Anemia - a decrease in the total amount of Hb (or red blood cells), which, with the exception of acute blood loss, is characterized by a decrease in hemoglobin level per unit volume of blood.Her reasons are in a small amount of iron in the body or a large blood loss.If you have anemia treatment drugs conducted after identifying her laboratory methods.Anemia can be a symptom of a particular disease (eg iron deficiency anemia), or be a symptom of other disease states.
How to anemia?
First, anemia, or anemia, manifested pallor.And sometimes the skin gets pale green tint.Quite often this happens in girls during adolescence.This anemia develops as a consequence of endocrine disorders and body iron absorption process.
patients with a certain diagnosis of anemia may complain of weakness and constant fatigue, drowsiness, fainting, dizziness, blackout.
If this disease is left untreated, may eventually appear tinnitus, a constant shortness of breath and heart palpitations.On examination, the therapist can l
When anemia is disturbed nutrition of the skin, it becomes dry, because it does not produce the right amount of melanin.Such skin is virtually impossible to tan.
very much trouble with anemia deliver hair.Become brittle, they are cut and drop.Nail plate in humans are crooked and loose.There may be ulcers and cracks in the corners of the mouth.
But in anemia there are problems not only with the appearance.Much worse, if the patient has irregularities in the functioning of internal organs.In this disease, there are constipation, can be belching, abdominal pain and a constant feeling of heaviness in the stomach.Many complain of a runny nose with an unpleasant odor, which is impossible to deal with conventional drop.Disrupt the swallowing of solid food, the patient has a feeling that the food will certainly need to drink.
Patients with anemia have these strange habits that are in eating chalk, raw cereals, dough, raw meat, sand, etc.
known that a lack of iron in the cells leads to oxygen starvation and disruption of oxidation and reduction processes in human tissues.
often have problems with how to define anemia.Sometimes it goes unnoticed, without particularly pronounced symptoms, so time The performed medical diagnostics can help to avoid starvation and its adverse effects.
Symptoms of anemia of various types
in the pathogenesis of disorders that arise in the treatment of anemia drugs, the leading role is played by a violation of the oxygenation of cells of various organs and systems.As a consequence of tissue hypoxia symptoms occur violation of cellular metabolism and metabolic acidosis.The first sign of hypoxia is a central nervous system response.
initial symptoms of anemia
Clinical data pathological processes manifested in the form of anemia characterized by pale skin and visible mucous membranes, weakness, fatigue.Compensatory increase in cardiac output and minute volume, heart rate quickens.This is the main symptoms of anemia requiring treatment.
Symptoms of iron deficiency anemia
Light degree of anemia often asymptomatic in the early stages of treatment of anemia clinical picture is nonspecific.Symptoms of anemia are not something stable and constant.Patients go to the doctor with moderate to severe anemia, complaining of symptoms such as fatigue, weakness, dizziness, irritability, headaches, shortness of breath, tachycardia.The history of such symptoms are often noted as chronic physical (including cancer) diseases, gastrointestinal surgery, the use of drugs (NSAIDs, glucocorticoids), chronic infection and inflammation.Women in the treatment of anemia ascertain the nature and duration of menstrual bleeding.On questioning is often possible to identify the symptoms of dysgeusia - a passion for chalk, lime, clay, coal, tooth powder.
- clinical symptoms of anemia main symptom - Hb content of less than 100 g / l;
- number of red blood cells less than 4 o 1012 / l;
- additional symptom - serum iron content of less than 14.3 mmol / L.
Symptoms of B12-deficiency anemia
Characteristic symptoms of anemia: complaints of weakness, shortness of breath, tachycardia, pallor, tinnitus.In the history of anemia may be surgery on the digestive tract and gastrointestinal diseases (Crohn's disease, cancer of the small intestine and ileum), autoimmune processes (rheumatoid arthritis, Grave's disease, hypothyroidism, hypoparathyroidism, Hashimoto's thyroiditis, diabetes mellitus), idiopathic adrenal insufficiency, agammaglobulinemia.
Symptoms of acquired aplastic anemia
This bright anemia symptoms is different.Anemia can develop gradually or begin acutely, with a rapidly growing pancytopenia, severe haemorrhagic syndrome, infectious complications.Analysis of blood for the treatment of anemia: normochromic anemia, reticulocyte content may be very low or high multiple (usually no more than 2.3%), the total number of platelets and leukocytes decreased.One of the symptoms of this type of anemia is the presence in the bone marrow punctate: very low cellularity.Another symptom of anemia - the presence in bone marrow trephine biopsy: bone marrow space is almost entirely filled with fat pockets hematopoiesis rare and malokletochny.Immunophenotyping with biopsy of bone marrow cells is necessary for an accurate diagnosis of the disease.These are the main symptoms of anemia when purchased.
