What are the main types of microcytic anemia. How is microcytic anemia diagnosed. What are the most effective treatments for microcytic anemia. How does iron deficiency lead to microcytic anemia. Can microcytic anemia be prevented through dietary changes.

Understanding Microcytic Anemia: A Comprehensive Overview

Microcytic anemia is a condition characterized by the presence of smaller-than-normal red blood cells in lower quantities than typically found in healthy individuals. This condition can arise from various factors, with iron deficiency being the most common cause. To fully grasp the implications of microcytic anemia, it’s crucial to understand its definition, causes, and impact on the body.

Red blood cells play a vital role in transporting oxygen throughout the body. When these cells are smaller and fewer in number, the body’s ability to deliver oxygen to tissues and organs is compromised. This can lead to a range of symptoms that affect an individual’s overall health and quality of life.

What Causes Microcytic Anemia?

The primary cause of microcytic anemia is a deficiency in hemoglobin production. Hemoglobin, a protein in red blood cells responsible for carrying oxygen, requires iron for its synthesis. When the body lacks sufficient iron or faces challenges in hemoglobin production, microcytic anemia can develop. Some common causes include:

• Iron deficiency due to poor dietary intake or absorption issues
• Chronic blood loss, such as heavy menstrual periods or gastrointestinal bleeding
• Genetic disorders affecting hemoglobin production, like thalassemia
• Chronic diseases that interfere with iron metabolism

Recognizing the Symptoms of Microcytic Anemia

Identifying microcytic anemia in its early stages can be challenging, as symptoms often develop gradually. As the condition progresses, individuals may experience a range of symptoms that impact their daily lives. Common signs and symptoms include:

• Persistent fatigue and weakness
• Shortness of breath, especially during physical activity
• Dizziness or lightheadedness
• Pale skin and mucous membranes
• Decreased exercise tolerance
• Cognitive difficulties, such as poor concentration

It’s important to note that these symptoms can be indicative of various health issues. If you experience any of these symptoms persistently for more than two weeks, it’s advisable to consult a healthcare professional for proper evaluation and diagnosis.

When Should You Seek Medical Attention?

While mild symptoms may not require immediate medical intervention, certain signs warrant prompt attention. Seek medical care if you experience:

• Severe dizziness or fainting spells
• Chest pain or palpitations
• Extreme shortness of breath
• Unusual paleness or jaundice

Types of Microcytic Anemia: Understanding the Variations

Microcytic anemia can be further classified based on the hemoglobin content of the red blood cells. This classification helps in determining the underlying cause and guiding appropriate treatment strategies. The three main types are:

1. Hypochromic Microcytic Anemia

In this type, red blood cells are not only smaller but also contain less hemoglobin than normal, appearing paler in color. Hypochromic microcytic anemia is the most common form and includes:

• Iron deficiency anemia
• Thalassemia
• Sideroblastic anemia (congenital form)

2. Normochromic Microcytic Anemia

This type features small red blood cells with normal hemoglobin content. It’s often associated with chronic diseases and inflammation, including:

• Infectious diseases (e.g., tuberculosis, HIV/AIDS)
• Inflammatory conditions (e.g., rheumatoid arthritis, Crohn’s disease)
• Kidney disease
• Certain types of cancer

3. Hyperchromic Microcytic Anemia

Although rare, this type involves small red blood cells with higher-than-normal hemoglobin content. It’s often associated with specific genetic disorders affecting hemoglobin synthesis.

Diagnosing Microcytic Anemia: The Path to Accurate Identification

Proper diagnosis of microcytic anemia involves a comprehensive approach that combines clinical evaluation, laboratory tests, and sometimes additional diagnostic procedures. The diagnostic process typically includes:

1. Medical history review and physical examination
2. Complete blood count (CBC) to assess red blood cell size and number
3. Iron studies to measure serum iron, ferritin, and total iron-binding capacity
4. Hemoglobin electrophoresis to detect abnormal hemoglobin variants
5. Additional tests to identify underlying causes (e.g., celiac disease screening, stool tests for occult blood)

Accurate diagnosis is crucial for determining the appropriate treatment approach and addressing any underlying health conditions contributing to the anemia.

How is the Mean Corpuscular Volume (MCV) Used in Diagnosis?

The Mean Corpuscular Volume (MCV) is a key metric in diagnosing microcytic anemia. It measures the average size of red blood cells. In microcytic anemia, the MCV is typically below 80 femtoliters (fL). This value, combined with other blood test results, helps healthcare providers differentiate between various types of anemia and guide further diagnostic steps.

