Young forms of erythrocyte blood disease severe anemia. Anemia - symptoms, causes, types, treatment and prevention of anemia

Anemia is a clinical and hematological syndrome in which there is a decrease in the concentration of hemoglobin in the blood and the number of red blood cells.

In the people, anemia is often called "anemia", because in the presence of this disease there is a violation of the blood supply internal organs that do not receive enough oxygen to function properly and fully.

The iron-deficiency form of anemia, which develops against the background of a lack of iron in the body, should be considered as a symptom of another pathology or a temporary phenomenon, and not an independent disease.

What it is?

Anemia is pathological syndrome, consisting of clinical and laboratory data. It is based on:

1. Decrease in the amount of hemoglobin;
2. Decrease in the number of red blood cells (occurs in most cases);
3. Signs of impaired blood supply to tissues and their hypoxia (oxygen starvation).

At the same time, there is a decrease in the intensity of metabolic processes and the functioning of all body systems, and the course of existing diseases is aggravated.

Causes of anemia

There are many causes of anemia, but there are also the main ones:

• violation of the production of red blood cells by the bone marrow;
• hemolysis (destruction) or shortening of the life span of erythrocytes in the blood, normally 4 months;
• acute or chronic bleeding.

Now let's take a closer look at the above points.

The first reason is a violation or decrease in the production of red blood cells. This fact, as a rule, underlies anemia, which is accompanied by kidney disease, endocrine insufficiency, protein depletion, cancer, chronic infections.

The cause of anemia can be an insufficient amount of iron, vitamin B12 and folic acid in the body, and in rare cases, mainly in children, vitamin C and pyridoxine deficiency. These substances are necessary for the formation of red blood cells in the body.

Other pathogens include hemolysis. The main cause of this disease can be attributed to the malfunction of red blood cells, or simply their defect. With anemia, red blood cells begin to break down in the blood, this may occur due to a violation of hemoglobin or a change in internal hormones. It happens that the cause of hemolysis is a disease of the spleen.

Bleeding. This fact causes anemia only if the bleeding was prolonged.

All the main parts of erythrocytes are restored, except for iron. Thus, chronic blood loss due to the depletion of iron stores in the body causes anemia, which can develop even with a sufficient amount of iron in the food consumed. As a rule, bleeding occurs in the uterus and gastrointestinal tract.

Classification

In general, the classification of anemia is based on three groups:

• Posthemorrhagic anemia, i.e. anemia caused by severe blood loss.
• Anemia formed against the background of disturbances in the process of blood formation, as well as pathologies in the synthesis of RNA and DNA - megaloblastic, iron deficiency, folate deficiency, B-12 deficiency, hypoplastic, aplastic, Fanconi anemia and other types of anemia.
• Hemolytic anemias, i.e. anemia due to increased erythrocyte destruction (autoimmune hemolytic anemia, sickle cell anemia, etc.).

In addition, anemia is divided into several degrees of severity, which depend on the content of hemoglobin. It:

• Severe - when hemoglobin in the blood is less than 70 hl.
• Average - 70-90 g / l.
• Light - more than 90 g / l (anemia of 1 degree).

Forms of anemia

What forms of anemia are considered the most common, and how are they characterized?

1. B12 deficiency or pernicious anemia. This form of the disease occurs due to a lack of vitamin B group - B12, which is also called cyanocobalamin. He takes part in the formation of red blood cells. In situations of its deficiency, a similar form of the pathological condition is diagnosed, and anemia of a malignant order, affecting the central nervous system and the brain, can also be detected.
2. . Refers to the number of pathology options based on violations of the production of hemoglobin, erythrocytes. Its basis is a lack of iron, which is responsible for the presence of hemoglobin in the blood. This form of anemia mostly affects women. This type of anemia is also typical for children, people whose diet limits the intake of iron with food, and with serious injuries.
3. Posthemorrhagic anemia. It includes two options: acute and chronic. The basis for making any of the forms of such a diagnosis is blood loss. With a significant loss of blood that occurred at a time, an assumption is made about the occurrence of an acute form of posthemorrhagic anemia. When bleeding occurs from time to time, and its volumes can be quite scarce, a chronic form can be diagnosed.
4. Aplastic anemia. This subspecies belongs to the so-called depressive blood diseases. Based on a significant shortening of the life of erythrocytes, it is also manifested by transient destruction blood cells in bone marrow. This type of anemia is considered quite severe and requires medical intervention.
5. Anemia Diamond-Blackfan. This subspecies has no specific etiology. In this case, anemia is diagnosed in infants; its main manifestation, which allows such a diagnosis to be made, is a lack of erythropoiesis.
6. Folate deficiency anemia. This is one of the forms of anemia, which is among the group of megaloblastic anemias. It develops due to a lack of folic acid, which can also occur due to an incorrectly selected diet, and due to the impossibility of absorption of the substance by the intestinal walls. The main characteristic of the pathological condition is the formation of megaloblasts in the bone marrow and the destruction of red blood cells.
7. Sickle cell anemia. It is considered a pathological condition that is inherited. Normally, erythrocytes have a biconcave shape, resembling a disk in appearance. However, in the case of the development of this pathology, the blood cells change during the transfer of oxygen, they become like a sickle, hence the name of anemia. This happens due to the fact that normal hemoglobin is replaced by pathological.

Separately, anemia is also distinguished, which accompanies any diseases, for example, due to infectious diseases that cause chronic inflammatory processes, or within the framework of collagenoses (pathology of connective tissues or rheumatic diseases).

Symptoms of anemia

This state The body can have several symptoms, the main of which are those that are directly related to hypoxia.

The severity of anemia depends on how much hemoglobin is contained in the blood:

1. Light: hemoglobin index - 90-115 g / l. It is accompanied by a weakening of the body, accelerated fatigue, it is more difficult for a person to concentrate his attention on something.
2. Medium: hemoglobin index 70-90 g / l. The main symptoms are shortness of breath, rapid heartbeat, the condition may be accompanied by a regular headache, sleep problems, appetite decreases, sexual desire disappears, the skin becomes pale.
3. Severe: the hemoglobin index does not exceed 70 g / l. Accompanied by symptoms characteristic of heart failure.

If the symptoms of anemia are manifested under the influence of another disease, the symptoms can be supplemented by other disorders, they can be used to determine which disease one has to deal with.

Iron-deficiency anemia

Symptoms of iron deficiency anemia quite a lot and they are often similar to the symptoms of other anemias:

• First, the skin. It becomes dull, pale, scaly and dry (usually on the hands and face).
• Secondly, nails. They become brittle, dull, soft and begin to exfoliate.
• Thirdly, hair. In people with IDA, they become brittle, split, begin to fall out intensively and grow slowly.
• Fourth, teeth. One of characteristic features iron deficiency anemia is tooth staining and tooth decay. The enamel on the teeth becomes rough, and the teeth themselves lose their former luster.
• Often a sign of anemia is a disease, for example, atrophic gastritis, functional disorders intestines, urinary tract, etc.
• Patients with IDA suffer from gustatory and olfactory perversion. This is manifested in the desire to eat clay, chalk, sand. Often such patients suddenly begin to like the smell of varnish, paint, acetone, gasoline, exhaust gases, etc.
• Iron deficiency anemia also affects the general condition. It is accompanied by frequent pains in the head, palpitations, weakness, flickering of "midges", dizziness, drowsiness.

A blood test for IDA shows a serious drop in hemoglobin. The level of erythrocytes is also reduced, but to a lesser extent, since anemia is hypochromic in nature (the color index tends to decrease). In the blood serum, the iron content drops significantly. Siderocytes completely disappear from the peripheral blood.

Diagnostics

Diagnosis of anemia can be divided into general and narrowly focused, depending on the specific type of anemia.

