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In common understanding, an anemic is a physically weak, sickly, pale person with slow reactions. However, not everyone is aware that these features may be the result of a disease – anemia, which causes the body to actually weaken – mainly due to reduced oxygen supply to the tissues.
Another name for the disease anemia, suggests that it is related to too little blood. More precisely – the changes observed in the patient’s blood concern a reduced number of red blood cells (erythrocytes) and a reduced concentration of their most important biochemical component – hemoglobin. There are many reasons for this – from impaired red blood cell division or their “filling” with hemoglobin, to increased loss or destruction of red blood cells. Blood tests can both detect the disease and determine its cause.
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The picture of the patient described above is confirmed by the basic analytical test he is blood count. You should pay attention to such elements as number of erythrocytes (RBC), hemoglobin concentration (Hb) i hematocrit (Ht) that fall below the reference range suggests anemia. The so-called erythrocyte volume (MCV) and mean concentration (MCHC) and mean mass (MCH) of hemoglobin in the blood cell. Together with more detailed blood tests, these parameters help to differentiate the types of anemia. Depending on the cause of the disease, there are three main types of anemia: associated with impaired red blood cell production (e.g. as a result of iron or vitamin deficiency, impaired hematopoietic function of the bone marrow), blood loss (hemorrhages) and shortened red blood cell survival time (e.g. as a result of congenital defects in the structure of erythrocytes or extrinsic factors causing their breakdown).
Sideropenic (iron deficiency) anemia
The most common cause of anemia is iron deficiencywhich builds the hemoglobin molecule that carries oxygen through the red blood cell. It may result, inter alia, from from insufficient supply of this element in the diet (e.g. vegetarian), disturbances in its absorption (e.g. in diseases of the gastrointestinal tract) or increased demand (e.g. during pregnancy). Blood tests such as blood tests indicate the state of the body’s iron supply iron levels (Fe), the concentration of proteins associated with its storage and transport – respectively ferritin and transferrin and parameters TIBC i UIBC. You can also do oral iron overload functional teston the basis of which the correct absorption of this element is assessed.
Megaloblastic anemia
Another common cause of anemia are vitamin B deficiencies12 and / or folic acidcontributing to disorders of red blood cell production – inhibition of their division. The resulting blood cells are larger, hence the term megaloblastic anemia. This type of anemia is especially common in older people (poorer absorption of vitamin B)12), also occurs in alcoholics (folate deficiency). In addition to the insufficient supply of the above-mentioned vitamins in the diet, impaired absorption may lead to this type of anemia. A special form of this disorder is the so-called Pernicious (Addison-Biermer) anemia, most often developing on the background of autoimmune disorders. The patient’s organism produces antibodies (p / c) against the protein associated with the absorption of vitamin B12 – Castle’s intrinsic factor (IF) and / or the parietal cells that produce it. Detecting these autoantibodies in the patient’s serum confirms the diagnosis of the disease and determines further therapeutic management.
Hemolytic anemia
Anemia can also occur as a result of increased breakdown of red blood cells (haemolysis). Blood cells live shorter as a result of their defective structure or external factors that destroy them. These factors include toxic substances such as snake venom, heavy metals, and certain medications. Often haemolysis is also caused by anti-blood cell antibodies, which arise in the course of many diseases, including visceral lupus, infections and tumors. Reduced survival is also characteristic of erythrocytes, in which there is a reduced activity of such enzymes as glucose-6-phosphate dehydrogenase (G6PD) or pyruvate kinase. It also happens that an abnormal structure of hemoglobin causes chronic hemolytic anemia – as is the case, for example, in sickle cell anemia.
Regardless of the mechanism by which red blood cells break down, common signs of this process are seen in laboratory studies. The signal of the increased effort of the bone marrow, aimed at replenishing the loss of red blood cells, is the significantly increased percentage of young forms of erythrocytes – reticulocytes in blood. In the serum, you can also observe an increase in the level of particles derived from decaying erythrocytes – products of hemoglobin breakdown (free bilirubin and iron) and the enzyme LDH. If blood cells are destroyed outside the liver and spleen, the body must prevent iron loss by uptake of hemoglobin released from the red blood cells. Protein performs this function haptoglobinathe concentration of which in the blood decreases as a result of wear and tear in this process.
In conclusion – regardless of the cause of the disease, the diagnosis and treatment of anemia is always based on the results of laboratory tests.
Dr n. med. Emilia Martin
DIAGNOSTICS Medical laboratories