Treatment Approaches for Microcytic Anemia

The treatment of microcytic anemia is primarily focused on addressing the underlying cause and replenishing iron stores when necessary. Treatment strategies may include:

1. Iron Supplementation

For iron deficiency anemia, oral iron supplements are often the first line of treatment. These supplements come in various forms, including ferrous sulfate, ferrous gluconate, and ferrous fumarate. The choice of supplement and dosage depends on the severity of the deficiency and the individual’s tolerance.

2. Dietary Modifications

Increasing iron intake through diet can help prevent and treat mild cases of iron deficiency anemia. Iron-rich foods include:

• Lean red meat
• Poultry
• Fish
• Leafy green vegetables
• Legumes
• Fortified cereals

Combining iron-rich foods with vitamin C sources can enhance iron absorption.

3. Intravenous Iron Therapy

In cases of severe iron deficiency or when oral supplements are not well-tolerated, intravenous iron therapy may be recommended. This approach allows for faster replenishment of iron stores and is particularly useful in cases of malabsorption or chronic blood loss.

4. Treating Underlying Conditions

For microcytic anemias caused by chronic diseases or genetic disorders, treatment focuses on managing the underlying condition. This may involve:

• Medications to control inflammation in autoimmune diseases
• Antibiotics for infectious causes
• Specific treatments for genetic disorders like thalassemia

Preventing Microcytic Anemia: Strategies for Maintaining Healthy Red Blood Cells

While not all cases of microcytic anemia can be prevented, certain strategies can reduce the risk of developing iron deficiency anemia, the most common form. Preventive measures include:

1. Maintaining a balanced diet rich in iron, particularly for individuals at higher risk of deficiency
2. Regular health check-ups to monitor iron levels, especially for women of childbearing age and individuals with chronic conditions
3. Addressing chronic blood loss promptly, such as seeking treatment for heavy menstrual periods or gastrointestinal bleeding
4. Considering iron supplementation during pregnancy or when following restrictive diets

By implementing these preventive strategies and maintaining awareness of potential risk factors, individuals can significantly reduce their likelihood of developing microcytic anemia.

Living with Microcytic Anemia: Management and Lifestyle Considerations

For individuals diagnosed with microcytic anemia, managing the condition extends beyond medical treatment. Lifestyle adjustments and ongoing care are essential for optimizing health and quality of life. Key considerations include:

1. Adherence to Treatment Plans

Consistent follow-through with prescribed treatments, whether iron supplements or medications for underlying conditions, is crucial for managing microcytic anemia effectively. Regular communication with healthcare providers ensures that treatment plans can be adjusted as needed.

2. Dietary Vigilance

Maintaining a diet rich in iron and other essential nutrients supports ongoing treatment and helps prevent recurrence of iron deficiency. This may involve working with a nutritionist to develop meal plans that meet individual needs and preferences.

3. Regular Monitoring

Periodic blood tests to check iron levels and red blood cell counts are important for tracking progress and detecting any changes early. The frequency of these tests will depend on the severity of the anemia and the individual’s response to treatment.

4. Exercise and Activity Management

While physical activity is important for overall health, individuals with microcytic anemia may need to adjust their exercise routines. Gradually increasing activity levels as anemia improves can help manage fatigue and prevent overexertion.

5. Stress Management

Chronic conditions like anemia can be stressful. Incorporating stress-reduction techniques such as meditation, yoga, or counseling can support overall well-being and potentially improve treatment outcomes.

The Future of Microcytic Anemia Research and Treatment

As medical science advances, new insights into the mechanisms of microcytic anemia and innovative treatment approaches are emerging. Current areas of research and development include:

• Novel iron formulations with improved absorption and fewer side effects
• Gene therapy approaches for inherited forms of microcytic anemia, such as thalassemia
• Advanced diagnostic tools for earlier and more precise identification of anemia subtypes
• Personalized treatment strategies based on genetic profiles and individual risk factors

These advancements hold promise for more effective management of microcytic anemia and improved quality of life for affected individuals.

How Might Emerging Technologies Impact Anemia Care?

Emerging technologies, such as wearable devices that can monitor hemoglobin levels non-invasively, may revolutionize how microcytic anemia is monitored and managed. These innovations could allow for more frequent and convenient monitoring, enabling faster interventions and more personalized treatment adjustments.