To general diagnostics should include:

• examination by a doctor;
• a general blood test to determine: hematocrit, hemoglobin, reticulocytes, erythrocyte volume, platelet count, leukocytes.

To diagnose iron deficiency anemia, it will be necessary to additionally determine the level of iron, saturated transferrins, ferritin, and the binding capacity of unsaturated transferrins. A bone marrow biopsy, as a way to diagnose iron deficiency anemia, is performed in exceptional cases. Folate deficiency and B12 deficiency anemia are diagnosed, respectively, by detecting the level of vitamin B12 in the blood and folic acid in serum and red blood cells.

Anemia treatment

The basic ones can be called those drugs that are appropriate for any type of anemia, as they will allow the bone marrow to quickly make up for the deficiency of red blood cells and hemoglobin in the blood. These include:

1. Iron preparations: fenyuls, totem, sorbifer, aktiferrin;
2. Vitamin products: cyanocobalamin (vitamin B12), folic acid, vitamin B complexes (milgama, neurobex), ascorbic acid, vitamin E.

Specific agents in the treatment of anemia include:

1. Blood products: washed erythrocytes, erythrocyte mass;
2. Glucocorticoid hormones: dexamethasone, methylprednisolone, solu-cortef, cortinef;
3. Chemotherapeutic agents: cytostatics (Imuran);
4. Erythropoietins: epoetin, epocomb, eprex, anabolic steroids (mesterolone, nadrolone).

Any type of medical correction must necessarily be combined with lifestyle correction and proper nutrition. The diet is enriched with beef, offal, fish and seafood, fresh vegetables and fruits. Strict rejection recommended bad habits and dosed physical exercise in the form of exercise therapy, preferably in the fresh air.

Folk remedies

Folk remedies will help to increase hemoglobin, which in their arsenal have many recipes for increasing the level of hemoglobin in the blood. Consider a few recipes:

• For cooking, you will need 150 ml of fresh aloe juice + 250 g of honey and 350 ml of Cahors wine. Mix everything well and take 1 spoon 3 times a day for 1 month.
• A good effect can be obtained from the following infusion. You will need: rose hips, wild strawberries in equal parts of 10 gr. Pour fruit with boiling water, put in a water bath for 15 minutes, then cool, squeeze and take 1/2 cup 2 times a day.
• Strawberry leaves (2 tablespoons) should be poured with boiling water, drained and taken 3 times a day, 2 tablespoons.

Treatment folk remedies can only serve as adjuvant therapy.

What to eat with anemia

Of great importance in overcoming deficiency states that provoke anemia is given to a balanced diet. The lack of iron and other nutrients develops due to the presence of incorrectly formed gastronomic preferences in a person.

Nutrition for anemia in adults must include:

• fatty fish;
• eggs;
• beef;
• liver;
• dried fruits.

It is known that sugars, coffee and tea provoke anemia due to their negative impact on the absorption of many elements necessary for a person.

Prevention

To prevent anemia, you need to lead an active lifestyle, play sports, walk more in the fresh air. Try to make your diet varied, and be sure to eat foods that are sources of substances necessary for hematopoiesis.

1. See your doctor at the first sign of anemia timely diagnosis and proper treatment.
2. Treat diseases of the gastrointestinal tract in a timely manner intestinal tract and carry out the prevention of helminthic invasions. Limit contact with toxic substances or use personal protective equipment when working with them.

Psychosomatics of diseases states that anemia is a lack of positive emotions and fear of life. Therefore, do not forget to smile more often and enjoy every new day!

Anemia is considered one of the most common pathological conditions among the population of the planet. Among the varieties of anemia, there are several main conditions, classifying them according to the causes of anemia:

• Iron-deficiency anemia;
• hemolytic anemia;
• aplastic anemia;
• sideroblastic type of anemia;
• B12-deficient, resulting from vitamin B12 deficiency;
• posthemorrhagic anemia;
• sickle cell anemia and other forms.

Approximately every fourth person on the planet, in accordance with the research of specialists, suffers from an iron deficiency form of anemia due to a decrease in the concentration of iron. The danger of this state is in the erased clinical picture iron deficiency anemia. Symptoms become pronounced when the level of iron and, accordingly, hemoglobin drops to a critical level.

The risk groups for developing anemia in adults include the following categories of the population:

• followers of vegetarian principles of nutrition;
• people suffering from blood loss due to physiological reasons (heavy menstruation in women), diseases (internal bleeding, pronounced stages of hemorrhoids, etc.), as well as donors who donate blood and plasma on a regular basis;
• pregnant and lactating women;
• professional athletes;
• patients with chronic or sharp forms some diseases;
• categories of the population experiencing malnutrition or a limited diet.

The most common form of iron deficiency anemia is due to a lack of iron, which in turn can be triggered by one of the following factors:

• insufficiency of iron intake with food;
• increased need for iron due to situational or individual characteristics (developmental pathologies, dysfunctions, diseases, physiological conditions of pregnancy, lactation, professional activity etc.);
• increased loss of iron.

Mild forms of anemia, as a rule, can be cured by correcting the diet, prescribing vitamin-mineral complexes, and iron-containing preparations. The moderate and severe form of anemia requires the intervention of a specialist and a course of appropriate therapy.

Causes of anemia in men

Anemia in women

Anemia in women is diagnosed when hemoglobin levels are below 120 g / l (or 110 g / l during childbearing). Physiologically, women are more prone to anemia.
With monthly menstrual bleeding, the female body loses red blood cells. The average volume of monthly blood loss is 40-50 ml of blood, however, with heavy menstruation, the amount of discharge can reach up to 100 ml or more over a period of 5-7 days. Several months of such regular blood loss can lead to the development of anemia.
Another form of occult anemia, common among the female population with a high frequency (20% of women), is provoked by a decrease in the concentration of ferritin, a protein that stores iron in the blood and releases it when the hemoglobin level decreases.

Anemia in pregnancy

Anemia in pregnant women occurs under the influence of various factors. The growing fetus removes from the maternal bloodstream substances necessary for development, including iron, vitamin B12, folic acid, necessary for the synthesis of hemoglobin. With insufficient intake of vitamins and minerals with food, violations of its processing, chronic diseases (hepatitis, pyelonephritis), severe toxicosis of the first trimester, as well as with multiple pregnancy the expectant mother develops anemia.
Physiological anemia of pregnant women includes hydremia, "thinning" of the blood: in the second half of the gestational period, the volume of the liquid part of the blood increases, which leads to a natural decrease in the concentration of red blood cells and the iron transported by them. This condition is normal and is not a sign of pathological anemia if the hemoglobin level does not fall below 110 g / l or recovers on its own in a short time, and there are no signs of vitamin and microelement deficiency.
Severe anemia in pregnant women threatens with miscarriage, premature birth, toxicosis of the third trimester (preeclampsia, preeclampsia), complications of the delivery process, as well as anemia in the newborn.
The symptoms of anemia in pregnant women include the general clinical picture of anemia (fatigue, drowsiness, irritability, nausea, dizziness, dry skin, brittle hair), as well as perversions of smell and taste (the desire to eat chalk, plaster, clay, raw meat, sniff substances with a sharp smell among household chemicals, building materials, etc.).
Slight anemia of pregnant and lactating women recovers after childbirth and the end of the lactation period. However, with a short interval between repeated births, the process of restoring the body does not have time to complete, which leads to increased signs of anemia, especially pronounced when the interval between births is less than 2 years. Optimal time recovery female body is 3-4 years.

