Getting To Know ANEMIA

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Hmm… Ever wonder what –exactly the word of ANEMIA or ANAEMIA is?

ANEMIA or ANAEMIA??? 

Why is the different? 

Well, both words have the same definition! 

It is just the frequent usage of the ANEMIA among Americans whereas usage of ANAEMIA is often used in British.

Well, no worries… is a very common type disorders of one of the most important cells in human’s body....which is red blood cells (RBCs) or also known as erythrocytes! 

Plus, according to the 18^th International Edition of the Harrison’s Manual of Medicine, anemia is also a common clinical problem in medicine. Anemia occurs either due to inadequate or insufficient RBCs (less than approximately 3.5 million of RBCs per microliter!) or due to shortening of the RBCs lifespan (which is normally 105 to 120 days!). 

This phenomenon may happen through loss of RBCs from circulation or RBCs destruction!

So, how can anemia are classified? Well, worry not; it is simply and easy as cake! (LOL!) Below are the summary of the general classifications of anemia according to the cause/etiology of its occurrences:

1. HYPOPROLIFERATIVE ANEMIA (most common)

The term hypo- means lacking or decrease from the normal; thus in this type of anemia, the RBCs morphology (its size, shape, colour etc) are normal! However, the amount of RBCs or more clinically called as reticulocyte index (RI) is LOW! How is this happen? It may be due to damage to marrow (the factory to RBCs-making), early iron deficiency, and decrease erythropoietin (EPO) production or action!

2. MATURATION DISORDERS

This type of anemia is due to the abnormality of the RBCs itself, which often result from either defect in hemoglobin synthesis or abnormally-slow replication of DNA in the RBCs!

 What happen if the most important part of the RBCs which act as oxygen-carrier known as hemoglobin is not produced enough to supply the numerous cells in human’s body? Well, if there is any defect or abnormality in hemoglobin production, this will certainly affect the RBCs on becoming abnormally immature (cytoplasmic) and small!

Slower DNA replication in RBCs on the other hand result nuclear maturation defects and large full red cells! Both of this causes may occurs due to nutritional problems such as insufficient iron supply, not enough vitamin B12 and folate, or even because of toxic exposure such as methotrexate, the cancer chemotherapeutic agent!

3. ANEMIA DUE TO RBC DESTRUCTION OR ACUTE BLOOD LOSS

Loss of blood often happens due to trauma, gastrointestinal hemorrhage (a.k.a bleeding!); other less common factor can be hematuria, heavy menstrual, internal bleeding such as from those spleen or organ rupture, or even due to fracture of bones especially the hip fractures that is also known as the retroperitoneal illipsoas hemorrhage!

Ever heard about the term HEMOLYSIS? Hemo- means related to blood, whereas lysis- means the breakdown or rupture of something, thus it is simply means the abnormally breakdown of the RBCs (before reaching its maximum lifespan!) There are numerous conditions that can leads to hemolysis as listed below:

·         Intracellular RBC abnormalities

·         G6PD deficiency

·         Sickle-cell anemia (SCA)

·         Membrane abnormalities (rare)

·         Immunohemolytic anemia (positive Coombs’ test, spherocytes)

·         Mechanical trauma

·         Direct toxic effect-infections such as Malaria

·         Hypersplenism

Whew! Interested to know more? Well, see ya’ till next chapter again about the further details on the type of anemia and mechanism on how anemia occurs!

Xoxo