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Anaemia

Anaemia is a disease that occurs when the number of red blood cells (RBCs) and/or the amount of haemoglobin found in the red blood cells falls below normal. Red blood cells and the haemoglobin contained within them are necessary for moving oxygen from the lungs to the rest of the body. It is a fairly common condition and affects both men and women of all ages and ethnic groups. Certain people are at an increased risk of developing anaemia. These include people with diets poor in iron and some vitamins, long lasting illnessesa such as kidney disease, diabetes, cancer, inflammatory bowel disease, a family history of inherited anaemia, longstanding infections such as tuberculosis or HIV and those who have had significant blood loss from injury or surgery.
In general, anaemia has two main causes:

  • Impaired or decreased production of RBCs as can occur in iron deficiency, B vitamin deficiencies or a number of diseases affecting the bone marrow’s ability to make red blood cells.
  • Decreased survival or increased destruction of red blood cells as can occur in bleeding or haemolysis. There are several different types of anaemia and various causes.

Type of Anaemia

Description

Examples of Causes

Iron Deficiency

Lack of iron leads to decreased amounts haemoglobin; low levels of haemoglobin in turn leads to decreased production of normal RBCs

Blood loss; diet low in iron; poor absorption of iron

Pernicious Anaemia and B Vitamin Deficiency

Lack of B vitamins does not allow RBCs to grow and then divide as they normally would during development; leads to decreased production of normal RBCs

Lack of intrinsic factor; diet low in B vitamins; decreased absorption of B vitamins with illnesses such as Crohn's disease or after surgical removal of parts of the bowel

Aplastic

Decreased production of all cells produced by the bone marrow of which RBCs are one type. "Pure red cell aplasia" is similar disease where only production of the red blood cells is affected.

Cancer therapy, exposure to toxic substances, autoimmune disorders, viral infections

Haemolytic

RBCs survive less than the normal 120 days in the circulation; leads to a decrease in the numbers of RBCs

Inherited causes include sickle cell and thalassemia; other causes include transfusion reaction, autoimmune disease, certain drugs (penicillin)

Anaemia of Chronic Diseases

Various illnesses over a long time can reduce the production of RBCs

Autoimmune disease such as rheumatoid arthritis, kidney disease, diabetes, longstanding infections including tuberculosis or HIV

Anaemia may be acute or chronic – which means fast-developing or longstanding. Chronic anaemia may develop slowly over a period of time with long-term illnesses such as rheumatoid arthritis, diabetes, chronic kidney disease or cancer. In these situations the anaemia may not be apparent because symptoms are hidden by the main disease. Anaemia may also occur in acute episodes such as with bleeding or with certain haemolytic anaemias in which the red blood cells are destroyed. Signs and symptoms may develop quickly and the cause found from a physical examination, medical history and testing.

Signs and Symptoms
Though different types of anaemia have different causes, the signs and symptoms can be very similar. Mild or moderate forms of anaemia may cause few if any symptoms. The most common symptoms are:

  • a general feeling of tiredness, lack of energy or weakness (fatigue)
  • breathlessness
  • pale complexion

Other signs and symptoms that may develop as the anaemia becomes more severe include headache, dizziness, feeling of cold or numbness in hands and/or feet, pale complexion, fast or irregular heartbeat and chest pain. Some patients complain of hearing a pounding sound (their pulse) in their ears.

Laboratory Tests
Full Blood Count (FBC)
Anaemia may first be detected when a full blood count (FBC) is done as part of a health check or during investigations for another illness. FBC is a routine test that counts the number and relative proportion of each of the different types of cells in your blood. It gives your doctor information about the size, shape, and relative maturity of the blood cells present in your blood at that moment.

Name of screen / tests

Components

Anaemia Profile FBC – ESR – Iron – Ferritin – B12 – Serum Folate
Haematology Profile FBC – ESR