As research progresses, individuals with microcytic anemia can look forward to more targeted and effective treatment options. Staying informed about these developments and discussing new possibilities with healthcare providers can help patients make the best decisions for their health and well-being.

Microcytic Anemia: Symptoms, Types, and Treatment

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Microcytic anemia means that you have smaller red blood cells than typical — and fewer of them. It can result from an iron deficiency or a health condition.

Microcytic anemia definition

Microcytosis is a term used to describe red blood cells that are smaller than normal. Anemia is when you have low numbers of properly functioning red blood cells in your body.

In microcytic anemias, your body has fewer red blood cells than normal. The red blood cells it does have are also too small. Several different types of anemias can be described as microcytic.

Microcytic anemias are caused by conditions that prevent your body from producing enough hemoglobin. Hemoglobin is a component of your blood. It helps transport oxygen to your tissues and gives your red blood cells their red color.

Iron deficiency causes most microcytic anemias. Your body needs iron to produce hemoglobin. But other conditions can cause microcytic anemias, too. To treat a microcytic anemia, your doctor will first diagnose the underlying cause.

You may not notice any symptoms of microcytic anemia at first. Symptoms often appear at an advanced stage when the lack of normal red blood cells is affecting your tissues.

Common symptoms of microcytic anemias include:

• fatigue, weakness, and tiredness
• loss of stamina
• shortness of breath
• dizziness
• pale skin

If you experience any of these symptoms and they don’t resolve within two weeks, make an appointment to see your doctor.

You should make an appointment to see your doctor as soon as possible if you experience severe dizziness or shortness of breath.

Microcytic anemias can be further described according to the amount of hemoglobin in the red blood cells. They can be either hypochromic, normochromic, or hyperchromic:

1. Hypochromic microcytic anemias

Hypochromic means that the red blood cells have less hemoglobin than normal. Low levels of hemoglobin in your red blood cells leads to appear paler in color. In microcytic hypochromic anemia, your body has low levels of red blood cells that are both smaller and paler than normal.

Most microcytic anemias are hypochromic. Hypochromic microcytic anemias include:

Iron deficiency anemia: The most common cause of microcytic anemia is an iron deficiency in the blood. Iron deficiency anemia can be caused by:

• inadequate iron intake, usually as a result of your diet
• being unable to absorb iron due to conditions like celiac disease or Helicobacter pylori infection
• chronic blood loss due to frequent or heavy periods in women or by gastrointestinal (GI) bleeds from upper GI ulcers or inflammatory bowel disease
• pregnancy

Thalassemia: Thalassemia is a type of anemia that’s caused by an inherited abnormality. It involves mutations in the genes needed for normal hemoglobin production.

Sideroblastic anemia: Sideroblastic anemia can be inherited due to gene mutations (congenital). It can also be caused by a condition acquired later in life that impedes your body’s ability to integrate iron into one of the components needed to make hemoglobin. This results in a buildup of iron in your red blood cells.

Congenital sideroblastic anemia is usually microcytic and hypochromic.

2. Normochromic microcytic anemias

Normochromic means that your red blood cells have a normal amount of hemoglobin, and the hue of red is not too pale or deep in color. An example of a normochromic microcytic anemia is:

Anemia of inflammation and chronic disease: Anemia due to these conditions is usually normochromic and normocytic (red blood cells are normal in size). Normochromic microcytic anemia may be seen in people with:

• infectious diseases, such as tuberculosis, HIV/AIDS, or endocarditis
• inflammatory diseases, such as rheumatoid arthritis, Crohn’s disease, or diabetes mellitus
• kidney disease
• cancer

These conditions can prevent red blood cells from functioning normally. This can lead to decreased iron absorption or utilization.

3. Hyperchromic microcytic anemias

Hyperchromic means that the red blood cells have more hemoglobin than normal. High levels of hemoglobin in your red blood cells makes them a deeper hue of red than normal.

Congenital spherocytic anemia: Hyperchromic microcytic anemias are rare. They may be caused by a genetic condition known as congenital spherocytic anemia. This is also called hereditary spherocytosis.

In this disorder, the membrane of your red blood cells doesn’t form correctly. This causes them to be rigid and improperly spherical shaped. They are sent to be broken down and die in the spleen because they don’t travel in the blood cells properly.

