Aplastic anemia – Symptoms & causes

Overview

Aplastic anemia is a condition that occurs when your body stops producing enough new blood cells. The condition leaves you fatigued and more prone to infections and uncontrolled bleeding.

A rare and serious condition, aplastic anemia can develop at any age. It can occur suddenly, or it can come on slowly and worsen over time. It can be mild or severe.

Treatment for aplastic anemia might include medications, blood transfusions or a stem cell transplant, also known as a bone marrow transplant.

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Symptoms

Aplastic anemia can have no symptoms. When present, signs and symptoms can include:

• Fatigue
• Shortness of breath
• Rapid or irregular heart rate
• Pale skin
• Frequent or prolonged infections
• Unexplained or easy bruising
• Nosebleeds and bleeding gums
• Prolonged bleeding from cuts
• Skin rash
• Dizziness
• Headache
• Fever

Aplastic anemia can be short-lived, or it can become chronic. It can be severe and even fatal.

Causes

Stem cells in the bone marrow produce blood cells — red cells, white cells and platelets. In aplastic anemia, stem cells are damaged. As a result, the bone marrow is either empty (aplastic) or contains few blood cells (hypoplastic).

Bone marrow

Bone marrow is a red, spongy material inside your bones that produces blood cells.

The most common cause of aplastic anemia is from your immune system attacking the stem cells in your bone marrow. Other factors that can injure bone marrow and affect blood cell production include:

• Radiation and chemotherapy treatments. While these cancer-fighting therapies kill cancer cells, they can also damage healthy cells, including stem cells in bone marrow. Aplastic anemia can be a temporary side effect of these treatments.
• Exposure to toxic chemicals. Toxic chemicals, such as some used in pesticides and insecticides, and benzene, an ingredient in gasoline, have been linked to aplastic anemia. This type of anemia might improve if you avoid repeated exposure to the chemicals that caused your illness.
• Use of certain drugs. Some medications, such as those used to treat rheumatoid arthritis and some antibiotics, can cause aplastic anemia.
• Autoimmune disorders. An autoimmune disorder, in which your immune system attacks healthy cells, might involve stem cells in your bone marrow.
• A viral infection. Viral infections that affect bone marrow can play a role in the development of aplastic anemia. Viruses that have been linked to aplastic anemia include hepatitis, Epstein-Barr, cytomegalovirus, parvovirus B19 and HIV.
• Pregnancy. Your immune system might attack your bone marrow during pregnancy.
• Unknown factors. In many cases, doctors aren’t able to identify the cause of aplastic anemia (idiopathic aplastic anemia).

Connections with other rare disorders

Some people with aplastic anemia also have a rare disorder known as paroxysmal nocturnal hemoglobinuria, which causes red blood cells to break down too soon. This condition can lead to aplastic anemia, or aplastic anemia can evolve into paroxysmal nocturnal hemoglobinuria.

Fanconi’s anemia is a rare, inherited disease that leads to aplastic anemia. Children born with it tend to be smaller than average and have birth defects, such as underdeveloped limbs. The disease is diagnosed with the help of blood tests.

Risk factors

Aplastic anemia is rare. Factors that can increase risk include:

• Treatment with high-dose radiation or chemotherapy for cancer
• Exposure to toxic chemicals
• The use of some prescription drugs — such as chloramphenicol, which is used to treat bacterial infections, and gold compounds used to treat rheumatoid arthritis
• Certain blood diseases, autoimmune disorders and serious infections
• Pregnancy, rarely

Prevention

There’s no prevention for most cases of aplastic anemia. Avoiding exposure to insecticides, herbicides, organic solvents, paint removers and other toxic chemicals might lower your risk of the disease.

Chronic Anemia: Symptoms, Causes, and Treatment

What is anemia?

If you have anemia, you have a lower-than-normal number of red blood cells, or the amount of hemoglobin in your red blood cells has dropped below normal. Because of this, your body’s cells aren’t getting enough oxygen.

There are three primary causes of anemia: blood loss, lack of red blood cell production, and high rates of red blood cell destruction.

Chronic anemia is also known as anemia of chronic disease and anemia of inflammation and chronic disease. This anemia is a result of other long-term health conditions that affect your body’s ability to make red blood cells.

These health conditions include:

• cancer, such as non-Hodgkin’s lymphoma, Hodgkin’s disease, and breast cancer
• kidney disease
• autoimmune disorders and inflammatory diseases, such as rheumatoid arthritis, diabetes, Crohn’s disease, lupus, and inflammatory bowel disease (IBD)
• long-term infections, such as HIV, endocarditis, tuberculosis, osteomyelitis, lung abscess, and hepatitis B or hepatitis C

Sometimes the chemotherapy used to treat certain cancers undermines your body’s ability to make new blood cells, resulting in anemia.