Anemia during lactation

According to the research of specialists, lactation anemia is most often diagnosed at a fairly pronounced stage of the disease. The development of anemia is associated with blood loss during delivery and lactation against the background of a hypoallergenic diet of nursing. The production itself breast milk does not contribute to the development of anemia, however, when some important food groups are excluded from the diet, for example, legumes (due to the risk of increased gas formation in a child), dairy and meat products(due to allergic reactions at baby) the likelihood of developing anemia increases significantly.
The reason for the late diagnosis of postpartum anemia is considered to be a shift in the focus of attention from the state of the mother to the child, especially in the youngest mother. The health features of the baby excite her more than her well-being, and the symptom complex of anemia - dizziness, fatigue, drowsiness, decreased concentration, pallor of the skin - are most often perceived as a result of overwork associated with caring for a newborn.
Another reason for the prevalence of iron deficiency anemia in nursing is associated with the wrong opinion about the effect of iron preparations that penetrate into breast milk on the functioning of the infant's gastrointestinal tract. This opinion is not confirmed by specialists, and, when diagnosing iron deficiency anemia, medicines and vitamin-mineral complexes prescribed by a specialist are mandatory.

Anemia of the menopause

Anemia during the female menopause is quite common. Hormonal restructuring, the consequences of the period of menstruation, gestation, childbirth, various dysfunctional conditions and surgical interventions cause chronic anemia, which is aggravated against the background of menopausal changes in the body.
A provocative role is also played by dietary restrictions, unbalanced diets, which are resorted to by women seeking to reduce the rate of weight gain due to fluctuations in hormonal balance in the premenopausal period and directly during menopause.
By the age of menopause, there is also a decrease in ferritin reserves in the body, which is an additional factor in the development of anemia.
Fluctuations in well-being, fatigue, irritability, dizziness are often perceived as symptoms of menopause, which leads to late diagnosis of anemia.

Anemia of childhood

According to the World Health Organization (WHO), 82% of children suffer from anemia varying degrees expressiveness. Low level hemoglobin and iron deficiency states of various etiologies lead to impaired mental and physical development of the child. The main causes of anemia in children's age include:

The need for iron differs in children depending on age, and after reaching puberty, it correlates with gender. Therapy of deficient anemia in children with a balanced diet is not always effective, so experts prefer regulation with medications that guarantee the intake of the required dose of trace elements in the child's body.

Anemia in infancy

A newborn baby is born with a certain supply of iron obtained from the mother's body during fetal development. The combination of imperfection of one's own hematopoiesis and rapid physical growth lead to a physiological decrease in the level of hemoglobin in the blood in healthy children born on time by 4-5 months of life, in premature babies - by the age of 3 months.
Artificial and mixed feeding are considered risk factors that increase the likelihood of developing anemia. Hemoglobin deficiency develops especially rapidly when replacing breast milk and / or artificial mixtures with cow's, goat's milk, cereals and other products in the period up to 9-12 months.
Symptoms of anemia in children under one year old include:

• pallor of the skin, since the skin is still very thin, there is an increased "transparency", "cyanosis" of the skin;
• anxiety, causeless crying;
• sleep disorders;
• loss of appetite;
• hair loss outside the physiological framework of the change of hairline;
• frequent regurgitation;
• low weight gain;
• lagging behind first in physical, then in psycho-emotional development, a decrease in interest, the lack of expression of the revitalization complex, etc.

A feature of children of this age is the ability for high (up to 70%) absorption of iron from food, therefore, not in all cases of anemia, pediatricians see the need for prescribing drugs, limiting themselves to correcting the child’s diet, transferring to full breast-feeding, the selection of a substitute mixture that meets the needs. With a pronounced degree of anemia, iron preparations are prescribed in an age dosage, for example, Ferrum Lek or Maltofer in the form of syrup drops.
When diagnosing a pronounced degree of anemia, the causes may not be in the diet, but in diseases, pathologies and dysfunctions of the child's body. Anemia can also be caused by hereditary diseases, some hereditary developmental disorders and diseases are characterized by a decrease in iron concentration, erythrocytopenia, insufficiency of the hematopoietic system, etc. With persistent low rates hemoglobin levels, a mandatory examination of children and correction of the primary disease are necessary.

Anemia in preschool children

A large-scale study conducted in 2010 revealed a high incidence of iron deficiency anemia in preschool children: every second child suffers from a lack of hemoglobin due to reduced level gland. There may be various factors in the etiology of this phenomenon, but the most common is the consequences of uncorrected anemia in the first year of life.
The second factor that provokes anemia in preschoolers is often combined with the first. An insufficiently balanced diet, a lack of protein (meat products) and vitamins (vegetables) is often explained by the child's reluctance to eat meat and vegetables, preferring semi-finished products and sweets. It is purely a matter of educating and focusing parents on a healthy diet without providing alternative foods with early age, which also requires the transfer of family members to a rationally formulated diet.
In the case when the nutrition corresponds to age norms, and the child shows signs of anemia (pallor, dry skin, fatigue, decreased appetite, increased fragility of the nail plates, etc.), an examination by a specialist is necessary. Despite the fact that in 9 out of 10 preschool children diagnosed with anemia it is due to iron deficiency, in 10% of anemia the cause is in diseases and pathologies (celiac disease, leukemia, etc.).

Anemia in children of primary school age

The norms of hemoglobin content in the blood in children 7-11 years old are 130 g / l. Manifestations of anemia in this age period increase gradually. The signs of developing anemia include, in addition to symptoms of anemia in preschoolers, decreased concentration, frequent acute respiratory viral and bacterial diseases, increased fatigue, which can affect the results of educational activities.
An important factor in the development of anemia in children attending educational institutions is the lack of control over the diet. In this age period, a sufficient level of iron absorption from food entering the body is still maintained (up to 10%, decreasing by the age of an adult to 3%), therefore, the prevention and correction of the iron deficiency type of anemia is a properly organized meal with dishes rich in vitamins and microelements based on it. .
Hypodynamia, limited stay in the fresh air, preference for games in the house, especially with tablets, smartphones, etc., dictating a long stay in a static position, also provoke anemia.

Anemia of puberty

Adolescence is dangerous for the development of anemia, especially in girls with the onset of menstruation, characterized by a periodic decrease in hemoglobin with blood loss. The second factor that provokes the onset of anemia in adolescent girls is associated with a concentration on one's own appearance, the desire to follow various diets and reduce the daily diet, and the exclusion of products necessary for health.
Rapid growth, intensive sports, malnutrition and anemias of the previous period also affect adolescents of both sexes. Symptoms of adolescent anemia include a blue tint of the sclera of the eyes, changes in the shape of the nails (cup-shaped form of the nail plate), dysfunctions digestive system, violations of taste, smell.
Severe forms of the disease in adolescence require drug therapy. A change in the blood formula is noted, as a rule, not earlier than 10-12 days after the start of the course of treatment, signs of clinical recovery, subject to the specialist's prescriptions, are observed after 6-8 weeks.

Causes of anemia

Anemia is characterized by a decrease in the concentration of hemoglobin and red blood cells in a unit of blood. The main purpose of erythrocytes is participation in gas exchange, transport of oxygen and carbon dioxide, as well as nutrients and metabolic products to cells and tissues for further processing.
The red blood cell is filled with hemoglobin, a protein that gives red blood cells and blood their red color. The composition of hemoglobin includes iron, and therefore its lack in the body causes a high incidence of iron deficiency anemia among all varieties of this condition.
There are three main factors in the development of anemia:

• acute or chronic blood loss;
• hemolysis, destruction of red blood cells;
• decreased production of red blood cells by the bone marrow.

According to the variety of factors and causes, the following types of anemia are distinguished:

The classification of the anemic state is based on various signs describing the etiology, mechanisms of the development of the disease, the stage of anemia, diagnostic parameters.