4. Other causes of microcytic anemia

Other causes of microcytic anemia include:

• lead toxicity
• copper deficiency
• zinc excess, which causes copper deficiency
• alcohol use
• drug use

Microcytic anemias are often first spotted after your doctor has ordered a blood test known as a complete blood count (CBC) for another reason. If your CBC indicates that you have anemia, your doctor will order another test known as a peripheral blood smear.

This test can help spot early microcytic or macrocytic changes to your red blood cells. Hypochromia, normochromia, or hyperchromia can also be seen with the peripheral blood smear test.

Your primary care doctor may refer you to a hematologist. A hematologist is a specialist who works with blood disorders. They may be able to best diagnose and treat the specific type of microcytic anemia and identify its underlying cause.

Once a doctor has diagnosed you with microcytic anemia, they will run tests to determine the cause of the condition. They may run blood tests to check for celiac disease. They may test your blood and stool for H. pylori bacterial infection.

Your doctor might ask you about other symptoms you’ve experienced if they suspect that chronic blood loss is the cause of your microcytic anemia. They may refer you to a gastroenterologist if you have stomach or other abdominal pain. A gastroenterologist might run imaging tests to look for different conditions. These tests include:

• abdominal ultrasound
• upper GI endoscopy (EGD)
• CT scan of the abdomen

For women with pelvic pain and heavy periods, a gynecologist may look for uterine fibroids or other conditions that could cause heavier flows.

Treatment for microcytic anemia focuses on treating the underlying cause of the condition.

Your doctor may recommend that you take iron and vitamin C supplements. The iron will help treat the anemia while the vitamin C will help increase your body’s ability to absorb the iron.

Your doctor will focus on diagnosing and treating the cause of the blood loss if acute or chronic blood loss is causing or contributing to microcytic anemia. Women with iron deficiency from severe periods may be prescribed hormonal therapy, such as birth control pills.

In cases of microcytic anemia so severe that you’re at risk for complications like cardiac failure, you may need to get a blood transfusion of donor red blood cells. This can increase the number of healthy red blood cells that your organs need.

Treatment can be relatively straightforward if simple nutrient deficiencies are the cause of microcytic anemia. As long as the underlying cause of the anemia can be treated, the anemia itself can be treated and even cured.

In very severe cases, untreated microcytic anemia can become dangerous. It can cause tissue hypoxia. This is when the tissue is deprived of oxygen. It can cause complications including:

• low blood pressure, also called hypotension
• coronary artery problems
• pulmonary problems
• shock

These complications are more common in older adults who already have pulmonary or cardiovascular diseases.

The best way to prevent microcytic anemia is to get enough iron in your diet. Increasing your vitamin C intake can also help your body absorb more iron.

You can also consider taking a daily iron supplement. These are often recommended if you already have anemia. You should always talk to your doctor before you start taking any supplements.

You can also try to get more nutrients through your food.

Foods rich in iron include:

• red meat like beef
• poultry
• dark leafy greens
• beans
• dried fruits like raisins and apricots

Foods rich in vitamin C include:

• citrus fruits, especially oranges and grapefruits
• kale
• red peppers
• Brussels sprouts
• strawberries
• broccoli

Microcytic Anemia: Symptoms, Types, and Treatment

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission Here’s our process.

Healthline only shows you brands and products that we stand behind.

Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:

• Evaluate ingredients and composition: Do they have the potential to cause harm?
• Fact-check all health claims: Do they align with the current body of scientific evidence?
• Assess the brand: Does it operate with integrity and adhere to industry best practices?

We do the research so you can find trusted products for your health and wellness.

Read more about our vetting process.

Was this helpful?

Microcytic anemia means that you have smaller red blood cells than typical — and fewer of them. It can result from an iron deficiency or a health condition.

Microcytic anemia definition

Microcytosis is a term used to describe red blood cells that are smaller than normal. Anemia is when you have low numbers of properly functioning red blood cells in your body.

In microcytic anemias, your body has fewer red blood cells than normal. The red blood cells it does have are also too small. Several different types of anemias can be described as microcytic.

Microcytic anemias are caused by conditions that prevent your body from producing enough hemoglobin. Hemoglobin is a component of your blood. It helps transport oxygen to your tissues and gives your red blood cells their red color.

Iron deficiency causes most microcytic anemias. Your body needs iron to produce hemoglobin. But other conditions can cause microcytic anemias, too. To treat a microcytic anemia, your doctor will first diagnose the underlying cause.

