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Anemia 

Overview of Anemia

Anemia affects millions of people worldwide. The National Center for Health Statistics estimated that 3.4 million Americans are living with anemia.1 Nevertheless the actual anemic individuals may be even greater as anemia is often under-diagnosed and under-treated.

Anemia is one of the most prevalent public health problems in most of the developing countries and has serious consequences on national development.

Iron deficiency anemia: Iron deficiency anemia (IDA) is the most common nutritional deficiency and is one of the leading risk factors for disability and death worldwide, affecting an estimated two billion people.2

Although anemia is usually a consequence of many diseases including chronic inflammatory, infectious or neoplastic disorders, it may also occur from the treatment of the disease itself. Anemia may affect school children, adolescents, elderly and reproductive-age women.

Anemia has serious negative consequences including

  • Increased mortality in women and children
  • Reduced capacity to learn and
  • Decreased productivity in all individuals

Anemia in the elderly is linked to an increase in morbidity and mortality.3 Pregnant women often show iron deficiency anemia as a consequence of increased plasma volume during pregnancy. Gynecological anemia is often caused by hypermenorrhea (increased menstrual bleeding).4

Treatment should be directed at the cause of the anemia. This article will discuss in detail regarding the different classes and types of anemia, the causes, the risk factors and the diagnosis and management strategies for anemia of various origin. 


Classifications of Anemia

Classification of Anemia

Anemia can be classified by cytometric methods, based on the morphology of red blood cells (RBCs), erythrokinetic schemes (the rates of RBCs production and destruction) and biochemical or molecular methods.

Causes of Anemia

Causes of Anemia

Significant causes of anemia include nutritional deficiencies other than iron deficiency (folic acid and vitamin B12 deficiencies), genetic conditions (thalassemia, sickle cell anemia (SCA) or hemoglobinopathies).
 

Symptoms of Anemia

Symptoms of Anemia

Symptoms of anemia vary depending on the severity of the condition. Symptoms can sometimes be vague and be detected only during a clinical examination and investigation. 
 

Diagnosis of Anemia

Diagnosis of Anemia

Anemia is diagnosed based on the patient's symptoms and from various laboratory tests.9 As anemia is best defined in relation to hemoglobin (Hb) and hematocrit (HCT) levels below the normal reference range, the first test used 

Treatment and Prevention of Anemia

Treatment of Anemia

Treatment is directed at the cause of the anemia. Severe anemia is life-threatening and can be treated in the hospital with blood transfusions. The treatment of different types of anemia will be discussed in detail in their 

Summary Points
  • Anemia is one of the most prevalent public health problems.
  • Anemia is often underdiagnosed and undertreated.
  • Iron deficiency is the most prevalent nutritional disorder worldwide, especially in developing countries.
  • Iron deficiency is the most common type of anemia followed by ACD.
  • Some types of anemia are due to inherited or genetic defects.
  • Different types of anemia are characterized by discrete hematologic patterns.
  • The consequences of anemia are many and serious, affecting not only individuals’ health but also the development of societies and countries.
  • There are many different treatments for anemia and the treatment depends on severity and the cause.
  • Iron supplementation and food fortification are the most cost-effective means of addressing IDA.
  • Anemia in pregnancy is very common but severe anemia in pregnancy may have adverse effects for the newborn and should be treated or prevented early in pregnancy.


Related topics:

Types of Anemia

Anemia in Pregnancy

Iron deficiency Anemia

Vitamin deficiency anemia

Anemia of chronic disease

Written by: Healthplus24 team
Date last updated: April 17, 2012

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References 
  1. National Center for Health Statistics. FASTATS-Anemia. National Center for Health Statistics. Availabe at: http://www.cdc.gov/nchs/fastats/anemia.htm
  2. Zimmermann MB, Hurrell RF. Nutritional iron deficiency. Lancet. 2007; 370(9586): 511-520.
  3. Gabrilove J. Anemia and the elderly: clinical considerations. Best Pract Res Clin Haematol. 2005; 18(3): 417-422.
  4. Adachi T. Anemia in the field of obstetrics and gynecology. Nippon Rinsho. 2008; 66(3): 548-552.
  5. Thomas C, Thomas L. Anemia of chronic disease: Pathophysiology and laboratory diagnosis. Lab Hematol. 2005; 511(1): 514–523.
  6. Louw VJ, du Preez P, Malan A, et al. Pica and food craving in adult patients with iron deficiency in Bloemfontein, South Africa. S Afr Med J. 2007; 97(11): 1069–1071.
  7. Konofal E, Lecendreux M, Arnulf I, Mouren MC. Iron deficiency in children with attention-deficit/hyperactivity disorder. Arch Pediatr Adolesc Med. 2004; 158(12): 1113–1115.
  8. Handelman GJ, Levin NW. Iron and anemia in human biology: A review of mechanisms. Heart Fail Rev. 2008 Mar 25; (Epub ahead of print).
  9. Huisman A, van Solinge WW. A flow chart for the laboratory diagnosis of anaemia as requested by general practice. Ned Tijdschr Geneeskd. 2007; 151(42): 2302—2304 (article in Dutch)..
  10. Clark SF. Iron deficiency anemia. Nutr Clin Pract. 2008; 23(2): 128–141.
  11. Vucelić D, Nenadić B, Pesko P, et al. Iron deficiency anemia and its importance in gastroenterology clinical practice. Acta Chir Iugosl. 2007; 54(1): 91—105 (article in Serbian).
  12. Algarin C, Peirano P, Garrido M, Pizarro F, Lozoff B. Iron deficiency anemia in infancy: long–lasting effects on auditory and visual system functioning. Pediatr Res. 2003; 53: 217–223.
  13. Verdon F, Burnand B, Stubi CL, et al. Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. BMJ. 2003; 326: 1124.
  14. Centers for Disease Control and Prevention. Recommendations to prevent and control iron deficiency in the United States. MMWR Morb Mortal Wkly Rep. 1998; 47(RR-3): 1–29.
  15. Cook JD. Newer aspects of the diagnosis and treatment of iron deficiency. American Society of Hematology Educational Program Book, 2003: 40–61.
  16. Matsumura I, Kanakura Y. Pathogenesis of anemia of chronic disease. Nippon Rinsho. 2008; 66(3): 535–539. Japanese.
  17. Valent P, Lechner K. Diagnosis and treatment of autoimmune haemolytic anaemias in adults: a clinical review. Wien Klin Wochenschr. 2008; 120(5–6): 136–151.
  18. Müngen E. Iron supplementation in pregnancy. J Perinat Med. 2003; 31(5): 420–426.
  19. Malhotra M, Sharma JB, Batra S, et al. Maternal and perinatal outcome in varying degrees of anemia. Int J Gynaecol Obstet. 2002; 79(2): 93–100.
  20. El Guindi W, Pronost J, Carles G, et al. Severe maternal anemia and pregnancy outcome. J Gynecol Obstet Biol Reprod (Paris). 2004; 33(6 Pt 1): 506–509 (article in French).
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