An(a)emia
Summary/Definition
Anaemia is a condition in which the red blood cell count and haemoglobin content fall below normal. Anaemia can have a variety of manifestations with co-morbidities and its symptoms can range from mild weakness to acute and severe clinical presentation with an individual incubation period for each patient. The risk of anaemia is increased in persons with chronic diseases and women, especially in the menstrual cycle (chronic posthaemorrhagic anaemia). When anaemia is detected, it is important not only to initiate treatment, which, in the absence of a clear diagnosis of the underlying disease and appropriate interventions, can lead to serious and irreversible consequences. That also means that a more in-depth and comprehensive examination should be carried out to identify the causes of anaemia. In the case of iron deficiency anaemia, comprehensive preventive measures can be taken, such as increasing the intake of iron-rich foods. Iron deficiency anaemia is a condition caused by a deficiency of iron, which is essential for haemoglobin synthesis, and is the most common type of anaemia. Vitamin B12-deficiency anaemia is associated with a deficiency of vitamin B12, which is necessary for the reproduction of mature red blood cells (sometimes referred to as pernicious anaemia). A chronic iron-deficiency anaemia refers to anaemias that develop due to long-term problems that interfere with the formation of red blood cells, such as cancer, rheumatoid arthritis, Crohn’s disease and other chronic inflammatory diseases. Aplastic anaemia is characterised by a decrease in the bone marrow’s ability to produce platelets, white blood cells or reticulocytes (young red blood cells). Anaemia can also occur as a result of bone marrow damage. Haemolytic anaemia is anaemia in which the rate of red blood cell destruction exceeds the rate of red blood cell reproduction. Drugs to treat autoimmune or specific blood diseases and infections, including antibiotics, can cause Haemolytic anaemia. Sickle cell anaemia, erythroblastic anaemia (Mediterranean anaemia) and other rare types of anaemia may also occur.
Symptoms
In most people, the main signs of anaemia are a feeling of weakness and fatigue. Other symptoms may include pale skin, rapid or arrhythmic heartbeat, shortness of breath (dyspnoea), chest pain, dizziness, cognitive impairment, numbness or coldness in the extremities, headache and other manifestations. It is important to note that in the early stages of mild anaemia, symptoms may not be noticeable and become more pronounced as the condition worsens.
Diagnostics
If there is doubt about anaemia, diagnosis is made on the basis of additional data from the patient’s medical history, general clinical examination, including tests such as a general blood count (GBC). These tests measure the haemoglobin level and the number of red blood cells in the blood. A microscopic blood smear test may also be performed to assess the colour, shape and size of red blood cells in the smear. If a diagnosis of anaemia has already been made from previous tests, further tests may be carried out to identify the cause of the anaemia.
Treatment and course of the disease
First of all, the treatment of anaemia is aimed at eliminating its underlying causes. In case of iron-deficiency anaemia, regular intake of iron-containing preparations is recommended, and for vitamin-deficiency anaemia, long-term therapy with vitamin B12 injections is recommended. Folic-deficiency anaemia is treated with folic acid, and in the case of chronic iron deficiency anaemia, it is used as an adjunct to the main therapy. In the presence of severe symptoms and severe anaemia, a blood transfusion may be required. In cases of anaemia due to bone marrow pathology, bone marrow transplants and other specialised procedures may be performed. A variety of medications may also be prescribed to help increase the number of red blood cells and treat the underlying causes of anaemia. These include antibiotics, hormone therapy, immunosuppressants and other medications. Although anaemia can usually be successfully treated, the process of restoring normal levels of red blood cells in the blood can take several weeks to several months. This requires a comprehensive approach to treatment.