Classification according to the severity of the condition

The severity of anemia is based on blood tests and depends on age, gender and physiological period.
Normally, in a healthy adult male, hemoglobin levels are 130-160 g / l of blood, in a woman - from 120 to 140 g / l, during the gestation period from 110 to 130 g / l.
A mild degree is diagnosed when the level of hemoglobin concentration drops to 90 g / l in both sexes, with an average indicator corresponding to the range from 70 to 90 g / l, a severe degree of anemia is characterized by a decrease in hemoglobin levels below the limit of 70 g / l.

Classification of varieties according to the mechanism of state development

In the pathogenesis of anemia, three factors are observed that can act individually or together:

• blood loss of an acute or chronic nature;
• disorders of the hematopoietic system, production of red blood cells by the bone marrow (iron deficiency, renal, aplastic anemia, deficiency anemia with a lack of vitamin B12 and / or folic acid);
• increased destruction of erythrocytes before the end of the functioning period (120 days) due to genetic factors, autoimmune diseases.

Classification by color index

The color indicator serves as an indicator of the saturation of red blood cells with hemoglobin and is calculated using a special formula in the blood test process.
A hypochromic form with a weakened color of erythrocytes is diagnosed with a color index below 0.80.
The normochromic form, with a color index within the normal range, is determined by the range of 0.80-1.05.
The hyperchromic form, with excessive hemoglobin saturation, corresponds to a color index above 1.05.

Classification by morphological feature

The size of red blood cells is an important indicator in diagnosing the cause of anemia. Different sizes of red blood cells may indicate the etiology and pathogenesis of the condition. Normally, red blood cells are produced with a diameter of 7 to 8.2 micrometers. The following varieties are distinguished on the basis of determining the size of the prevailing number of red blood cells in the blood:

• microcytic, erythrocyte diameter less than 7 microns, indicates a high probability of iron deficiency;
• normocytic variety, the size of red blood cells is from 7 to 8.2 microns. Normocytosis is a sign of the posthemarogic form;
• macrocytic, with a red blood cell size of more than 8.2 and less than 11 microns, as a rule, indicates a deficiency of vitamin B12 (pernicious form) or folic acid;
• megalocytosis, megalocytic (megaloblastic) form, in which the diameter of erythrocytes is more than 11 microns, corresponds to the severe stages of some forms, disorders in the formation of red blood cells, etc.

Classification based on the assessment of the ability of the bone marrow to regenerate

The degree of erythropoiesis, the ability of the red bone marrow to form erythrocytes, is assessed by the quantitative index of reticulocytes, progenitor cells or "immature" erythrocytes, which is considered the main criterion in assessing the ability of bone marrow tissues to regenerate and is an important factor for predicting the patient's condition and choosing methods of therapy . The normal concentration of reticulocytes is an indicator of 0.5-1.2% of the total number of red blood cells per unit of blood.
Depending on the level of reticulocytes, the following forms are distinguished:

• regenerative, indicating the normal ability of the bone marrow to recover. The level of reticulocytes is 0.5-1.2%;
• hyporegenerative, with a concentration of immature erythrocytes below 0.5%, which indicates a reduced ability of the bone marrow to self-repair;
• hyperregenerative, reticulocyte count more than 2%;
• aplastic anemia is diagnosed when the concentration of immature erythrocytes is less than 0.2% among the mass of all red blood cells and is a sign of a sharp suppression of the ability to regenerate.

Iron deficiency anemia (IDA)

The iron deficiency form accounts for up to 90% of all types of anemic conditions. According to research by the World Health Organization, this form affects one in 6 men and every third woman in the world.
Hemoglobin is a complex protein compound containing iron, capable of reversible bonding with oxygen molecules, which is the basis for the process of transporting oxygen from the lungs to body tissues.
The iron deficiency form is hypochromic anemia, with signs of microcytosis, the presence of erythrocytes with a diameter less than normal in the blood formula, which is associated with iron deficiency, the basic element for the formation of hemoglobin, which fills the erythrocyte cavity and gives it a red color.
Iron is a vital trace element involved in many metabolic processes, nutrient metabolism, and gas exchange in the body. During the day, an adult consumes 20-25 mg of iron, while the total supply of this element in the body is about 4 g.

Reasons for the development of IDA

The reasons for the development of this form of the condition include factors of various etiologies.
Iron intake disorders:

• unbalanced diet, strict vegetarianism without compensation for iron-containing products, starvation, diets, taking medications, narcotic and other substances that suppress hunger, appetite disorders due to diseases of physical or psycho-emotional etiology;
• socio-economic causes of malnutrition, lack of food.

Violations of the process of absorption, assimilation of iron:

• diseases of the gastrointestinal tract (gastritis, colitis, gastric ulcer, resection of this organ).

Imbalance of consumption and intake of iron due to increased needs of the body:

• pregnancy, lactation;
• age of pubertal jumps in physical growth;
• chronic diseases that provoke hypoxia (bronchitis, obstructive pulmonary disease, heart defects and other diseases cordially- vascular system and respiratory organs);
• diseases accompanied by purulent-necrotic processes: sepsis, tissue abscesses, bronchiectasis, etc.

Loss of iron by the body, acute or chronic post-hemorrhagic:

• with pulmonary bleeding (tuberculosis, tumor formations in the lungs);
• with gastrointestinal bleeding accompanying gastric ulcer, duodenum, cancers of the stomach and intestines, severe erosion of the gastrointestinal mucosa, varicose veins of the esophagus, rectum, hemorrhoids, intestinal helminthic invasion, ulcerative colitis and others;
• with uterine bleeding (heavy menstruation, cancer of the uterus, cervix, fibroids, placental abruption in the gestational period or in childbirth, ectopic pregnancy during exile, birth trauma of the uterus and cervix);
• bleeding with localization in the kidneys (tumor formations in the kidneys, tuberculous changes in the kidneys);
• bleeding, including internal and hidden, due to injuries, blood loss from burns, frostbite, during planned and emergency surgical interventions, etc.

IDA symptoms

The clinical picture of the iron deficiency form is anemic and sideropenic syndrome, caused primarily by insufficient gas exchange in the tissues of the body.
Symptoms of anemic syndrome include:

• general malaise, chronic fatigue;
• weakness, inability to endure prolonged physical and mental stress;
• attention deficit disorder, difficulty concentrating, rigidity;
• irritability;
• headache;
• dizziness, sometimes fainting;
• drowsiness and sleep disturbances;
• shortness of breath, rapid heart rate both during physical and / or psycho-emotional stress, and at rest;
• black color of the stool (with bleeding of the gastrointestinal tract).

Sideropenic syndrome is characterized by the following manifestations:

• perversion of taste preferences, craving for eating chalk, clay, raw meat, etc.;
• distortion of smell, desire to sniff paint, household chemicals, substances with a pungent odor (acetone, gasoline, washing powder, etc.);
• fragility, dry hair, lack of shine;
• white spots on the nail plates of the hands;
• dry skin, peeling;
• pallor of the skin, sometimes blueness of the sclera;
• the presence of cheilitis (cracks, "zayed") in the corners of the lips.

In severe stages of IDA, there are neurological symptoms: sensations of "goosebumps", numbness of the extremities, difficulty in swallowing, weakening of control over bladder etc.

Diagnosis of IDA

The diagnosis of "iron deficiency anemia" is based on the data of an external examination, evaluation of the results laboratory tests blood and instrumental examination of the patient.
During an external medical examination and anamnesis, attention is paid to the condition of the skin, mucous surfaces of the mouth, corners of the lips, and the size of the spleen is assessed on palpation.
A general blood test in the classical clinical picture of IDA shows a decrease in the concentration of erythrocytes and hemoglobin relative to age and gender norms, the presence of erythrocytes of different sizes (poikilocytosis), reveals microcytosis, the presence, in severe forms- the predominance of red blood cells with a diameter of less than 7.2 microns, hypochromic, weakly expressed color of erythrocytes, low color index.
results biochemical research blood with IDA have the following indicators:

• the concentration of ferritin, a protein that performs the function of an iron depot in the body, is reduced relative to the limits of the norm;
• low level serum iron;
• increased iron-binding capacity of blood serum.

