By anemia and a reduced resistance to infections, which can cause. Other infections Risk of chronic infection is also present.
Blood loss
For (much) blood loss, such as an accident or major surgery or menstruation, anemia may also occur. This can be remedied by a blood transfusion., If the situation is very serious, Dynamometer anemia after major bleeding one gives rather iron and let the body make new blood cells necessary. Strengthens blood loss can also occur if there is an inherited disorder of blood clotting, in haemophilia, so it continues to bleed, even in a relatively minor accident such as a cut in the finger, nosebleed. The use of anticoagulants can lead to increased blood loss.
Lack of vitamin B12
This form of anemia is not always detected. Especially the elderly may suffer from a vitamin B12 deficiency will exhibit their metabolic disorders. Due to the lack of vitamin B12 is the formation of red blood cells is disturbed. This can get very tired. B12 deficiency can be caused by deficient diet, namely lack animal products, but also by an acquired defect in the absorption of vitamin B12 in pernicious anemie-. In anemia due to lack of vitamin B12 or folic acid are the blood cells that can still usually has too large; in iron deficiency precisely mostly too small.
Symptoms
Common signs and symptoms of anemia are:
fatigue faster than normal
shortness of breath faster than normal
Tachycardia, rapid heart rate
headache
general feeling of weakness
With severe anemia sometimes one sees:
pale skin (especially under the fingernails)
pale lips
palpitations
dizziness
tinnitus
cold hands and feet
tingling in the feet followed by to have bumps / bulges to walk the feeling.
cracked corners of the mouth, or cracked lips
In people with narrowed coronary arteries, the first symptom of anemia may well be that they get faster chest pain.
Estimating the anemia by looking at the patient is difficult and one can easily be mistaken. Moreover, a person can have a very significant anemia without symptoms or signs. Anemia can be objectively determined by blood tests. Depending on the cause of the anemia, the doctor will prescribe appropriate medication. Some forms are untreatable. Those are usually happy or rare, or not serious.
Hemoglobin contains iron. Iron deficiency may be the direct result of too little iron in the diet, but also the result of inability to incorporate iron or an increased loss of iron already present. However, iron deficiency is not the only cause of anemia, there are dozens of other possible causes, mostly rare or very rare. In the Netherlands, there is talk of anemia when the molar concentration of Hb is less than 7.5 mmol / l in women, 6.8 in pregnant women, and lower than 8.5 mmol / l in men.
Diagnosis of anemia
If there is anemia is determined by means of an Hb determination, a patient is additional diagnostics performed to determine the cause of this anemia to determine. First, a distinction is made between the different types of anemia. This distinction is made by measuring the mean corpuscular volume (MCV) from the red blood cells:
Microcytic anemia MCV <80 fl="" nbsp="" p="">Normocytic anemia MCV 80-100 fl
Macrocytic anemia MCV> 100 fl
The image of a microcytic anemia is found in iron deficiency, with hereditary abnormal forms of hemoglobin, such as thalassemia or sickle cell anemia, or chronic illness. In order to show an iron deficiency anemia, the amount of ferritin determined in the blood of the patient, often in combination with serum iron and transferrin. Is ferritin concentration less than 15 g / l, and there is no question of an inflammatory process, it is an iron deficiency is almost certainly the cause of microcytic anemia.
Normocytic anemia can be caused by bone marrow disease, kidney problems, or by hemolysis, destruction of red blood cells.
Macrocytic anemia can be caused by a deficiency of vitamin B12 and folic acid, alcoholism, drugs, hypothyroidism, liver function or myelodysplastic syndrome (MDS).
