Anemia is defined as an abnormally low hemoglobin level, number of circulating red blood cells or both, resulting in diminished oxygen-carrying

capacity of the blood. Anemia usually results from excessive loss (i.e. bleeding) or destruction (i.e. hemolysis) of red blood cells or from deficient red blood cell production because of a lack of nutritional elements or bone marrow failure. Anemia is not a disease, but rather an indication of some disease process or alteration in body function. IV. Common Types of Anemia - There are different categories of Anemia 4.1 Anemia caused by Blood Loss Acute Blood Loss Is the decrease in a large amount of circulating RBCs. And adult of average build can lose 500 ml of blood (out of total 6000 ml) without serious or lasting effects. Losses of 1000 ml or more can cause acute consequences. The severity of symptoms depends on the severity of blood loss and the resulting degree of hypoxia; as the number of RBCs decreases less oxygen is delivered to tissues. Chronic Blood Loss Is a microcytic, hypochromic anemia following chronic loss of blood The major cause of chronic blood loss are bleeding, peptic ulcers, prolonged or excessive menses, bleeding hemorrhoids, and cancerous lesions within the gastrointestinal tract. The results of chronic bleeding are continuous loss of small numbers of erythrocytes, usually replaced by bone marrow; and continuous loss of iron which results in total depletion of iron stores. 4.2 Anemia caused by Impaired Production of Red Blood Cells Aplastic Anemia It is usually characterized by depression or cessation or activity of all blood-producing elements. The person has decrease in the number of white blood cells, a decrease in the number of platelets and a decrease in the formation of RBCs which leads to anemia. Anemia of Chronic Disease Is one of the most common types of anemia, second only to iron deficiency anemia. It is a normochromic, normocytic, hypoproliferative anemia. This anemia commonly accompanies such diseases as chronic inflammatory disorders, some infections, malignancy, AIDS, Chrons disease, and other systematic disorders.

4.3 Hemolytic Anemias

Hereditary spherocytosis Is the most common problem of alteration in erythrocyte shape. This anomaly occurs in approximately 1 of every 5000 persons. It affects all races and both genders fairly equally. HS, is inherited as an autosomal dominant trait, is characterized by membrane abnormality that leads to osmotic swelling of the RBC and susceptibility to destruction by spleen. It usually is detected in childhood but may appear initially in adult. Thalassemia Is an autosomal-recessive genetic disorder that results in inadequate Hb production. Whereas IDA affects heme synthesis, thalassemia disrupts the synthesis of globin. Sickle cell disease Is an umbrella term for a group of inherited hemoglobinopathies in which abnormal sickle hemoglobin (Hb S) partially or completely replaces normal adult hemoglobin (Hb A). 4.4 Nutritional Anemia Iron deficiency anemia Iron deficiency anemia is a chronic, hypochromic, microcytic anemia resulting from an insufficient supply of iron in the body. Without iron, hemoglobin concentration in the RBCs is reduced and the cells are unable to oxygenate the bodys tissue adequately, resulting in anemia. Megaloblastic Anemia Refers to anemia with characteristic morphologic changes caused by defective deoxyribonucleic acid synthesis and abnormal RBC maturation. On the peripheral blood smear, macrocytic RBCs and hypersegmented neutrophils are present. (Please refer to the other hand-out)