Diagnosis of IDA is not limited to the detection of iron deficiency. For effective correction of the condition after collecting anamnesis, the specialist, if necessary, prescribes instrumental studies in order to clarify the pathogenesis of the disease. Instrumental studies in this case include:

• fibrogastroduodenoscopy, examination of the condition of the mucosa of the esophagus, walls of the stomach, duodenum;
• ultrasound examination of the liver, kidneys, female reproductive organs;
• colonoscopy, examination of the walls of the large intestine;
• methods of computed tomography;
• x-ray examination of the lungs.

Treatment of anemia of iron deficiency etiology

Depending on the stage and pathogenesis of IDA, therapy is chosen by correcting the diet, a drug course of treatment, surgical intervention to eliminate the causes of blood loss or a combination of methods.

Therapeutic diet for iron deficiency

The iron that enters the body with food is divided into heme, animal origin, and non-heme iron. plant origin. The heme variety is much better absorbed and its lack in nutrition, for example, in vegetarians, leads to the development of IDA.
Products recommended for correcting iron deficiency include the following:

• heme group in descending order of the amount of iron: beef liver, beef tongue, rabbit meat, turkey meat, goose meat, beef, some varieties of fish;
• non-heme group: dried mushrooms, fresh peas, buckwheat grain, hercules and oats, fresh mushrooms, apricots, pears, apples, plums, cherries, beets, etc.

Despite the seemingly high content of iron in vegetables, fruits, products of plant origin when studying the composition, the absorption of iron from them is insignificant, 1-3% of the total volume, especially when compared with products of animal origin. So, when eating beef, the body is able to absorb up to 12% of the necessary element contained in the meat.
When correcting IDA with diet, increase the intake of foods rich in vitamin C and protein (meat) and reduce the intake of eggs, salt, caffeinated drinks and foods rich in calcium due to the effect on the absorption of dietary iron.

Medical therapy

In moderate and severe form, a therapeutic diet is combined with the appointment of drugs that supply iron in an easily digestible form. Medicines differ in the type of compound, dosage, form of release: tablets, dragees, syrups, drops, capsules, injection solutions.
Preparations for oral administration are taken one hour before meals or two hours after due to the peculiarities of iron absorption, while it is not recommended to use caffeinated drinks (tea, coffee) as a liquid that facilitates swallowing, as this impairs the absorption of the element. The interval between doses of drugs should be at least 4 hours. Self-administration of medications can cause side effects from an incorrectly selected form or dosage, and iron poisoning.
The dosage of drugs and the form of release is determined by a specialist, focusing on age, stage of the disease, causes of the condition, general clinical picture and individual characteristics patient. Doses may be adjusted during the course of treatment based on the results of intermediate or control blood tests and / or the patient's well-being.
Iron preparations in the course of treatment are taken from 3-4 weeks to several months with periodic monitoring of hemoglobin levels.
Among the preparations-suppliers of iron taken orally, there are medicines with two- and three-valent form of iron. For now, according to research, ferrous iron is considered to be the preferred oral form due to its higher absorption capacity and gentler effect on the stomach.
For children, iron-containing products are produced in the form of drops and syrups, which is caused both by age-related characteristics of taking drugs and a shorter course of therapy than in adults, due to the increased absorption of iron from food. If it is possible to take capsules, dragees and tablets, as well as for long courses, preference should be given to solid forms of drugs containing iron, since liquid forms with prolonged use can have a negative effect on tooth enamel and cause it to darken.
The most popular tablet forms include the following medicines: Ferroplex, Sorbifer, Aktiferrin, Totem (ferrous form of iron) and Maltofer, Ferrostat, Ferrum Lek with ferric iron.
Oral forms are combined with vitamin C (ascorbic acid) at the dosage prescribed by the doctor for better absorption.
Intramuscular and intravenous injections of iron preparations are prescribed in limited situations, such as:

• severe stage of anemia;
• course failure oral forms drugs;
• the presence of specific diseases of the gastrointestinal tract, in which oral forms may worsen the patient's condition (with acute gastritis, peptic ulcer stomach, duodenum, nonspecific ulcerative colitis, Crohn's disease, etc.);
• with individual intolerance to oral forms of iron-containing drugs;
• in situations where there is a need for emergency saturation of the body with iron, for example, with significant blood loss due to injury or before surgery.

The introduction of iron preparations intravenously and intramuscularly can lead to an intolerance reaction, which is why such a course of therapy is carried out exclusively under the supervision of a specialist in a hospital or clinical setting. To the side negative consequences intramuscular injection iron-containing fluids include the deposition of hemosiderin subcutaneously at the injection site. dark spots on the skin at the injection sites can persist from one and a half to 5 years.
Iron deficiency anemia responds well drug therapy subject to the prescribed dose and duration of treatment. However, if in the etiology of the condition lie primary serious illness and disorders, therapy will be symptomatic and have a short-term effect.
To eliminate causes such as internal bleeding, with a hemorrhagic form, iron deficiency anemia is treated surgical methods. Surgical intervention allows you to eliminate the main factor of acute or chronic bleeding, stop blood loss. With internal bleeding of the gastrointestinal tract, fibrogastroduodenoscopy methods or colonoscopy are used to identify the area of ​​bleeding and measures to stop it, for example, cutting off a polyp, coagulating an ulcer.
With internal bleeding of the peritoneal organs and reproductive organs in women, a laparoscopic method of intervention is used.
The methods of emergency treatment include the transfusion of donor erythrocyte mass to quickly restore the level of concentration of erythrocytes and hemoglobin per unit of blood.
Prevention of the iron deficiency form is considered to be a balanced diet and timely diagnostic and therapeutic measures to maintain health.

Anemia due to deficiency of cobalamin or vitamin B12

Deficiency forms are not limited to iron deficiency anemia. Pernicious anemia is a condition that occurs against the background of malabsorption, its insufficient intake, increased consumption, abnormalities in the synthesis of a protective protein, or liver pathologies that prevent the accumulation and storage of cobalamin. In the ptogenesis of this form, a frequent combination with folic acid deficiency is also noted.
Among the reasons for this deficient form are the following:

The clinical picture of vitamin B12 and folic acid deficiency includes anemic, gastrointestinal and neuralgic syndromes.
The features of the anemic symptom complex with this type of deficiency include such specific symptoms as yellowness of the skin and sclera and increased blood pressure. Other manifestations are typical for IDA: weakness, fatigue, dizziness, shortness of breath, rapid heartbeat (situational), tachycardia, etc.
The manifestations associated with the functioning of the gastrointestinal tract include the following symptoms of atrophy of the mucous membranes of the gastrointestinal tract and oral cavity:

• red, "glossy" tongue, often with complaints of a burning sensation on its surface;
• phenomena aphthous stomatitis, ulceration of the mucous surface of the oral cavity;
• appetite disorders: decrease up to total absence;
• feeling of heaviness in the stomach after eating;
• weight loss of the patient in the immediate history;
• violations, difficulties in the process of defecation, constipation, pain in the rectum;
• hepatomegaly, enlarged liver.

Neuralgic syndrome with vitamin B12 deficiency consists of the following manifestations:

• feeling of weakness in lower limbs with severe physical activity;
• numbness, tingling, "goosebumps" on the surface of the arms and legs;
• decreased peripheral sensitivity;
• atrophy of the muscle tissue of the legs;
• convulsive manifestations, muscle spasms, etc.