Systematic list of causes
Anemia can be caused by:
decreased production of blood cells;
iron deficiency
megaloblastic anemia, vitamin B12 deficiency
megaloblastic anemia, folic acid deficiency
pernicious anemia
by inherited abnormal forms of hemoglobin: eg, thalassemia and sickle cell anemia,
chronic diseases: rheumatoid arthritis, chronic infectious diseases and malignant neoplasms
aplastic anemia: bone marrow diseases where production has been reduced
myelophthisis: diseases in which the bone marrow will disappear, for example, by displacement by tumor cells
hemolysis: increased degradation of blood cells
by abnormalities in the cells themselves: ovalocytose, spherocytosis
by affecting the red blood cells by protozoan parasites: malaria
by auto-immune processes
by splenomegaly
by enzyme deficiencies, such as G6P dehydrogenase and pyruvaatkinasedeficiëntie
by membrane abnormalities, such as paroxysmal nocturnal hemoglobinuria or hereditary spherocytosis
by immunohemolytische anemia
by microangiopathieën such as thrombotic thrombocytopenic purpura, hemolytic uremic syndrome
by blood loss.
in injury or in childbirth, blood loss is so great that more blood is lost than can be made quickly by the body
with heavy periods
prolonged, often unnoticed blood loss from the gut: polyps, tumors, parasites, particularly worms, causing the iron stores of the body is slowly depleted
Iron deficiency
This is, in humans, the most common cause of anemia. Blood loss during menstruation is a lot of iron loss, and / or eating too little iron-containing foods, the synthesis of hemoglobin inhibited. This form of anemia is also common in women of childbearing age. This can be treated by consuming rich in iron, such as beef and lamb, whole grain bread, dark green leafy vegetables, broccoli and green beans food. With prolonged periods strong iron will in tablet form: steel pills must be given additionally. By adding vitamin C to eat iron absorption is enhanced in blood. Vitamin C is found mainly in vegetables such as peppers, especially the red, and broccoli. When fruit is mainly the kiwi which contains lots of vitamin C.
If the cause of iron deficiency anemia, an iron deficiency anemia is not clear beforehand, for example with heavy menstrual periods, should be used to, for example, an intestinal tumor in which the patient daily unnoticed a few ml of blood lost to be excluded. Done further research For people coming from Africa and the area around the Mediterranean are hemoglobinopathies much more than in people from northern areas. This is probably a result of selection pressure by malaria which occurs in warmer climate areas: that runs tend to be less severe in a hemoglobinopathy.
Infections
Serious infections and other chronic diseases that much of the energy of the body can require lead to anemia. By anemia and a reduced resistance to infections, which can cause. Other infections Risk of chronic infection is also present.
Blood loss
For (much) blood loss, such as an accident or major surgery or menstruation, anemia may also occur. This can be remedied by a blood transfusion., If the situation is very serious, Dynamometer anemia after major bleeding one gives rather iron and let the body make new blood cells necessary. Strengthens blood loss can also occur if there is an inherited disorder of blood clotting, in haemophilia, so it continues to bleed, even in a relatively minor accident such as a cut in the finger, nosebleed. The use of anticoagulants can lead to increased blood loss.
Lack of vitamin B12
This form of anemia is not always detected. Especially the elderly may suffer from a vitamin B12 deficiency will exhibit their metabolic disorders. Due to the lack of vitamin B12 is the formation of red blood cells is disturbed. This can get very tired. B12 deficiency can be caused by deficient diet, namely lack animal products, but also by an acquired defect in the absorption of vitamin B12 in pernicious anemie-. In anemia due to lack of vitamin B12 or folic acid are the blood cells that can still usually has too large; in iron deficiency precisely mostly too small.
Symptoms
Common signs and symptoms of anemia are:
fatigue faster than normal
shortness of breath faster than normal
Tachycardia, rapid heart rate
headache
general feeling of weakness
With severe anemia sometimes one sees:
pale skin (especially under the fingernails)
pale lips
palpitations
dizziness
tinnitus
cold hands and feet
tingling in the feet followed by to have bumps / bulges to walk the feeling.
cracked corners of the mouth, or cracked lips
In people with narrowed coronary arteries, the first symptom of anemia may well be that they get faster chest pain.
Estimating the anemia by looking at the patient is difficult and one can easily be mistaken. Moreover, a person can have a very significant anemia without symptoms or signs. Anemia can be objectively determined by blood tests. Depending on the cause of the anemia, the doctor will prescribe appropriate medication. Some forms are untreatable. Those are usually happy or rare, or not serious.