You may not notice any symptoms of microcytic anemia at first. Symptoms often appear at an advanced stage when the lack of normal red blood cells is affecting your tissues.

Common symptoms of microcytic anemias include:

• fatigue, weakness, and tiredness
• loss of stamina
• shortness of breath
• dizziness
• pale skin

If you experience any of these symptoms and they don’t resolve within two weeks, make an appointment to see your doctor.

You should make an appointment to see your doctor as soon as possible if you experience severe dizziness or shortness of breath.

Microcytic anemias can be further described according to the amount of hemoglobin in the red blood cells. They can be either hypochromic, normochromic, or hyperchromic:

1. Hypochromic microcytic anemias

Hypochromic means that the red blood cells have less hemoglobin than normal. Low levels of hemoglobin in your red blood cells leads to appear paler in color. In microcytic hypochromic anemia, your body has low levels of red blood cells that are both smaller and paler than normal.

Most microcytic anemias are hypochromic. Hypochromic microcytic anemias include:

Iron deficiency anemia: The most common cause of microcytic anemia is an iron deficiency in the blood. Iron deficiency anemia can be caused by:

• inadequate iron intake, usually as a result of your diet
• being unable to absorb iron due to conditions like celiac disease or Helicobacter pylori infection
• chronic blood loss due to frequent or heavy periods in women or by gastrointestinal (GI) bleeds from upper GI ulcers or inflammatory bowel disease
• pregnancy

Thalassemia: Thalassemia is a type of anemia that’s caused by an inherited abnormality. It involves mutations in the genes needed for normal hemoglobin production.

Sideroblastic anemia: Sideroblastic anemia can be inherited due to gene mutations (congenital). It can also be caused by a condition acquired later in life that impedes your body’s ability to integrate iron into one of the components needed to make hemoglobin. This results in a buildup of iron in your red blood cells.

Congenital sideroblastic anemia is usually microcytic and hypochromic.

2. Normochromic microcytic anemias

Normochromic means that your red blood cells have a normal amount of hemoglobin, and the hue of red is not too pale or deep in color. An example of a normochromic microcytic anemia is:

Anemia of inflammation and chronic disease: Anemia due to these conditions is usually normochromic and normocytic (red blood cells are normal in size). Normochromic microcytic anemia may be seen in people with:

• infectious diseases, such as tuberculosis, HIV/AIDS, or endocarditis
• inflammatory diseases, such as rheumatoid arthritis, Crohn’s disease, or diabetes mellitus
• kidney disease
• cancer

These conditions can prevent red blood cells from functioning normally. This can lead to decreased iron absorption or utilization.

3. Hyperchromic microcytic anemias

Hyperchromic means that the red blood cells have more hemoglobin than normal. High levels of hemoglobin in your red blood cells makes them a deeper hue of red than normal.

Congenital spherocytic anemia: Hyperchromic microcytic anemias are rare. They may be caused by a genetic condition known as congenital spherocytic anemia. This is also called hereditary spherocytosis.

In this disorder, the membrane of your red blood cells doesn’t form correctly. This causes them to be rigid and improperly spherical shaped. They are sent to be broken down and die in the spleen because they don’t travel in the blood cells properly.

4. Other causes of microcytic anemia

Other causes of microcytic anemia include:

• lead toxicity
• copper deficiency
• zinc excess, which causes copper deficiency
• alcohol use
• drug use

Microcytic anemias are often first spotted after your doctor has ordered a blood test known as a complete blood count (CBC) for another reason. If your CBC indicates that you have anemia, your doctor will order another test known as a peripheral blood smear.

This test can help spot early microcytic or macrocytic changes to your red blood cells. Hypochromia, normochromia, or hyperchromia can also be seen with the peripheral blood smear test.

Your primary care doctor may refer you to a hematologist. A hematologist is a specialist who works with blood disorders. They may be able to best diagnose and treat the specific type of microcytic anemia and identify its underlying cause.

Once a doctor has diagnosed you with microcytic anemia, they will run tests to determine the cause of the condition. They may run blood tests to check for celiac disease. They may test your blood and stool for H. pylori bacterial infection.

Your doctor might ask you about other symptoms you’ve experienced if they suspect that chronic blood loss is the cause of your microcytic anemia. They may refer you to a gastroenterologist if you have stomach or other abdominal pain. A gastroenterologist might run imaging tests to look for different conditions. These tests include:

• abdominal ultrasound
• upper GI endoscopy (EGD)
• CT scan of the abdomen

For women with pelvic pain and heavy periods, a gynecologist may look for uterine fibroids or other conditions that could cause heavier flows.