Symptoms might include:

• weakness
• fatigue
• pale skin
• shortness of breath
• fast heartbeat

These symptoms may be masked by underlying conditions.

Many doctors will focus on treating the condition that is causing the chronic anemia and not always treat it separately.

For example, if you have IBD, your doctor might prescribe anti-inflammatories such as corticosteroids and antibiotics such as ciprofloxacin (Cipro). These can treat the IBD and make the chronic anemia disappear.

There are other conditions in which your doctor might suggest treatments specifically targeted at the chronic anemia.

For example, if you have kidney disease with chronic anemia, your doctor might prescribe vitamin B-12 and folic acid supplements if you have a vitamin B-12 or folate deficiency. Or your doctor might prescribe a synthetic form of erythropoietin.

Also, if you have chronic anemia and blood work indicates an iron deficiency, your doctor might recommend iron supplements.

People with chronic anemia are often advised to incorporate dietary changes to address specific deficiencies. Following are a few suggestions if your iron, folic acid, or vitamin B-12 levels are low.

Dietary sources of iron:

• beans
• chicken
• spinach
• breakfast cereals

Dietary sources of folic acid:

• beans
• chicken
• breakfast cereals
• rice

Dietary sources of vitamin B-12:

• chicken
• breakfast cereals
• fish
• beef liver

Iron deficiency anemia

Iron deficiency anemia is the most common type of anemia. It’s caused by a lack of iron from blood loss, a diet deficient in iron, or poor absorption of iron.

Vitamin deficiency anemia

Vitamin deficiency anemia is caused by a lack of vitamin B-12 or folic acid either from a diet deficient in these nutrients or poor absorption of them.

When vitamin B-12 can’t be absorbed in the gastrointestinal tract, it results in pernicious anemia.

Aplastic anemia

Aplastic anemia is a rare condition that occurs when your bone marrow stops making enough blood cells.

Hemolytic anemia

Hemolytic anemia occurs when red blood cells are broken up in the bloodstream or in the spleen. It may be due to mechanical problems (leaky heart valves or aneurysms), infections, autoimmune disorders, or congenital abnormalities in red blood cells.

Sickle cell anemia

Sickle cell anemia is an inherited hemolytic anemia with abnormal hemoglobin protein that causes red blood cells to be rigid and clog circulation through small blood vessels.

Chronic anemia is a type of anemia that commonly occurs with infections, chronic illnesses, inflammatory disorders, or cancer. It often isn’t treated separately from the underlying condition causing it.

If you have a condition that may be associated with chronic anemia and think that you might be anemic, talk to your doctor about a complete blood count (CBC) blood test. If the result indicates chronic anemia, review treatment options with your doctor.

Treatment of anemia in adults in Zheleznodorozhny – symptoms, diagnosis

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Anemia

One of the common blood disorders seen in one out of every ten people is anemia. Symptoms of anemia do not occur on their own. This is a secondary pathology that accompanies other diseases: oncological, inflammatory processes caused by an infection or virus.

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Anemia: what is it and who treats it

Anemia is anemia when the structure of blood cells is disturbed and the percentage of hemoglobin is critically reduced. The disease is usually associated with a lack of red blood cells. The syndrome mainly manifests itself in the form of iron deficiency.

To treat this disease is the responsibility of hematologists and therapists. The examination is aimed at establishing the causes of the disease, determining the composition of the blood and preparing a treatment plan.

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Symptoms of anemia

• Feeling weak, sleepy.
• Rapid fatigue even in the absence of physical, mental, moral stress, minimal performance, deterioration in the ability to concentrate.
• Pale skin.
• Frequent mood swings.
• Great irritability.
• Lack of vitamins, constant desire to eat something.
• Migraines, attacks of severe headache.
• Extraneous noise or ringing in the ears.
• The appearance of “flies” before the eyes.
• Attacks of vertigo, often so severe that it is impossible to maintain balance.
• Shortness of breath.
• Brittleness of nails, hair, their dull appearance.
• Pain in the region of the heart.
• Muscle weakness.

If even some of these symptoms appear, you should visit the Family Medical Center, undergo the necessary examination, and receive recommendations for treatment.