Diagnosis of cobalamin deficiency

Diagnostic measures include general medical checkup patient, history taking, laboratory blood tests and, if necessary, instrumental methods examinations.
At general analysis blood, the following changes are noted:

• the level of erythrocytes and hemoglobin levels decreased relative to the limits of the age norm;
• hyperchromia, an increase in the color index of the color of erythrocytes;
• macrocytosis of erythrocytes, exceeding their size in diameter of more than 8.0 microns;
• poikilocytosis, the presence of red blood cells of different sizes;
• leukopenia, insufficient concentration of leukocytes;
• lymphocytosis, exceeding the limits of the norms of the level of lymphocytes in the blood;
• thrombocytopenia, insufficient number of platelets per unit of blood.

Biochemical studies of blood samples reveal hyperbilirubinemia and vitamin B12 deficiency.
To diagnose the presence and severity of atrophy of the mucous membranes of the stomach and intestines, as well as to identify possible primary diseases, instrumental methods of examining patients are used:

• fibrogastroduodenoscopy study;
• analysis of biopsy material;
• colonoscopy;
• irrigoscopy;
• Ultrasound of the liver.

Treatment Methods

In most cases, B12-deficiency anemia requires hospitalization or treatment in a hospital setting. For therapy, first of all, a diet with foods saturated with cobalamin and folic acid (liver, beef, mackerel, sardines, cod, cheese, etc.) is prescribed, and secondly, drug support is used.
In the presence of neurological symptoms injections of Cyanocobalamin intramuscularly at an increased dose are prescribed: 1000 mcg daily until the neurological signs of deficiency disappear. In the future, the dosage is reduced, however, with a diagnosis of secondary etiology, the drug is most often prescribed on a lifelong basis.
After being released from medical institution the patient is obliged to undergo regular preventive examinations by a general practitioner, hematologist and gastrologist.

Aplastic anemia: symptoms, causes, diagnosis, treatment

Aplastic anemia can be both congenital and acquired disease, developing under the influence of internal and external factors. The condition itself occurs due to bone marrow hypoplasia, a decrease in the ability to produce blood cells (erythrocytes, leukocytes, platelets, lymphocytes).

Reasons for the development of the aplastic form

In aplastic, hypoplastic forms of anemia, the causes of this condition may be as follows:

• stem cell defect
• suppression of the process of hematopoiesis (hematopoiesis);
• insufficiency of hematopoiesis stimulation factors;
• immune, autoimmune reactions;
• deficiency of iron, vitamin B12 or their exclusion from the process of hematopoiesis due to dysfunctions of hematopoietic tissues and organs.

The development of disorders that provoke an aplastic or hypoplastic form include the following factors:

• hereditary diseases and genetic pathologies;
• taking certain medications from the groups of antibiotics, cytostatics, non-steroidal anti-inflammatory drugs;
• poisoning chemicals(benzenes, arsenic, etc.);
• infectious diseases of viral etiology (parvovirus, human immunodeficiency virus);
• autoimmune disorders (systemic lupus erythematosus, rheumatoid arthritis);
• pronounced deficiencies of cobalamin and folic acid in the diet.

Despite the extensive list of causes of the disease, in 50% of cases the pathogenesis of the aplastic form remains unidentified.

Clinical picture

The severity of pancytopenia, a decrease in the number of basic types of blood cells, determines the severity of symptoms. The clinical picture of the aplastic form includes the following signs:

• tachycardia, palpitations;
• pallor of the skin, mucous membranes;
• headache;
• increased fatigue, drowsiness;
• shortness of breath
• swelling of the lower extremities;
• bleeding gums;
• petechial rash in the form of small red spots on the skin, a tendency to easy bruising;
• frequent acute infections, chronic diseases as a result of a decrease in general immunity and leukocyte insufficiency;
• erosion, ulcers on the inner surface of the oral cavity;
• yellowness of the skin, sclera of the eyes as a sign of liver damage that has begun.

Diagnostic procedures

To establish the diagnosis, laboratory methods for studying various biological fluids and tissues and instrumental examination are used.
In a general blood test, a reduced number of erythrocytes, hemoglobin, reticulocytes, leukocytes, and platelets is noted, while the color index and hemoglobin content in erythrocytes correspond to the norm. The results of a biochemical study showed an increase in serum iron, bilirubin, lactate dehydrogenase, saturation of transferrin with iron by 100% of the possible.
To clarify the diagnosis, histological examination material removed from the bone marrow during puncture. As a rule, according to the results of the study, underdevelopment of all sprouts and replacement of the bone marrow with fat are noted.

Treatment of the aplastic form

This type of anemia cannot be treated with dietary modification. First of all, a patient with aplastic anemia is prescribed a selective or combined intake of drugs from the following groups:

• immunosuppressants;
• glucocorticosteroids;
• immunoglobulins of antilymphocytic and antiplatelet action;
• antimetabolic drugs;
• stimulators of production of erythrocytes by stem cells.

With the ineffectiveness of drug therapy, non-drug methods of treatment are prescribed:

• bone marrow transplant;
• transfusion of erythrocyte, platelet mass;
• plasmapheresis.

Aplastic anemia is accompanied by a decrease in general immunity due to a lack of leukocytes, therefore, in addition to general therapy, an aseptic environment, antiseptic surface treatment, and no contact with carriers of infectious diseases are recommended.
If the above methods of treatment are insufficient, the patient is prescribed a splenectomy operation, removal of the spleen. Since it is in this organ that the breakdown of erythrocytes occurs, its removal improves general state patient and slow down the progression of the disease.

Anemia: ways to prevent

The most common form of the disease - iron deficiency anemia - is subject to prevention with a balanced diet with an increase in the amount of iron-containing foods in critical periods. An important factor is also the presence in food of vitamin C, cobalamin (vitamin B12), folic acid.
If you are at risk of developing this form of anemia (vegetarianism, age periods growth, pregnancy, lactation, prematurity in infants, abundant menstrual bleeding, chronic and acute diseases) recommended regular medical examination, a blood test for quantitative and qualitative indicators of hemoglobin, erythrocytes and additional medication in accordance with the appointment of specialists.

For most people, of greater interest are deficiency anemia, which can occur in almost every person. Therefore, we will dwell in more detail on this type of anemia.

Iron-deficiency anemia- causes, symptoms, diagnosis and treatment

Causes of iron deficiency anemia

Iron deficiency anemia occurs when:

1. lack of iron in the body (premature babies, children under 1 year old, pregnant women)
2. increased need for iron (pregnancy, breastfeeding, period of increased growth)
3. disorders of iron absorption from the gastrointestinal tract and its subsequent transportation
4. chronic blood loss

Clinically, iron deficiency anemia is manifested by three main syndromes - hypoxic, sideropenic and anemic. What are these syndromes? What characterizes each of them? A syndrome is a stable set of symptoms. So, hypoxic syndrome is characterized by shortness of breath, headaches, tinnitus, fatigue, drowsiness and tachycardia; anemic syndrome is expressed in a decrease in the content of the number of erythrocytes and hemoglobin. Sideropenic syndrome is directly related to a decrease in the amount of iron in the body and manifests itself as follows: malnutrition of the skin, nails, hair - skin of an "alabaster" shade, dryness and roughness of the skin, brittle hair and nails. Then the perversion of taste and smell joins (the desire to eat chalk, inhale the smell of washed concrete floors, etc.). Possible complications from the gastrointestinal tract - caries, dysphagia, decreased acidity gastric juice, involuntary urination (in severe cases), sweating.

Diagnosis of iron deficiency anemia

In the blood, there is a decrease in the content of hemoglobin to 60 - 70 g / l, erythrocytes to 1.5 - 2 T / l, the number of reticulocytes is also reduced or completely absent. Red blood cells appear various forms and sizes. The serum iron concentration is below normal.