Treatment for microcytic anemia focuses on treating the underlying cause of the condition.

Your doctor may recommend that you take iron and vitamin C supplements. The iron will help treat the anemia while the vitamin C will help increase your body’s ability to absorb the iron.

Your doctor will focus on diagnosing and treating the cause of the blood loss if acute or chronic blood loss is causing or contributing to microcytic anemia. Women with iron deficiency from severe periods may be prescribed hormonal therapy, such as birth control pills.

In cases of microcytic anemia so severe that you’re at risk for complications like cardiac failure, you may need to get a blood transfusion of donor red blood cells. This can increase the number of healthy red blood cells that your organs need.

Treatment can be relatively straightforward if simple nutrient deficiencies are the cause of microcytic anemia. As long as the underlying cause of the anemia can be treated, the anemia itself can be treated and even cured.

In very severe cases, untreated microcytic anemia can become dangerous. It can cause tissue hypoxia. This is when the tissue is deprived of oxygen. It can cause complications including:

• low blood pressure, also called hypotension
• coronary artery problems
• pulmonary problems
• shock

These complications are more common in older adults who already have pulmonary or cardiovascular diseases.

The best way to prevent microcytic anemia is to get enough iron in your diet. Increasing your vitamin C intake can also help your body absorb more iron.

You can also consider taking a daily iron supplement. These are often recommended if you already have anemia. You should always talk to your doctor before you start taking any supplements.

You can also try to get more nutrients through your food.

Foods rich in iron include:

• red meat like beef
• poultry
• dark leafy greens
• beans
• dried fruits like raisins and apricots

Foods rich in vitamin C include:

• citrus fruits, especially oranges and grapefruits
• kale
• red peppers
• Brussels sprouts
• strawberries
• broccoli

Erythrocytes and hemoglobin as a diagnostic criterion – “InfoMedPharmDialog”

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Erythrocytes and hemoglobin as a diagnostic criterion

Erythrocytes and hemoglobin as a diagnostic criterion

A routine clinical blood test, despite the limited range of indicators, can give the doctor enough information about the patient’s condition. Although the identified deviations do not always allow one to unequivocally establish the disease, they make it possible to make the diagnostic search more targeted.
The composition and number of erythrocytes, as well as the average content and concentration of hemoglobin in erythrocytes, are among the most important blood indicators. Deviations from the norm can signal pathological processes occurring in the body – somatic, hematological, oncological diseases.

Erythrocytosis

Daria KUSEVICH,
rheumatologist, deputy chief physician of the Clinic of Dr. Anikina, head of the department “Rheumatology”

Normally, the number of red blood cells in an adult ranges from 3.7 to 4.7 × 1012/l. An increase in their level to 5.0 × 1012 / l in women and more than 5.5 × 1012 / l in men is called erythrocytosis. Such a state can be based on several processes – physiological, i.e. adaptive-adaptive, and pathological.

Physiological ones include, for example, an increased production of red blood cells in high altitude conditions or a decrease in plasma volume due to dehydration, this pattern can also be observed in active smokers. In the case of dehydration, the increase in erythrocytes and hemoglobin will be intermittent and, in the absence of other causes, will return to the reference values ​​during the control analysis.

Pathological processes that lead to erythrocytosis are also possible. In this case, it is important not to miss hereditary anomalies, which may be based on various pathogenetic mechanisms.

In the diagnostic search, attention should also be paid to the volume of erythrocytes and the volume of circulating blood. These two indicators will allow you to determine exactly what – absolute or relative – is erythrocytosis.

Relative is noted due to a decrease in plasma volume, for example, in acute intestinal infections accompanied by vomiting, diarrhea, as well as extensive burns, ascites. The mass of erythrocytes does not change. Absolute erythrocytosis is observed against the background of an increase in the process of formation of erythrocytes in the hematopoietic tissue of the bone marrow – erythropoiesis. In this case, the mass of red blood cells will always be increased. Hypoxia can primarily stimulate increased production of red blood cells due to the release of erythropoietin (that is, absolute erythrocytosis). This condition occurs, for example, in smokers, patients with chronic obstructive pulmonary disease, emphysema, bronchial asthma on the background of respiratory failure. In diseases or tumors of the kidneys, increased production of erythropoietin is caused by local hypoxia in the kidney tissue.