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Classification

Types of anemia in adults are globally divided into anemia with reduced hemoglobin and other manifestations when hemoglobin is normal, namely:

1. Iron deficiency. Appears due to the fact that the body lacks iron and, as a rule, speaks of other concomitant disorders. Most of the iron comes from the diet, so this kind of anemia is often indicative of poor food choices, a lack of dietary variety. We can also talk about poor absorption of iron (for example, this condition is typical after a significant loss of blood, with oncology, stomach ulcers).
2. Hemolytic. The condition is associated with a decrease in the lifespan of red blood cells. The manifestation is a yellowish skin tone due to a serious increase in the amount of bilirubin in the body. This substance is a derivative during the destruction of red blood cells. The nature of the pathology may be hereditary, associated with genetic abnormalities in the function of red blood cells. The acquired disease progresses due to the intense destruction of red blood cells caused by exposure to external factors, toxins.
3. Posthemorrhagic. Anemia is associated with chronic or sudden loss of large volumes of blood. The acute form is associated with unexpected internal bleeding caused by a violation of the integrity of the skin, internal organs. The chronic form is formed if slow bleeding continued for a long time. This is typical, for example, for ulcers.
4. Thalassemia. Pathology, the cause of which is heredity. Too small volumes of hemoglobin are formed – a protein for transporting oxygen and carbon dioxide molecules. The patient needs to reduce high iron levels. It is necessary either to frequently transfuse blood, or to transplant bone marrow in order to be cured by 100%.
5. Aplastic. A rare pathology – a violation of the formation of blood cells at the bone marrow level. The production of platelets, erythrocytes, leukocytes is minimal, up to a complete stop.
6. Pernicious – associated with a lack of vitamin B12, a lack of red blood cells, an intense decrease in hemoglobin levels. There may be pathologies of the gastrointestinal tract, disorders of the nervous system. Suspicion of a pathology may appear with a loss of hardness of the gait, the appearance of a feeling of numbness, tingling of the fingers.
7. Folate deficiency. The reason for the appearance is a low level of vitamin B9 (folic acid) in the body. The volumes of hemoglobin, erythrocytes in such situations fall greatly.
8. Refractory. A common type of myelodysplastic syndrome is a violation of blood maturation, a decrease in hemoglobin levels. Formed signs indicating the development of leukemia. This is a stable disorder that cannot be corrected by taking even large doses of vitamins, iron supplements, or changing the diet.

Causes of anemia

• An unbalanced diet, in which there is too little iron, B vitamins, refusal of food, too much exclusion of foods rich in protein.
• Diseases that slow down the production of red blood cells in the bone marrow. Basically, these are pathologies that disrupt renal function, a complex lack of protein, a number of infections in a chronic form, and malignant tumors.
• Hemolysis. This condition is expressed in the destruction of red blood cells, reducing their lifespan. It can only be determined by blood tests.
• Heavy periods, regular nosebleeds, hidden internal bleeding and other conditions associated with blood loss are the most common causes.

Secondary factors of development

• Pathologies of the spleen.
• Pregnancy associated with severe hormonal fluctuations.
• Regular blood donation.
• Intense physical activity, professional sports life.

Musculature “takes” large amounts of iron.

Complications of anemia

The consequences can be serious, up to conditions that require immediate medical attention – acute strokes, heart attacks. If untreated, the following problems are also likely:

• Deterioration of immune system function.
• Heart failure, pathology of the heart, blood vessels.
• Developmental delay, growth, if we are talking about childhood.
• Hypoxia in the presence of diseases of the heart, lungs.
• Preterm birth in pregnant women.

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Therapies

Treatment of anemia is made individually. The doctor needs to interview the patient, conduct a diagnosis, and correctly interpret its results. It should be understood how pronounced the pathology is, what treatment methods will be effective in a particular case. The basic types of treatment for anemia are as follows:

• Elimination of the cause of iron deficiency.
• Active consumption of foods high in iron.
• Taking appropriate medications, vitamin complexes.
• Transfusions of formulations with a high content of red blood cells, if a severe form of pathology is diagnosed.

Diagnosis of anemia

To accurately establish the form, the causes of anemia, the hematologist directs a number of studies:

• Study of the biochemical composition of blood.
• A wide blood test for fixing indicators that indirectly or directly indicate anemia – laboratory tests for hemoglobin, ferritin, serum iron.
• Analysis of biological fluids.
• Endoscopy of the stomach, intestines, if there is a suspicion of an ulcer and internal bleeding.

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Anemia: causes, symptoms, diagnosis and treatment approaches

Definition
Anemia (synonymous with anemia) is a decrease in the content of hemoglobin and / or the number of red blood cells per unit volume of blood, leading to a deterioration in the supply of oxygen to tissues, i.e. to the development of hypoxia. The diagnosis of “anemia” is established when hemoglobin is less than 130 g/l in men and less than 120 g/l in women, and in children age is taken into account, considering hemoglobin levels less than 110 g/l (up to 4 years), 115 g/l as anemia ( up to 11 years old), 120 g/l (up to 15 years old).

Anemia is not an independent disease, but is a manifestation or complication of many other pathological conditions (low iron intake, wounds and injuries, erosions and ulcers of the gastrointestinal tract, atrophic gastritis, enteritis, surgical interventions on the stomach and small intestine, chronic diseases liver and kidneys, oncological, infectious, autoimmune diseases, helminthic invasions, leukemia, menstrual disorders and other gynecological pathology, intoxication and radiation injuries).