Treatment of iron deficiency anemia

The treatment of iron deficiency anemia is based on the principles of eliminating the cause of its occurrence - the treatment of diseases of the gastrointestinal tract, as well as the introduction of a balanced diet. The diet should contain foods high in iron (liver, meat, milk, cheese, eggs, cereals, etc.). However, the main means of restoring the amount of iron in the body at the initial stage are medications gland. In most cases, these drugs are prescribed in the form of tablets. In severe cases, resort to intramuscular or intravenous injections. In the treatment of this anemia, for example, such drugs are used: sorbifer, ferrum-lek, tardiferon, totem and others. The choice of various medicines, including combined ones, is very wide.

When choosing, you should consult with your doctor. Usually, the daily dose for the prevention and treatment of mild anemia is 50-60 mg of iron, for the treatment of anemia moderate- 100-120 mg of iron per day. Treatment of severe anemia is carried out in a hospital and iron preparations are used in the form of injections. Then they switch to tablet forms. Iron preparations cause dark stools, but this is normal in this situation. If an iron preparation causes discomfort in the stomach, it must be replaced.

Iron refractory anemia causes, symptoms, diagnosis and treatment

Cause of iron refractory anemia

Iron refractory anemia is also called sideroblastic or sideroachristic. Iron refractory anemia develops against the background of normal iron content in the blood serum and a lack of enzymes that are involved in the synthesis of hemoglobin. That is, the main cause of iron refractory anemia is a violation of the processes of "assimilation" of iron.

Symptoms of iron refractory anemia, what is hemosiderosis?

Iron refractory anemia is manifested by shortness of breath, headaches, dizziness, tinnitus, fatigue, drowsiness, sleep disturbances and tachycardia. Due to the high content of iron in the blood, tissues are observed hemosiderosis .Hemosiderosis is the deposition of iron in organs and tissues due to its excess. With hemosiderosis, insufficiency of the cardiovascular system develops due to the deposition of iron in the heart muscle, diabetes, damage to the lungs and increase the size of the liver and spleen. The skin becomes earthy.

Diagnosis of iron refractory anemia, what are sideroblasts?

The color index of blood is reduced to 0.6 - 0.4, erythrocytes of various shapes and sizes are present, the amount of hemoglobin and erythrocytes is below normal. There are also changes in the bone marrow - cells appear - sideroblasts. Sideroblasts are cells that have a corolla of iron around the nucleus. Normally, such cells in the bone marrow are 2.0 - 4.6%, and with iron refractory anemia, their number can reach up to 70%.

Treatment of iron refractory anemia

There is currently no treatment that can eliminate it completely. Application possible replacement therapy– infusion of erythrocyte mass and blood substitutes.

B12 deficiency anemia, causes of the disease, diagnosis and treatment.

What is B12? Where is this vitamin found?

First, what is B12? AT 12 is a vitamin that also has the name cyanocobalamin . Cyanocobalamin is found mainly in animal products - meat, liver, kidneys, milk, eggs, cheese. The level of vitamin B12 must be constantly maintained by the use of appropriate foods, since its natural physiological losses occur with feces and bile.

Causes of B12 deficiency anemia

So, B12 deficiency anemia is an anemia that occurs due to vitamin B12 deficiency. A lack of vitamin B12 can be caused by insufficient intake from food or a violation of its absorption in the gastrointestinal tract. Insufficient intake of cyanocobalamin with food is possible in strict vegetarians. Also, a lack of B12 can manifest itself with an increase in the need for it in pregnant women, nursing mothers, and cancer patients. Non-absorption of vitamin B12, supplied with food in sufficient quantities, occurs with diseases of the stomach, small intestine (diverticula, worms) and treatment with anticonvulsants or oral contraceptives.

Symptoms of B12 deficiency anemia

Symptoms of manifestation of B12 - deficiency anemia are characterized by disturbances in the central nervous system and the gastrointestinal tract. So, consider these two large groups of symptoms:

1. from the central nervous system. There is a decrease in reflexes, paresthesia (“goosebumps”), numbness of the limbs, a feeling of cottony legs, gait disturbance, memory loss
2. from the gastrointestinal tract. There is an increased sensitivity to acidic foods, glossitis, difficulty swallowing, atrophy of the gastric mucosa, an increase in the size of the liver and spleen

In the blood system, there is a transition to the megaloblastic type of hematopoiesis. This means that giant erythrocytes with a shortened life span, brightly colored erythrocytes without enlightenment in the center, pear-shaped and oval erythrocytes with Jolly bodies and Kabo rings appear in the blood. There are also giant neutrophils, the number of eosinophils(up to complete absence), basophils and the total number of leukocytes. In the blood, the concentration of bilirubin is increased, and therefore, slight yellowness of the skin and sclera of the eyes can be observed.

Treatment of B12 deficiency anemia

First of all, it is necessary to cure diseases of the gastrointestinal tract and establish a balanced food with adequate vitamin B12 content. The use of a course of vitamin B12 injections quickly normalizes hematopoiesis in the bone marrow, and then a constant, regular intake of a sufficient amount of vitamin B12 with food is necessary.

Folate deficiency anemia, causes, symptoms and treatment

Symptoms of folate deficiency anemia

With folic deficiency anemia, the gastrointestinal tract suffers, therefore, the manifestations of this anemia are associated with disorders of the gastrointestinal tract. There is an appearance hypersensitivity to sour food, glossitis, difficulty swallowing, atrophy of the gastric mucosa, enlargement of the liver and spleen.
In the blood system, the same changes occur as in B12 deficiency anemia. This is a transition to the megaloblastic type of hematopoiesis, the appearance of giant neutrophils, a decrease in the number of eosinophils, basophils and the total number of leukocytes.

Treatment of folate deficiency anemia

To treat this type of anemia, folic acid tablets are used and the diet is normalized, in which there should be foods containing a sufficient amount of folic acid.

Hypoplastic anemia, causes, diagnosis, treatment

Symptoms of hypoplastic anemia

Hypoplastic anemia can be hereditary or acquired, but all subtypes of this type of anemia are characterized by the same manifestations. Consider these symptoms:

1. Bleeding, bleeding gums, fragility of blood vessels, bruising on the skin, etc. These phenomena occur due to the low content of platelets in the blood.
2. Ulcerative - necrotic lesions of the mouth, pharynx, nose, skin. Accession of infections. This is due to the low number of white blood cells in the blood.
3. Dizziness, headaches, tinnitus, drowsiness, fatigue, fainting, sleep disturbances, shortness of breath, heart palpitations, etc.
4. In the general blood test, a decrease in the content of all blood cells - erythrocytes, leukocytes, platelets. In the bone marrow, there is a picture of desolation, since the foci of hematopoiesis are replaced by adipose tissue.

What causes can cause such damage to the bone marrow? Hereditary anemia, respectively, is inherited, but acquired? All factors that can lead to the development of hypoplastic anemia are divided into exogenous (external) and endogenous (internal). The table shows the main exogenous and endogenous causes capable of causing hypoplastic anemia.

Treatment of hypoplastic anemia is strictly within the competence of a hematologist. May apply various methods stimulation of hematopoiesis, or bone marrow transplantation.

So, we have considered all the main types of anemia. Of course, there are many more of them, but we cannot embrace the immensity. If any signs of anemia appear, you should consult a doctor in a timely manner. And regularly take a blood test for hemoglobin.

Anemia is a decrease in the number of red blood cells in the blood - erythrocytes below 4.0x109 / l, or a decrease in hemoglobin below 130 g / l in men and below 120 g / l in women. Anemia during pregnancy is characterized by a decrease in hemoglobin below 110 g / l.

This is not an independent disease, anemia occurs as a syndrome in a number of diseases and leads to a disruption in the supply of oxygen to all organs and tissues of the body, which, in turn, provokes the development of many other diseases and pathological conditions.