Hormones – ACTH, TSH, HTG, STT, pituitary and placental prolactin, androgens can also act as erythropoiesis stimulators. In this case, the trigger may not be hypoxia, but damage to the kidneys, liver and spleen. An increase in the production of ACTH hormones and glucocorticoids, which contribute to the occurrence of erythrocytosis, is also observed in Itsenko-Cushing’s disease and syndrome.

Erythrocytosis, finally, may be the result of a myeloproliferative disease – polycythemia vera, myelofibrosis. These rare pathologies are characterized by the formation in the bone marrow of an excess of both red blood cells and white blood cells or platelets. With sequential control in the analyzes, an increase in the number of erythrocytes and hemoglobin is observed. If this trend persists for more than two months, investigation is needed to rule out myeloproliferative disease.

Erytropenia

A decrease in absolute red blood cell count below 3.7–5 × 10¹²/l for women and below 4.0–5.1 × 10¹² for men is referred to as erythropenia. As well as erythrocytosis, erythropenia can be absolute and relative. Relative – occurs with a rapid increase in the volume of circulating blood due to heavy drinking and / or in pregnant women in the II-III trimester. Absolute – is a consequence of acute or chronic blood loss, hemolysis, intoxication in acute infectious conditions, chronic inflammation in autoimmune diseases, reduced activity of the red bone marrow. In addition, pathological erythropenia occurs with a deficiency of iron, folic acid, vitamin B12, starvation, malignant neoplasms. Diagnostic search for erythropenia should be carried out comprehensively based on the history, taking into account the patient’s lifestyle and concomitant diseases.

With prolonged erythrocytosis, it is necessary to exclude pathological processes that caused a persistent increase in erythrocytes, primarily hereditary anomalies

Increase and decrease in hemoglobin levels 65 g/l in men and 120–145 g/l in women. An increase in its level can be a consequence of both erythrocytosis and a decrease in plasma volume. As in the case of red blood cells, the increase in hemoglobin may be due to hypoxia and dehydration. In addition, hemoglobin increases with intense training, constant high physical exertion (in particular, among athletes), as well as in people who have been living in high mountain conditions for a long time.

A decrease in hemoglobin concentration below 110 g/l is called anemia. It can be caused by both a lack of iron and vitamins, and other causes, for example, blood loss (including in chronic diseases), various infectious, oncological and somatic diseases.

Types of anemia

Iron deficiency anemias are among the most common. Their cause may be primarily blood loss: in women due to adenomyosis and uterine fibroids, as well as in patients with gastric and duodenal ulcers, hemorrhoids, neoplasms – these are the so-called occult losses from the gastrointestinal tract. With iron deficiency anemia, a general blood test shows a decrease in color index, microcytosis and hypochromia.

Anemia of chronic disease occurs in pathologies such as rheumatoid arthritis, systemic lupus erythematosus, vasculitis, sarcoidosis, amyloidosis, chronic renal failure, hepatitis, cirrhosis, ulcerative colitis, Crohn’s disease. A decrease in hemoglobin is also observed in chronic infections – viral, including HIV, and bacterial – for example, with tuberculosis, sepsis, osteomyelitis, lung abscess, bacterial endocarditis.

Anemia due to vitamin B12 deficiency can be caused by congenital or acquired deficiency of intrinsic factor Castle, selective malabsorption of vitamin B12, it can also occur after extensive resections of the stomach and intestines, massive transfusions, dialysis, prolonged parenteral nutrition, as a result of helminthic invasions (for example , wide ribbon). Vitamin B12 deficiency, leading to anemia, develops, for example, with a strict vegetarian diet, taking folate antagonists. Vitamin B12 levels are also affected by prolonged anesthesia with nitrous oxide, as well as the toxic effects of alcohol.

In all these cases, a general blood test reveals an increase in color index, macrocytosis and hyperchromia. In addition, there is an increased level of methylmalonic acid and homocysteine. To clarify the diagnosis, an additional study of the level of vitamin B12 in the blood serum is necessary.

Diagnostic search for erythropenia should be carried out comprehensively based on anamnesis, taking into account the patient’s lifestyle and concomitant diseases

Diagnostic search for anemia

The study of iron metabolism makes it possible to differentiate iron deficiency anemia from anemia of chronic diseases. Iron deficiency anemia is characterized not only by hypochromia and microcytosis, but also, unlike anemia of chronic diseases, by a decrease in the iron transferrin saturation (ITS) and ferritin levels.