Symptoms of aplastic anemia, Fanconi
beginning of clinical symptoms of this type of anemia - in the 5-10 years old and is in need of treatment for drugs.Typical symptoms - short stature, congenital skeletal defects (microcephaly may lack radius or phalanges), abnormalities of the genitourinary system (eg, horseshoe kidney), hyper- or hypopigmentation of the skin, mental retardation.Additional symptoms of anemia - a blood test: macrocytic anemia, elevated content of HbF, no severe pancytopenia up to 3-8 years of age.Also characteristic symptoms of this type of anemia as breakage of chromosomes, repair defects, increased sensitivity to the chromosome diepoksibutanu, mitomycin and ultraviolet irradiation.In puncture bone marrow at the start of the treatment of anemia often do not detect the changes.On radiographs: malformations of the radius and thumb.Ultrasound of the internal organs: congenital malformations of the genitourinary system.Anemia in need of drug treatment.
Symptoms of hemolytic anemia
most often occur symptoms of anemia: AIHA with incomplete heat agglutinins, which are fixed on the red blood cells without causing their agglutination, but contributing to haemolysis of red blood cells in the spleen, liver (macrophages of the spleen and liver are fixed to the Fc-fragment ATlocated on erythrocytes) and in the vascular bed (with the participation of the complement).Clinical symptoms of anemia depends on the severity of hemolysis.Predominant symptoms of anemia (pallor, shortness of breath, dizziness, tachycardia, systolic murmur at the apex of the heart) and symptoms of hemolysis (jaundice, hepatosplenomegaly).Anemia is normochromic, microcytic often, reticulocytosis, erythroid hyperplasia of the bone marrow, hyperbilirubinemia due to indirect bilirubin, positive direct Coombs test.Osmotic resistance of erythrocytes often reduced, acid increased.
When AIHA with thermal hemolysin and AIHA with biphasic hemolysin prevails intravascular hemolysis.When these forms of anemia, especially large role in the complement hemolysis.A characteristic feature of hemolysin form AIHA - selection of black-colored urine.Often develop thrombosis of small mesenteric vessels, which is manifested by pain in the abdomen.
When AIHA with cold agglutinins causing agglutination of red blood cells at low temperatures, the patients are particularly sensitive to cold.Since the lowest temperature - in limbs capillaries under cooling erythrocytes in them stick together.There is a symptom of Raynaud's syndrome.The fingers, the tip of the nose, earlobes turn blue, then turn white, there is a strong pain.Prolonged exposure to cold may develop gangrene.The liver and spleen are enlarged.When drawing blood there autoagglutination, difficult to determine the blood group, which is the first symptom that suggest Kholodov AT.Preparations for the treatment of anemia of this type you will assign a doctor.
Iron deficiency anemia: diagnosis and treatment
diagnosis of iron deficiency anemia prior to treatment
leading diagnostic criteria of iron deficiency anemia prior to treatment - symptoms such as microcytic hypochromic nature of anemia, reduction of ferritin, serum iron, and improving overall and latent iron binding capacity of serum.It is necessary to identify the causes of iron deficiency anemia.
Differential diagnosis of iron deficiency anemia in the treatment of Thalassemia
are familial and are accompanied by symptoms of hemolysis reinforced: increase in spleen size, reticulocytosis, increased indirect bilirubin.The number of red blood cells in thalassemia is normal or elevated.Anemia resistant to iron therapy, signs of enhanced haemolysis of red blood cells with characteristic morphology (hypochromia, mishenevidnost) - thalassemia symptoms.If you suspect that thalassemia is necessary to revise the previous general blood tests (determination of long-term and low anemia in conjunction with mishenevidnostyu erythrocytes), explore NA2 content (by electrophoresis) of HbF (qualitative assay).
sideroblastic anemia - microcytic hypochromic anemia that occurs as a result of violations of intracellular iron utilization for hemoglobin synthesis in the background of normal or high content of iron in the mitochondria of erythroblasts.As a consequence, the bone marrow increases the number normoblasts with typical annular arrangement of iron granules around the nucleus at a special color for iron (Perls reaction).These cells are called ringed sideroblasts.Depending on the etiology distinguish hereditary and acquired idiopathic sideroblastic anemia.The clinical picture of anemia, hemolysis, hemosiderosis bodies, increased concentration of iron and ferritin in blood serum.Treatment of iron deficiency anemia drugs, particularly parenterally, are contraindicated.The final diagnosis is established by examining the level of porphyrins in erythrocytes.
iron metabolism in the body for the treatment of iron deficiency anemia
Iron is involved in the functioning of biological systems.The daily requirement for iron is 10 mg for men, for women 18 mg (during pregnancy and lactation - 38 and 33 mg, respectively).The total amount of iron in the body is distinguished 4-4.5 g Iron cellular, extracellular iron and iron stocks, different deviations in their number is one of the symptoms of anemia.