Severity

Depending on the concentration of hemoglobin, it is customary to distinguish three degrees of severity of anemia:

• anemia of the 1st degree is recorded when the hemoglobin level decreases by more than 20% of the normal value;
• anemia of the 2nd degree is characterized by a decrease in hemoglobin by about 20-40% of the normal level;
• grade 3 anemia is the most severe form of the disease, when hemoglobin is reduced by more than 40% of the normal value.

It is unequivocal to show that the patient has 1 degree or a more severe stage can only be a blood test.

The reasons

What it is: anemia, that is, anemia, is nothing more than. Namely, hemoglobin carries oxygen to all tissues of the body. That is, anemia is caused precisely by a lack of oxygen in the cells of all organs and systems.

1. The nature of nutrition. With insufficient intake of iron-containing foods, it can develop, this is more typical for population groups where there is already a high level of alimentary anemia;
2. Violation of the digestive tract (with violations of the absorption process). Since iron absorption occurs in the stomach and upper small intestine, in violation of the absorption process, the mucous membrane of the digestive tract, this disease develops.
3. Chronic blood loss (gastrointestinal bleeding, nosebleeds, hemoptysis, hematuria, uterine bleeding). Belongs to one of the most important causes of iron deficiency.

Iron-deficiency anemia

The most common form of anemia. It is based on a violation of the synthesis of hemoglobin (oxygen carrier) due to iron deficiency. It is manifested by dizziness, flashing flies before the eyes, palpitations. Dry skin, pallor, are noted. Typical manifestations there are fragility and layering of nails, their transverse striation.

aplastic anemia

It is more often acquired acute, subacute or chronic illness blood system, which is based on a violation of the hematopoietic function of the bone marrow, namely a sharp decrease in its ability to produce blood cells.

Sometimes aplastic anemia begins acutely and develops rapidly. But more often the disease occurs gradually and does not manifest itself with bright symptoms for quite a long time. The symptoms of aplastic anemia include all the symptoms characteristic of, and.

B12 deficiency anemia

It occurs when there is a lack of vitamin B12 in the body, which is necessary for the growth and maturation of red blood cells in the bone marrow, as well as for the proper functioning of the nervous system. For this reason, one of the hallmark symptoms of B12 deficiency anemia is tingling and numbness in the fingers and a wobbly gait.

Hemolysis occurs under the influence of antibodies. These can be maternal antibodies directed against the child's erythrocytes in case of incompatibility between the child and the mother for the Rh antigen and much less often for the antigens of the ABO system. Antibodies against one's own erythrocytes may be active at normal temperature or only when cooled.

They may appear without apparent reason or in connection with the fixation on erythrocytes of incomplete hapten antigens alien to the body.

signs

We list the main signs of anemia that can disturb a person.

• pallor of the skin;
• increased heart rate and respiration;
• fast fatiguability;
• dizziness;
• noise in ears;
• spots in the eyes;
• muscle weakness;
• difficulty concentrating;
• irritability;
• lethargy;
• slight rise in temperature.

Symptoms of anemia

Among the symptoms of anemia, manifestations directly related to hypoxia are considered to be the leading ones. Degree clinical manifestations depends on the severity of the decrease in the number of hemoglobin.

1. With a mild degree (hemoglobin level 115-90 g / l), general weakness, increased fatigue, and a decrease in concentration may be observed.
2. With an average (90-70 g / l), patients complain of shortness of breath, cardiopalmus, frequent headache, sleep disturbance, tinnitus, loss of appetite, lack of sexual desire. Patients are characterized by pallor of the skin.
3. In the case of a severe degree (hemoglobin less than 70 g / l), they develop.

With anemia, symptoms in many cases do not manifest themselves. The disease can only be detected when laboratory research blood.

Diagnosis of the disease

In order to understand how to treat anemia, it is important to determine its type and cause of development. The main method for diagnosing this disease is the study of the patient's blood.

Are considered:

• for men 130-160 grams per liter of blood.
• for women 120-147 g/l.
• for pregnant women, the lower limit of the norm is 110g / l.

Anemia treatment

Naturally, the methods of treating anemia radically differ depending on the type of anemia that caused its cause and severity. But the basic principle of treating anemia of any kind is the same - it is necessary to deal with the cause that caused the decrease in hemoglobin.

1. With anemia caused by blood loss, it is necessary to stop the bleeding as soon as possible. With a lot of blood loss life threatening using donated blood transfusion.
2. With iron deficiency anemia, you should eat foods rich in iron, vitamin B12 and folic acid (they improve iron absorption and blood formation processes), the doctor may also prescribe medications containing these substances. Often folk remedies are effective.
3. For anemia due to infectious diseases and intoxication, it is necessary to treat the underlying disease, to carry out urgent measures to detoxify the body.

In the case of anemia, an important condition for treatment is healthy lifestyle life - proper balanced nutrition, alternation of loads and rest. It is also necessary to avoid contact with chemical or poisonous substances and oil products.

Food

An important component of the treatment is a diet with foods rich in substances and trace elements that are necessary for the process of hematopoiesis. What foods should be eaten with anemia in a child and an adult? Here is the list:

• meat, sausages;
• offal - especially the liver;
• fish;
• egg yolks;
• whole grain flour products;
• seeds - pumpkin, sunflower, sesame;
• nuts - especially pistachios;
• spinach, cabbage, Brussels sprouts, fennel, parsley leaves;
• beet;
• black currant;
• sprouts, wheat germ;
• apricots, prunes, figs, dates;

Caffeinated beverages (eg, tea, coffee, cola) should be avoided, especially with meals, as caffeine interferes with iron absorption.

Iron supplements for anemia

Iron preparations for anemia are much more effective. The absorption of this trace element in the digestive tract from iron preparations is 15-20 times higher than from food.

This allows you to effectively use iron supplements for anemia: raise hemoglobin faster, restore iron stores, eliminate general weakness, fatigue and other symptoms.

1. Ferretab composite (0154g ferrous fumarate and 0.0005g folic acid). Additionally, it is desirable to take ascorbic acid in a daily dose of 0.2-0.3 g).
2. (0.32 g of ferrous sulfate and 0.06 g of vitamin C) is produced in a dragee daily dosage depending on the degree of anemia 2-3 times a day.
3. Totem - is available in bottles of 10 milliliters, the content of the elements is the same as in the sorbifer. It is used orally, it can be diluted with water, it is possible to prescribe it for intolerance to tablet forms of iron. Daily dose 1-2 doses.
4. (0.15g, ferrous sulfate, 0.05g vitamin C, vitamins B2, B6, 0.005g calcium pantothenate.
5. Vitamin B12 in 1 ml ampoules 0.02% and 0.05%.
6. Folic acid tablets 1mg.
7. Ampoule iron preparations for intramuscular and intravenous administration are sold only by prescription and require injections only in stationary conditions due to the high frequency of allergic reactions to these drugs.

You can not take iron supplements in conjunction with drugs that reduce their absorption: Levomycetin, Calcium preparations, Tetracyclines, Antacids. As a rule, iron preparations are prescribed before meals, if in medicine there is no vitamin C, then an additional intake of ascorbic acid is required in a daily dose of 0.2-0.3 g.

For each patient, the daily need for iron is specially calculated, as well as the duration of the course of treatment, the absorption of the specific prescribed drug and the iron content in it are taken into account. Usually, long courses of treatment are prescribed, therapeutic doses are taken within 1.5-2 months, and prophylactic doses are taken in the next 2-3 months.

Effects

Iron deficiency anemia untreated early stage, can have severe consequences. A severe degree turns into heart failure, associated with,. Sometimes people end up in the hospital with a sudden loss of consciousness, the cause of which is undertreated or not detected in time anemia.

Therefore, if you suspect that you have this disease or are prone to low hemoglobin, then it is worth taking a control blood test every three months.