Megaloblastic anemia (B12 and folate deficiency), which is also common, is characterized by hyperchromia and macrocytosis. If autoimmune hemolysis is suspected, a direct Coombs test is performed, which will usually be positive.

In the differential diagnosis of anemia, a general practitioner can use the above algorithm.

Anemia is always a symptom of another disease. Therefore, early identification of the causes of hematopoietic disorders is crucial for effective therapy. A successful diagnosis is possible only with the combined use of morphological and physiological data, with the reticulocyte count being of particular importance. The final diagnosis can be made with targeted biochemical, morphological and immunological analyses.

Incorrect diagnosis not only does not lead to the success of therapy, but also threatens with the risk of complications.

Algorithm for the differential diagnosis of anemia

1. Estimate the average volume of erythrocytes, which is necessary for the differential diagnosis of microcytic, normocytic or macrocytic anemia.
2. In case of microcytic anemia, assess the level of blood ferritin, in normocytic anemia, the presence of reticulocytosis, in macrocytic, perform the morphology of a blood smear to detect polymorphonuclear hypersegmented neutrophils.
3. In microcytic anemia, a decrease in ferritin indicates the possibility of iron deficiency anemia, a normal level indicates hereditary hemoglobinopathies, and an elevated level indicates anemia of chronic diseases or excessive accumulation of iron.
4. In normocytic anemia, a decrease in the number of reticulocytes may indicate anemia of chronic diseases, a normal level of reticulocytes is observed in acute blood loss, an increased level is observed in hemolysis or chronic blood loss, myelodysplasia.
5. In macrocytic anemia, the absence of polymorphonuclear hypersegmented neutrophils in a blood smear in combination with reticulocytosis may indicate chronic alcohol intoxication, hypothyroidism, myelodysplasia, liver disease, the presence of B12 or folic acid deficiency.

Nataliya2023-02-01T11:19:06+03:00

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Complete blood count – Clinic 1

Complete blood count – a set of tests aimed at determining the number of different blood cells, their parameters (size, etc.) and indicators that reflect their ratio and functioning.

What is the study used for?

This test is used for general health assessment, diagnosing anemia, infections and a variety of other diseases. In fact, this is a set of tests that evaluate various blood parameters.

• The leukocyte count determines the number of leukocytes per unit of blood (liter or microlitre). Its increase or decrease can be important in the diagnosis of infections or, for example, diseases of the bone marrow.
• Accordingly, the number of erythrocytes per unit of blood (liter or microliter) determines the count of the number of erythrocytes. It is necessary for the diagnosis of anemia or polycythemia and the differential diagnosis of various types of anemia.
• The level of hemoglobin is important for assessing the severity of anemia or polycythemia and for monitoring the effectiveness of the treatment of these conditions.
• Hematocrit is the percentage of blood cells (shaped elements) to its liquid part. Used in a comprehensive assessment of anemia and polycythemia, to make a decision on blood transfusion and evaluate the results of this procedure.
• The platelet count determines the number of platelets per unit of blood (liter or microlitre). Used to detect clotting disorders or diseases of the bone marrow.
• Mean cell volume (MCV) is an average value that reflects the size of red blood cells. It is necessary for the differential diagnosis of various types of anemia. So, with B ₁₂ -deficiency anemia, the size of erythrocytes increases, with iron deficiency – decreases.
• Mean hemoglobin content in an erythrocyte (MCH) is a measure of how much hemoglobin is contained in one erythrocyte on average. With B ₁₂ -deficiency anemia in enlarged erythrocytes, the amount of hemoglobin is increased, and with iron deficiency anemia it is reduced.
• Mean erythrocyte hemoglobin concentration (MCHC) reflects the saturation of the erythrocyte with hemoglobin. This is a more sensitive parameter for detecting hemoglobin formation disorders than MCH, since it does not depend on the average erythrocyte volume.
• Red blood cell distribution by volume (RDW) – an indicator that determines the degree of difference in size of red blood cells. Important in the diagnosis of anemia.
• Mean platelet volume (MPV) is a characteristic of platelets that may indirectly indicate their increased activity or the presence of an excessive number of young platelets.

When is the test scheduled?

Complete blood count is the most common laboratory test used to assess general health. It is performed during scheduled medical examinations, in preparation for surgery, and is included in the medical board when applying for a job.