The most common is anemia that occurs after acute or chronic blood loss. Examples of acute blood loss can be bleeding from a stomach ulcer, severe mechanical trauma, and chronic blood loss – heavy and prolonged menstruation, hemorrhoids, hematuria with nephritis, hemoptysis with tuberculosis or systemic vasculitis. Anemia due to chronic blood loss is usually iron deficiency. Pregnant women also often show signs of anemia due to the increased demand for iron.

Anemia may also result from impaired hematopoiesis (eg, vitamin B12 deficiency or leukemia, exposure to ionizing radiation), increased hemorrhage, or hemolysis (eg, autoimmune diseases, various intoxications).

Symptoms of anemia

The lower the hemoglobin level, the more severe the anemia. There are general (non-specific) manifestations of anemia and signs that are specific to a particular type of anemia.

Non-specific manifestations include pale skin, weakness, increased fatigue, drowsiness, dizziness, fainting, tinnitus, flickering “flies” before the eyes, shortness of breath, palpitations, rapid pulse, etc. , fragility of nails, hair, ulceration and cracks in the corners of the mouth, muscle weakness. Some patients have a burning sensation of the tongue, a perversion of taste in the form of an indomitable desire to eat chalk, toothpaste, earth, raw cereals, raw meat, as well as an addiction to certain smells (acetone, gasoline). Patients may report subjective signs of chronic blood loss (hemoptysis, epistaxis, episodes of black stools or fresh blood in the stool, red urine).

B12-deficiency anemias are characterized by paresthesias (a feeling of crawling all over the body), sensory disturbances, numbness of the extremities; in severe forms, mental disorders, delirium, hallucinations, acquired dementia are observed.

Hemolytic anemia is often accompanied by yellowness of the skin, sclera of the eyes, dyspeptic manifestations (nausea, vomiting), heaviness in the left side of the abdomen due to an increase in the size of the spleen.
Patients with aplastic anemia often suffer from concomitant bronchitis, pneumonia and other manifestations of immunodeficiency.

Diagnosis of anemia

If anemia is suspected in an adult patient, a general practitioner or family doctor should be consulted. Depending on the initial presentation, the patient should be referred to doctors of other specialties, in whose competence this clinical case may be, such as a hematologist, gastroenterologist, rheumatologist, nephrologist, infectious disease specialist, parasitologist, mycologist, surgeon, urologist, oncologist, etc.

Examination for the cause of anemia should be comprehensive, with an assessment of the patient’s vital activity, diet, medical history, and a thorough analysis of the clinical picture.

Laboratory diagnosis of anemia, carried out at the first stage, necessarily involves a general clinical blood test with the determination of hemoglobin concentration, the number of erythrocytes, leukocytes, platelets, hematocrit and erythrocyte indices, color index, leukocyte formula and ESR (with microscopy of a blood smear in the presence of pathological changes ).

In order to clarify the diagnosis and establish the cause of anemia in an individual patient, taking into account the characteristics of his disease, the first contact doctor and specialized specialists may recommend the following laboratory and instrumental studies: transferrin (iron carrier protein), latent (unsaturated) iron-binding capacity of serum blood (LVHSS, NZhSS), serum iron, folic acid, vitamin B12, indirect bilirubin, free hemoglobin in plasma, serum creatinine, total protein, hepatic transaminases, potassium, sodium, glucose, coagulogram, C-reactive protein, rheumatoid and antinuclear factor , general clinical sputum analysis, sputum examination for mycobacterium tuberculosis, “DiaskinTest”, T-SPOT test, general clinical urinalysis, analysis for daily protein loss, fecal occult blood analysis, electrocardiography, plain radiography or computed tomography of the chest, ultrasound of the abdominal organs cavity (liver, gallbladder, pancreas, spleen), kidneys, thyroid gland, parathyroid glands and regional lymph nodes, fibrogastroduodenoscopy (FGDS), fibrocolonoscopy (FCS), bone marrow puncture.

Treatment of anemia

Treatment of anemia depends on its etiology and may involve a variety of approaches. In general, treatment tactics depend on the type of anemia and the severity of the patient’s condition. Some anemias are treated in a hospital setting. It is important to eliminate the source of blood loss. Iron deficiency and B12 deficiency anemia are treated with iron supplements and vitamin B12. Also, with a low level of hemoglobin, red blood cell transfusions can be applied. According to vital indications, with a sharp violation of hemodynamics, a drop in hemoglobin below 70-80 g / l, blood transfusions are used. Therapy of individual forms of anemia is carried out taking into account their etiology and pathogenesis. Since anemia is always secondary, it is necessary to actively treat diseases that cause a decrease in hemoglobin levels (diseases of the gastrointestinal tract, infectious, parasitic, viral, fungal, oncological, etc.). According to the indications, immunosuppressive therapy is carried out; surgical interventions (removal of the spleen, bone marrow transplantation).