Cellular iron in the treatment zhelezodetsifitnoy anemia
cellular iron is a significant part of the total amount of iron in the body, is involved in the internal exchange of iron, and part of the heme-containing compounds (hemoglobin, myoglobin, enzymes such as cytochromes, catalase, peroxidase), non-heme enzyme (e.g., NADH dehydrogenase), metalloproteins (e.g. aconitase).
Extracellular iron in treating anemia
It includes free plasma iron and iron-whey proteins (transferrin, lactoferrin), involved in the transport of iron.
Iron reserves in the treatment of anemia
iron stores in the body is in the form of two protein compounds - ferritin and hemosiderin - with preferential deposition in the liver, spleen and muscles and is included in the exchange at the cellular iron deficiency.
iron entering the body from food is absorbed in the intestine (mainly in the duodenum and the early jejunum).Iron absorption in the digestive tract is limited and controlled by its plasma concentration (ratio of protein - apoferritin free of iron and ferritin).Enhance absorption ascorbic, succinic, pyruvic acid, sorbitol, alcohol, suppress - oxalates, calcium supplements and calcium-containing products (for example, cottage cheese, milk, etc.).The average daily 10 mg iron absorbed.
iron transport protein transferrin is performed that carries iron in the bone marrow, in place of the iron cell stocks (parenchymal organs, muscles) and in all cells of the body for the synthesis of enzymes.Iron dead red blood cells phagocytose macrophages.Problems with the transport of iron - a sign of the onset of disease - anemia.
main loss of iron in anemia occurs with faeces.A small part of the iron is lost in sweat and epidermal cells.The total loss of iron - 1 mg / day.Also consider physiological iron losses from the menstrual blood and breast milk.The loss of iron - the main symptom of the disease.
blood in the treatment of iron deficiency anemia
The general analysis of blood at the initial stage of the treatment of anemia show a decrease in the level of hemoglobin (hypochromia), the number of erythrocytes and reticulocytes, the reduction index mean corpuscular volume and the average content of hemoglobin in the red blood cell, a moderate leukopenia.Signs of anemia are also revealing microcytosis poikilocytosis and in the study of blood smear for anemia.Price-Jones curve has an expanded base.At the biochemical study of blood are reduction of ferritin, serum iron, increased total and latent iron binding capacity of serum, elevated protoporphyrins, a sharp decrease in the percentage of transferrin saturation with iron.
to ascertain the cause and treatment of iron deficiency symptoms for anemia patients underwent full range of necessary studies: identification of the source of bleeding (endoscopic and X-ray stomach, consulting gynecologist, chest X-ray, urinalysis, determination of hemosiderin in urine, examination of feces occultthe blood, the study volume of blood loss from the gastrointestinal tract by radioactive chromium), with the exception of iron absorption disorders.bone marrow puncture and trepanobiopsy only with vague diagnosis.iron exchange should be determined after 7-10 days after discontinuation of iron supplementation.
treatment of iron deficiency anemia in adults with diet
the treatment of anemia should limit milk consumption to 0.5 l / day (for adults).You can not drink milk and other dairy products for 2 hours before the reception of iron preparations.The diet must be a sufficient amount of animal protein, iron-containing foods (beef, veal, liver, beans, cottage cheese).
oral drugs for the treatment of iron deficiency anemia in adult
Classification of drugs for the treatment of anemia
monokomponentny iron supplements to treat anemia in adults: containing trivalent iron (Fe3 +) - iron poliizomaltozat;containing ferrous iron (Fe2 +) - ferric gluconate, ferrous sulfate, ferrous fumarate, ferrous chloride.
iron preparations containing ferrous sulfate and ascorbic acid: Sorbifer durules, ferropleks.
Iron supplements containing iron and folic acid: Maltofer foul ginotardiferon.
Doses of drugs for the treatment of anemia
The body of the adult patient with symptoms of iron deficiency anemia in a day should do no less than 20-30 mg Fe2 +, which may be provided by a daily dose of 100 mg (the minimum effective daily dose).With good endurance gradually increase the dose to 300-400 mg / day in 3-4 reception at intervals of not less than 4 hours;take medication 1 hour before meals or no earlier than 2 hours after a meal.When poor tolerability large daily dose divided into 6-8 receptions.